Introducing the ‘Taiwan Model’ for COVID-19
What is the “Taiwan Model” for COVID-19 and why is it considered a success? Taiwan Gazette Deputy Editor Elizabeth Shaw introduces how, with a population of over 23 million people, Taiwan has had a total of only 851 cases since the start of the pandemic.
By Elizabeth Shaw
Edited by S. Chung
This article was originally published on the Munk School of Global Affairs and Public Policy’ blog. It has since been updated to reflect the current COVID-19 situation in Taiwan.
Desks with plastic partitions separate students as they eat their lunch at Dajia Elementary School, April 2020.
Photo: SAM YEH | Credit: AFP via Getty Images
The COVID-19 pandemic has elevated Taiwan's visibility on the world stage. From its exclusion from the World Health Organization (WHO) to its rise as a “pandemic success model”, Taiwan’s international participation comes at a time where discussions surrounding national sovereignty and independence are becoming increasingly apparent. Fast response times, open communication, and public trust are but a few of the reasons why other countries are looking to mimic Taiwan’s unique model of combatting the virus, which as of January 17th has resulted in 851 cases and 7 deaths. Under President Tsai Ing-wen (蔡英文), Taiwan’s government never implemented a full national lockdown; instead, well-enforced social distancing measures and a two-week delay in school and workplace closures characterised its early stages of outbreak response. With the exception of 8 new cases on January 16, the federal Central Epidemic Command Center (CECC) has eased restrictions on social gatherings and domestic travel.
Taiwan’s distinguished response to large-scale outbreaks can be attributed to its history of centralized public health institutions. In the 1990s, it established its first universal National Health Insurance system. Hailed as its “most celebrated social policy reform,” the NHI provided people with equal access to healthcare coverage. Lessons learned from the 2003 SARS outbreak in Taiwan resulted in the further development of the federal Center for Disease Control (CDC).
The CDC directly communicates between central, regional, and local authorities when a large health outbreak occurs. During SARS, a CDC Task Force Committee dealt with disease containment; however, an overwhelmed hospital system indicated the need for more centralized management. Since then, it has gained jurisdiction over the Central Epidemic Command Center (CECC) that enacted the emergency powers seen in its COVID-19 response.
Strict travel restrictions against the virus’ origin allowed Taiwan to contain and treat its cases quickly. On December 31, 2019, Taiwan began screening passengers from Wuhan at the airport. The day after activating the CECC on January 21, it confirmed its first case imported from Wuhan. By January 26, 2020, the government restricted the entry of all Chinese tourists and this was soon expanded to all incoming flights from the People’s Republic of China (PRC). People from high-risk regions, including anyone arriving from overseas, must undergo strict quarantines monitored by mandatory “digital fencing”, wherein the government tracks cell phone locations to ensure no one breaks their quarantine. Travelers arriving at the airport can scan mobile codes to declare their recent health and travel history as soon as they land. Likewise, the National Health Insurance and National Immigration agencies integrate patient travel history of up to 3 months with their NHI identification cards.
As for domestic policies, President Tsai Ing-wen’s administration prioritized clear and transparent communication from the start. Minister of Health and Welfare Chen Shih-chung (陳時中) heads the CECC and hosts regular, “24/7 response cycle” press conferences dedicated to health and public safety, covering health facts, border controls, and workplace and school restrictions. Given the low number of cases in Taiwan, Chen’s press releases were reduced from once a day to once a week. There are PSAs on broadcast media and social media, in addition to communications from the Ministry of Health and Welfare’s website and phone hotline. The first 100 days the CECC was open, it tested over 60,000 people with only 429 cases confirmed. Due to the low infection rate, Chen announced that there was “no [more] need” for mass testing.
Through transparent and accountable governance, Taiwan’s economy is experiencing growth—an impressive feat, given that few countries can presently claim the same. Citizens post feedback and suggestions on a public forum called vTaiwan for tracking cases and alternative methods of pandemic response. Through a repurposed tax filing software, face mask mapping and ordering was implemented in a couple of days. Taiwan’s National Health Insurance card integrates a person’s health and travel history and boasts 99.9% resident usage. By making the fight against COVID a participatory process, trust in the government’s ability to take action is high. The government then makes “horizontalist” policy decisions based on citizen feedback. Under Tsai’s cabinet, the Executive Yuan announced in April a NT$150 billion (USD 4.98 billion) special budget that would entail economic stimulus, including small business and worker relief, a national health response, and COVID-19 recovery efforts. In spite of the pandemic, Taiwan’s key industry of electronics exports is anticipated to grow by 2% in 2020. Exports increased by 4.3% from 2019 and electronic products are up 24%.
Despite these successes, analysts note that structural inequalities amongst at-risk groups may cause issues later on. In April 2020, a Navy cluster outbreak led many to voice concerns about potential hotspots, especially in close-contact dormitories. Some claimed that Taiwan’s temporary migrant workers may meet the same fate as those in Singapore; crowded work and living conditions and wider societal barriers, if unchecked, could pose a problem. In early December 2020, the CECC suspended the entry of Indonesian migrant workers into the country, citing forty positive cases from flights from Indonesia. To fulfill employer contracts, the Ministry of Labor pivoted towards the acceptance of workers from Vietnam and the Philippines instead. Unlike South Korea, which grants amnesty to undocumented workers testing for COVID, Taiwan lacks a policy for migrant forgiveness. Foreign workers must hold an Alien Resident Card (ARC) that allows them to access healthcare, yet many have reported that harsh restrictions from employers prevent them from physically distancing or accessing testing and proper protective equipment.
Taiwan’s successful pandemic “model” benefits its move to self-differentiate from the neighbouring People’s Republic of China. Bolstered by President Tsai Ing-wen’s “Taiwan can help” approach, the Taiwanese identity continues to be reinforced as unique and separate from Mainland China. Global recognition for the “Taiwan model” to COVID-19 response may lead to meaningful implications for the future of Taiwan and its bid for national independence.
