Singapore’s response to the Covid-19 outbreak has been lauded by critics for its success.
While the country once had the highest infected cases outside mainland China in early February, it was swiftly overtaken by other Asian countries, such as Japan and South Korea.
59 cases reported in Taiwan
But besides Singapore, Taiwan also received its fair share of praise from various international media outlets for its containment measures.
The self-ruled island, despite being located just 130km from mainland China, and receiving a whopping 2.7 million tourists from the latter in 2019, has managed to keep its infected cases relatively low.
As of early Monday, March 16, Taiwan has reported 59 confirmed Covid-19 cases.
It reported its first death from the virus on Feb. 16.
Several European countries, located further from China, and with far less frequent direct travel with the country, have many times more cases than Taiwan.
According to a New York Times op-ed, an important indicator of success for Taiwan's containment strategy was that its imported infections are starting to make up the majority of all confirmed cases.
WHO praised Singapore but not Taiwan
But while Singapore was commended by the World Health Organisation (WHO) for its “all-government approach” in curbing the spread of the outbreak, Taiwan, given its awkward international standing, was not given the same treatment.
Taiwan used to be able to take part as an observer at WHO assemblies, albeit under the name Chinese Taipei.
But it was later excluded from the United Nations body after Beijing objected to the island’s participation in the wake of Taiwanese President Tsai Ing-wen’s election victory in 2016.
Taiwan's Covid-19 measures successful despite not being part of WHO
Taiwan’s exclusion from the WHO has been criticised as a threat to global public health, although both China and the WHO have maintained that Taiwan is getting the information it needs.
Taiwan is also excluded from WHO emergency meetings on Covid-19.
Perhaps it was this lack of inclusion that caused Taiwan to be on high alert, leading it to monitor early reports of the virus in China and take precautions early on even before it reported its first infected case.
Exclusion from WHO a blessing in disguise?
Chi Chunhuei, the Director for the Centre of Global Health at Oregon State University told Fortune that Taiwan’s exclusion from the global health body might have helped it in this case.
This is because Taiwan was forced to come up with a unilateral response to the outbreak, and it might have relied less on the early assessment from China that the virus could not be spread from one human to another.
Before China confirmed human-to-human transmission on Jan. 20, Taiwan had already been screening arrivals from Wuhan since the end of December.
Scepticism towards China helped Taiwan
Furthermore, Taiwan was already sceptical of data emanating from China to begin with.
Having learnt its lesson from SARS in 2003, Taiwan became "more self-reliant" in making its own assessment of the potential threats from new diseases, Jason Wang, director of the Centre for Policy, Outcomes, and Prevention at Stanford University, told Fortune.
“What we learned from SARS was that we need to be very sceptical with data from China,” Chan Chang-chuan, dean of National Taiwan University’s College of Public Health told The Guardian.
“We learnt very harsh lessons then and that experience is something other countries don’t have.”
Here are some of the key measures Taiwan imposed in its containment strategy.
Taiwan's containment strategy
Boarded planes to screen arrivals from Wuhan on Dec. 31, 2019
According to Taiwan Today, Taiwanese medical authorities started boarding incoming flights from Wuhan as early as Dec. 31 -- the same day that China informed WHO of the cases -- and screened travelers on the planes before they were allowed to disembark.
Taiwan sent fact-finding mission to China
Also, despite less-than-friendly relations with China, Taiwan managed to send a fact-finding mission there after receiving permission from China.
Taiwanese government spokesperson Kolas Yotaka told NBC News that although China did not let the experts see what they did not want others to see, the team "sensed the situation was not optimistic".
Taiwan then asked hospitals to test for and report cases shortly after the team came back.
Activated command centre for epidemic
By Jan. 20, Taiwan activated the Central Epidemic Command Centre -- a facility originally set up following the outbreak of SARS in 2003 -- which coordinated the government's response to the outbreak.
Such measures were implemented before Taiwan identified its first Covid-19 case from Wuhan on Jan. 21.
Banned arrivals from Wuhan five days after its first imported case
Shortly after, four major airlines suspended flights between Taiwan and Wuhan.
Five days later on Jan. 26, it banned arrivals from Hubei province other than a few exceptions, like people married to Taiwanese citizens.
Just a few days before, it had stopped tour groups from China from visiting.
Weeks later on Feb. 10, a ban on all flights from mainland China, except Beijing, Shanghai, Xiamen and Chengdu, was implemented.
Singapore, on the other hand, promptly suspended all incoming flights from the then-epicentre of the outbreak on Jan. 23 when it confirmed its first imported case from Wuhan.
Controlled mask distribution
Taiwan was quick to ban exports of surgical masks on Jan. 24 as a measure to make sure there are sufficient masks for the public, although it recently relaxed the ban on March 12.
It has ramped up production of masks as well.
In less than a month, the Taiwanese government set up 60 mask production lines, which were said to usually take a few months to complete.
Tsai with Taiwan's Minister of Economic Affairs Shen Jong-chin. (Photo via Taiwan Presidential Office)
It even made use of prison volunteers to fill in the orders.
Taiwan now produces more than 8.2 million masks per day, Fortune reported.
According to Taiwan News, residents can buy three masks per person per week at registered pharmacies, while children are allowed five per week.
The rationing helped put a stop to a brief spate of panic buying.
A mask-clad worker disinfects an area to prevent the spread of the COVID-19 coronavirus in Xindian district in New Taipei City on March 9, 2020. (Photo by Sam Yeh/AFP via Getty Images)
No need to foot the bill for Covid-19
Similar to Singapore, suspected cases of Covid-19 need not be afraid of huge medical expenses at the hospital due to the island's health insurance system that covers 99 percent of the population.
Should they be quarantined, the government would also foot the bill for their food, lodging, and medical care, Kolas told NBC News.
When it comes to tracking cases, Taiwan has been meticulous as well, employing technology such as location tracking on the mobile phones of people arriving from badly affected places.
Harsh penalties too
And like Singapore, Taiwan was not averse to meting out harsh penalties to those deemed to be socially irresponsible.
A man infected with Covid-19 was fined NT$300,000 (S$14,106) for not reporting symptoms after he returned from Wuhan and visited a dance club in Kaohsiung without wearing a face mask, Focus Taiwan reported.
Response outlined in at least 124 measures
Taiwan's response to the Covid-19 health crisis was outlined by Wang in a list of measures that consist of at least 124 action items since the end of January to the start of March.
The measures include border control from the air and sea, tracking of cases using data and technology, quarantine of suspected cases, and relaying information to the public while fighting misinformation.
But Taiwan's Covid-19 response was not perfect.
Wang said Taiwan had allowed the Diamond Princess cruise ship to dock in the city of Keelung in Taiwan.
Passengers from the ship, which later became a hotspot for infection, visited tourist locations on Jan. 31.
Taiwan Beijing-friendly TV channel praised Singapore's Covid-19 response:
Top image via CTS