John Chuan-Tion Lim “Why did Taiwan succeed in prevention of epidemics, in comparison with Hong Kong?”

Amid spreading of COVID-19 in the world, Taiwan is being highly appreciated for crisis management and preventive measures of infections not only in the East Asia but also the world. In this article, I focus on the cases of Taiwan and Hong Kong and analyze how Taiwan succeeded in achieving these results and how Hong Kong can be compared with Taiwan.

 

 

Taiwan’s advantage: Expertise and quickness.

 

According to the data of Johns Hopkins University dated April 2, the number of infected persons of COVID-19 in the East Asia region is 82,381 in China (main land), 765 in Hong Kong, and 329 in Taiwan. The number 329 of Taiwan is the smallest among “Asian 4 dragons” (9,976 in Korea and 1,000 in Singapore). Even in Japan, where the Taiwanese people often learn from, the number of infected people has already exceeded 2,384, and this time Japan is behind Taiwan.

 

 

Why is Taiwan able to achieve outstanding results in this “quarantine competition” of the world this time? I dare to say that Taiwan won the race over other countries by “quickness” not by “luck”. This keyword is due not only to the lessons learned from SARS in 2003, but also to the accumulation of expertise and the public opinion.

 

 

The economy in Taiwan has been poor for many years, and the GDP per capita and the salary level of experts have been far below those of other members of “Asia 4 Dragons,” South Korea, Hong Kong and Singapore. However, the experts in Taiwan have a high level of knowledge on average, and the overall evaluation of public services is as good as that of Japan. And the level of expertise for medical and public health are also evaluated highly in the field of international societies. “The Health Care Index of 2020” which was announced on February 9, 2020 shows Taiwan continues to maintain the top spot in the world ranking with 86.71 points followed by Korea in the second place and Japan in the third place. Incidentally, Hong Kong rank in 14^th position and China (main land) rank in the 16^th position. I think such high level of expertise in Taiwan’s medical and epidemics field also plays an important role in accurately responding to the current epidemic of COVID-19.

 

 

The “quickness” of the Taiwanese government’s reaction can be seen in the process of handling the first fatal case in Taiwan on February 16th of this year. A taxi driver was initially diagnosed with severe flu, but a sensitive physician sent him to an isolation ward based on his professional judgement. The patient was subsequently confirmed to have been confirmed with COVID-19 infection because the Taiwan Department of Hospital had been retroactively examining cases reported as severe influenza cases.

 

 

Due to the painful lessons of SARS (2003) in Taiwan, they have been practicing seminars periodically every year at each hospitals for the past few years. In this pandemic circumstance, discussions on various treatment measures including adjustment and effective management of mask production quantity, planned maintenance of supply network, distribution of manpower of frontline medical personnel, etc. has been advanced in a timely manner. After the first death, the Taiwan Central Epidemic Control Center (Taiwan Central Infectious Diseases Control Center) immediately announced the response principle of the city surveillance report and expanded the front line of the epidemic prevention system to the end of societies.

 

 

In addition, Taiwan’s “quickness” of reaction may be related to Taiwan’s keen and swift response to the will and its changes as the most complete democratic Chinese region. It can also be said that this is in sharp contrasts to the Hong Kong Government which has been criticized for their delays in the current epidemic.

 

 

“Slowness” of Hong Kong: Masks and “Restriction of the Border Entry”

 

We observed the “Confusion over masks” everywhere in the world after the epidemics. Taiwan and Hong Kong are also not an exception. For example, From the end of January, there were long queues of people looking for masks everywhere in Hong Kong. There were even elderly people lined up until midnight, but the Hong Kong Special Zone government finally admitted that it had been stockpiling 10 million masks all the time and decided to put it on demand in the medical field. It was not possible to respond promptly and temporarily release the inventory of masks.

 

 

Instead, in Taiwan, people can get minimum quantities of masks if they go to pharmacies

 

 

with health insurance cards. It is not necessary to line up in a long queue. Along with the development of IT in Taiwan, Minister Andrey Tang, Taiwan Executive Yuan (行政院)  designed “Mask supply information” application which enables Taiwanese People to search and check the stock status of masks at any pharmacy online. Eventually, it became possible to reduce the probability of not being able to buy a mask. This has received a great deal of praise from Japanese public opinion and IT fields.

 

 

In Taiwan, there is a public monitoring where the government must work by “120% power” and no oversight is allowed. On January 22, one day before declaration of lockout by the Wuhan Government in China, Taiwan President Tsai Ing-wen had already launched its quarantine system and was ready to put in under high alert. Minister Chen Shih-chung was appointed to the Commander of the Taiwan Center for Diseases Control (CDC) and he directed for day and night at the front line. During the operation, he not only summoned scholars and experts immediately, but also carried out the quarantine operation by successfully coordinating the coordination of the various departments of the government and taking the lead of himself continuously every day. Premier Su Tseng-chen declared strictly that “if we need human resources, we will supply human resources, and if we need funds, we will provide funds. If there is a break in the quarantine network, we will strictly deal with it”. In addition to the strict declaration, he immediately created an emergency special budget of 60 billion New Taiwanese Yuan and proposed measures to support industries such as transportations, domestic demands, agricultural and fisheries that will be suffered from the corona infections.

 

 

Since the government seriously tackled the fake “quick” production without tampering with it, the epidemic of COVID-19 in Taiwan was successfully controlled to a certain degree in the early stage, Taiwan was able to cope with the changing situation with the spare power without falling into the situation where manpower and resources had to be fully devoted to emergency treatment (for critically ill patients). This is how Taiwan has been relatively successful in this epidemic, and its excellent performance is reflected in its high public support.  

 

 

How should Hong Kong learn from Taiwan?

 

According to a public opinion poll released by TVBS (Taiwan Radio Satellite Television) on February 13, in response to the Taiwanese government’s prevention of epidemics, the satisfaction rate of President Cai Ing-wen has risen to 54%, which is the highest level since her inauguration. Satisfaction degree for Premier Su Tseng-chen was 52%. For Minister Chen Shih-chung, Minister of Sanitation and Welfare, who directed day and night at front line, marked 82%. In addition, 71% also for the total performance by the government against corona epidemics and the figure 83%, which people trusted for measures and ability of the government, showed the satisfaction of the people. There is a considerable difference in public opinions of Taiwan and HK. According to public opinion poll by HK Public Opinion Research Institute on February 14, dissatisfaction shown by HK people showed 84%. They showed dissatisfaction to the measure against corona epidemics by Chief Executive, Carrie Law Chen Yuet-ngor.

 

 

Besides their dissatisfaction with Carrie Law management, mentioned above, HK people were dissatisfied with “blockade” of the border. After Wuhan was locked down on January 23, in order to prevent the spread of infectious diseases, each country continued to move out of its own country, restrict entry, and stop air traffic to and from China. As Hong Kong is adjacent to the Main Land China. So, everybody in Hong Kong, either HK Democrats or pro-establishment camp, requested “blockade”. It is because epidemic in Hong Kong cannot be controlled by incoming of people from main land. However, Chief Executive did not accept it expressing that “blockade” means “discrimination” using “Guideline” of WHO (World Hospital Authority).

 

 

According to the survey data released by the Hong Kong Institute of Civil Affairs on January 31, more than 80% of Hong Kong people say that the government should “completely prohibit entry”.  Under these circumstances, the Hong Kong Medical Office labor union “Members and Workers’ Line” had a dialogue with the government complaining of “total entry prohibition”, but after this dialogue failed, a strike was launched on February 3rd. In contrast, Chief Executive, Carrie Law finally accepted her defeat. As a result, the airports and all ports were closed on 8^th February. The passengers entering Hong Kong from the mainland shall be quarantined. Finally, the medical workers finally ended the strike by calling for a new policy of isolation in their home or other facilities.

 

 

Taiwan made a brilliant success in prevention of epidemics because they could regulate production and supply of masks, improve medical system and prevent split of prevention of epidemics. This would also be proof that Taiwan’s democratic system is gradually maturing. I think Hong Kong needs to openly learn about Taiwan’s crisis management capabilities and professional response capabilities in the prevention of epidemics. How can we learn a democratic mechanism that is backed by such specialized knowledge and can react sharply to the situation? Hong Kong have to carry out the “Double Election” (election for Chief Executive and Legislative Council) basing on Hong Kong Basic Law. There would be “no choice”.    

 

 

SGRA Kawaraban 626 in Japanese (Original)

 

 

John_Chuan-Tiong_Lim / Researcher of Japan Research Center (Taiwan), Head of Japan Research Center (Wuhan) 　  

 

 

Translated by Kazuo Kawamura

English checked by Sabina Koirala