Don’t Panic!

Taiwanese Government has followed three basic principles for policy decisions to respond to the overall anxiety in society, which is counterproductive to disease control: being transparent, being responsive, and creating positive incentives.

• Transparency reduces suspicion: by daily press conferences on newly confirmed cases, the Government ensures that the public is aware of the current situation and the basic measures for self protection. Similar measures such as the release of API of mask distribution data also increase transparency and trust in the government.
• Being responsive to need for safety: the Government had exercised eminent domain on masks and ethanol; also, it had invested on related production lines. All these measures were decided and executed to ensure that all people can timely get some supplies for personal hygiene; though the efficacy of some measures (e.g. wearing masks to eliminate transmission of SARS-CoV-2) had not been proven, these measures together were enough to build trust and avoid chaos.
• Developing positive incentives for the affected sectors: the Government quickly announced that there would be a relief package, including loans, stipend and stimulus voucher, to help minimize the economic impact of disease control measures on the affected sectors; as a result, all the affected sectors has been more willing to conform the disease control measures.

Learn from Past Mistakes

Taiwan was badly hit by SARS in 2003. Public health information sharing by WHO was denied to Taiwan due to China. Since then, Taiwan has improved relevant regulations and adopted a “distrust and verify” attitude toward China.

The newly implemented SOPs and regulations grants authority to the newly established CDC for instant and centralized policy response.

The “distrust and verify” attitude assumes that instant and transparent information exchange on public health affairs with China may not be feasible, and any information received from Chinese officials shall not be taken for granted but verified with cautions.

It's a National Movement

Good disease control requires cooperation between public and private sectors. The Government has been working hard to reduce the burdens and create incentives so that society has been willing to conform with interventions such as social distancing and mandatory face covering.

For example, the Government has developed a real-name system that utilizes the NHI cards (which are held by 99.5% of all citizens and residents) to make the distribution of masks both highly-accessible and fair.

Another illustrating example is that officials of the epidemic control center (CECC) wore pink masks at the press conference, in response to complaints of school bullying for wearing the “sissy” color, to deliver the message that colors of mask don’t matter and gender stereotypes shall not become obstacles for people to conform disease prevention measures.

Healthcare Capacity Matters

The sustainability of the healthcare system during the pandemic always remains the top priority of policy decisions; consequently, several strategies were decided to avoid the collapse of healthcare (as a result of community spread).

• Higher protection gears (e.g. N95 masks and protective clothing) must be steadily supplied to the healthcare personnels.
• Mass testing hasn’t been adopted; in contrast, contact tracing, stringent home quarantine measures beginning immediately at the airport, and selective testing have been standard measures to avoid testing work overload of the healthcare system.
• SOPs developed by CDC were adopted and have been strictly followed by all hospitals and clinics in Taiwan; as a result, potential patients would be classified and distributed to different hospitals.
• Self-monitor and external surveillance are both important to ensure compliance of house quarantine; on the other hand, intrusion of privacy is a real and concrete concern and shall be weighed carefully. The Government had decided to utilize cell site location information collected from carriers to track the compliance of indoor requirements, and chatbot of communication for self-report during home quarantine; more invasive surveillance measures such as GPS tracking or electronic tagging hadn't been considered in the first place.

Creating a Non-Judgmental Space

Taiwanese Government and civil society have been greatly aware of disease stigma and its harmful results: potential patients and their contacts would be less likely to comply with disease prevention measures.

The CDC had consulted with HIV/AIDS advocacy groups and kept a non-judgmental attitude in policy making. The CECC, from the very beginnings, has repeatedly stated that being infected is not blameworthy; if patients were heavily disparaged and discredited, then they would conceal their own contact histories and make the disease prevention difficult.

For the same reason, information that could potentially be used to identify patients, such as precise location histories, would not be disclosed unless necessary. To strengthen support of the infected, the Government has set up a hotline for resource referrals and consulting. The desired outcome of these policies is to create an overall non-judgmental and supportive environment for the known patients and those potential ones.