IRI Expert Discusses Taiwan’s COVID-19 Management with Wired

How Taiwan Beat Covid-19


On December 30, 2019, Li Wenliang, the Chinese whistleblower who later died of Covid-19, sent a group message, warning colleagues about an outbreak of a SARS-like illness in Wuhan, China. Li’s private message ended up being shared online and picked up 1,010 km away, across the sea, in Taiwan.

The next day, it was reposted by a doctor with the username ‘nomorepipe’ on PTT, the Taiwanese equivalent of Reddit. As Li’s revelation spread across Taiwan’s social media, it was seen by the country’s health officials, who sent an email to the World Health Organization (WHO) to warn the rest of the world. On January 1, 2020, Taiwan kicked off a program of health inspections for all flights from Wuhan. As the country continued to mobilize over the next few days, the WHO stayed silent and the world remained oblivious.

Globally, Covid-19 cases have now surpassed 50 million, with ten million in the US alone. Multiple countries in Europe have entered national lockdowns for the second time as the virus continues to ravage through populations. But despite never having entered a nationwide lockdown, Taiwan is virus-free. To date, it has seen a total of 597 coronavirus cases and seven deaths.

By May, the country had largely returned to normal. In October, it celebrated 200 days without a single case; by the end of the month, thousands marched through the streets of Taipei for the Pride parade.

Many factors have played a part in Taiwan’s success, including an ethos of open data and open government, an enthusiastic “open source” movement, and the use of big data analytics in apps and services. Just look at Taiwan, a platform that sees the country’s government working closely with g0v, a group of “civic hackers”, to include citizens in the democracy process.

And crucially, trust in the government is high following 2014’s Sunflower Movement and the appointment of digital minister Audrey Tang, Taiwan’s first transgender official and the youngest-ever government minister.

Taiwan was well-prepared for the possibility of a coronavirus-related pandemic. The country was one of the worst hit by SARS in 2003, with 346 cases and 73 deaths. Following SARS, a careful legislative process resulted in the creation of Taiwan’s Central Epidemic Command Center (CECC) to manage outbreaks.

Since 2004, Taiwan’s citizens have been given a smart card under the government-run National Health Insurance system to demonstrate their eligibility for healthcare access. Over the years more health data has been added to the card, such as a person’s prescription history. This card was central to a mask rationing system spearheaded by digital minister Tang early in the pandemic, which ensured that all Taiwan’s citizens had access to an allocated quota. When people swiped their card at a pharmacy or convenience store, they were given the masks.

Taiwan understood the importance of face masks from the start – Tang herself calls them “a physical vaccine” – and this initiative meant everyone could easily get their quota. If people already had enough masks at home, the National Health Insurance’s own app helped them donate them to countries in need.

To help with the masks’ distribution, Tang also released data to the public via an open API and invited Taiwan’s civic hackers to create. They built more than 140 apps, including maps showing which pharmacies had supplies, visualizations of how many masks had been distributed and where, and voice assistants for the visually impaired.

Chihhao Yu, a founder of g0v’s international arm g0v-intl, explains how the leaderless organization’s contributors worked together with citizens when people were concerned about where to buy masks. “Faced with a lack of data detailing store locations and supply, a concerned engineer called Howard decided to build a website for people to add convenience stores to the map and report mask supply. It’s not perfect, but it works,” he says.

Taiwan also leveraged technology to build an effective “digital quarantine” system. Those returning to Taiwan from overseas are sent to a “quarantine hotel” – a hotel that has been repurposed for the pandemic – and not allowed to leave their room for two weeks. People who live in a flat with their own bathroom can quarantine at home.

Those quarantining – whether in a hotel or at home – are monitored by a “digital fence”: smartphone signal and nearby cell towers are combined by the country’s mobile phone carriers to provide a rough idea of a person’s location. The authorities can’t see exactly where you are, but they can tell if you’ve left the general area. The telecom provider will automatically text both the person in quarantine and a health officer, if they venture outside the zone. The phone must stay on: if someone runs out of battery, a health officer will soon appear at their door.

The whole process is carried out with privacy in mind, says Tang. “Because it’s not GPS, Bluetooth, or Wi-Fi, the resolution is very coarse. Even in the most urban areas, it’s maybe a 15-meter radius. We don’t know which room you are in, but we do know which district.” And the telcos process the information entirely within their own data centers. “We can’t keep the data, and the telecoms never hand it to a third party anyway, so it can’t be sold to advertisers,” Tang says.

The country also wisely uses incentives: if citizens stay in quarantine, they are paid £27 a day. If they break it, they are fined up to 1,000 times that.

Taiwan has long been a victim of disinformation, allegedly from China – which regards the country as part of its territory. It has been unable to join WHO meetings following opposition from China. But within its borders, Taiwan’s government actively pushes out daily press releases, memes and texts to rebut false information about Covid-19.

Although it was already common to wear a mask in Taiwan, the country’s approach to disinformation was a major factor in convincing the population of the efficacy of masks and hand-washing. The message to wear a mask and wash hands was spread by a cartoon “spokesdog”, a Shiba Inu named Zongchai, which translates science into funny memes.

“Whenever there’s a trending rumor, we make sure there’s humor over rumor. Within two hours, we roll out two pictures, each with less than 200 characters and that goes even more viral than the disinformation,” Tang says. The idea is that people would see the disinformation and a funny clarification on the same day, she says. That way, after they wake up the following day, the long-term association will likely be “joy and humor”, rather than “anger and outrage”.

At the same time, people actively identify and flag misinformation. CoFacts, a collaborative fact-checking chatbot spun up through a g0v project, allows those using end-to-end encrypted chat apps to send something they suspect is misinformation to be crowd-checked. Professional fact-checkers, such as the Taiwan FactCheck Center and MyGoPen, also play a role.

It’s an impressive approach built on a collective effort that could be difficult to replicate in more divided Western democracies. Is Taiwan a particularly altruistic society? Tang says no. “We know wearing a mask alone doesn’t work, you have to wash your hands, too. We say, ‘You wear a mask to protect yourself from your own unwashed hands’. This links hand sanitation and mask use together.

“It is appealing to one’s own self-interest. If we had said, ‘You wear a mask to protect the elderly, you wear a mask to respect each other’, that’s a collectivist argument, and it wouldn’t work.”

Even so, the Taiwanese’s collaborative attitude is undeniable. According to Chunhuei Chi, a public health professor at the Oregon State University, most countries don’t do quarantine properly. “In Taiwan, the border has been strongly guarded and the country still practices strict quarantine,” he says. He quotes Taiwan’s former vice-president Chen Chien-jen, who said success lies half on the government and half on citizens. “That’s an important political social culture.”

Tang agrees, saying that trust in citizens and businesses is vital. She describes how a hostess bar created its own contact-tracing system after a worker was diagnosed with Covid-19. “They invented code names, single-use emails, prepaid SIM cards and scratch pads, so they didn’t need to send any data to the central government.”

The most replicable factor in Taiwan’s success is the country’s high-trust open source culture, says Amy Studdart, a senior advisor at the International Republican Institute, an NGO focusing on digital democracy. “Taiwan has been smart about changing the institutions and structure of government and they have transformed citizens’ expectations of what the government does.”

But Daniel Faraci, director at consultancy Grassroots Political Consulting points out that parts of Taiwan’s approach could be difficult to replicate in the West, where social media are more often weaponized to sow discord than to fight disinformation. “Taiwan has a level of sophistication where the community and government are working together,” says Faraci. “Here [in the US] we don’t have those types of systems: we have websites.”

Despite news that a vaccine is close, Covid-19 is going to be an urgent global issue for some time. In the interim, Taiwan thinks it can help others: Tang’s Twitter profile displays the hashtag #TaiwanCanHelp.

“It’s a great opportunity for the world to look at this situation and learn that there’s no need to go into an authoritarian lockdown, or to succumb to surveillance capitalism to get data,” she says. “People don’t have to make the false choice between freedom and human rights on one side, and public health on the other.”

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