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How Taiwan Contained COVID-19: Early Action, Technology & Millions of Face Masks

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Taiwan, despite being just 100 miles from mainland China with regular flights to and from Wuhan, has successfully staved off the worst of the coronavirus pandemic. The country has so far seen five deaths and just under 350 confirmed cases, and most schools and businesses remain open. How did Taiwan do it? “Aggressive action,” says Dr. Jason Wang, the former project manager for Taiwan’s National Health Insurance Reform Task-force. He is now the director of the Center for Policy, Outcomes and Prevention and associate professor of pediatrics and medicine at Stanford University. He speaks with us about Taiwan’s strategy and what the world can learn from it.

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This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now! I’m Amy Goodman, as we turn to a country that’s successfully staved off the worst of the coronavirus pandemic: Taiwan. Despite being just a hundred miles from mainland China with regular flights to and from Wuhan, Taiwan has managed to contain the spread of COVID-19 through early action and aggressive measures, such as ramped-up production of medical supplies, advanced tracking of quarantined citizens. Taiwan has so far seen just five deaths and just under 350 confirmed cases. Most schools and businesses remain open.

For more on Taiwan’s strategy and what the world can learn from it, we’re joined by Dr. Jason Wang. He’s the director of the Center for Policy, Outcomes and Prevention and associate professor of pediatrics and medicine at Stanford University, joining us from the Stanford area in California.

Professor Wang, thanks so much for being with us. Lay out the story from the beginning. December happens. There’s the coronavirus outbreak in Wuhan. What happens next? And what specifically does Taiwan do, just next door?

DR. C. JASON WANG: Yes. So, last year, there was a rumor of a new coronavirus, so the Taiwanese government sent some doctors from their CDC to investigate in Wuhan. And they noticed that this could lead to an epidemic, or now a pandemic. So they were on high alert and vigilant. And so, as early as January 1st, they started to board on the flights coming from Wuhan to check on the symptoms and signs of passengers, so if they had fever or respiratory symptoms, and tried to take aggressive action. And later on, they stopped all flights from Wuhan and also other Alert 3, Level 3 alert, areas. So, they managed to triage passengers in the airport. So, if somebody is coming from Level 3 alert areas, they are asked to do 14 days of quarantine, and during which time the government brings them food and checks up on them three times a day. And if they get sicker, then the government will help them to get care in a special route, away from the main hospitals, so basically triage them to a special fever clinic. Now, if somebody decides to break quarantine, they will give them a big fine.

Now, they also integrated their National Health Insurance program with the immigration and customs database. And so, they sent batch files from the immigration database, the last 14 days only, because they want to protect private information. So they only send the last 14 days to the National Health Insurance data center. And then, when a doctor sees the patient, the doctor will be like, “Oh, you’ve been to Wuhan in the last 14 days.” So they may check up on you, make sure that doctors and nurses are all gowned up with the protective gear, and then they could order the appropriate tests, including COVID-19. And so this allows the frontline health workers to be protected.

AMY GOODMAN: Uh —

DR. C. JASON WANG: The other thing — yeah.

AMY GOODMAN: I want to just stop for a second, Professor Wang. The issue of protective gear, such a massive problem in the United States right now, President Trump boasting we’ve had the best response and the earliest response in the world. Now people are learning about the words “supply chain,” who are outside of the business world.

DR. C. JASON WANG: Yeah.

AMY GOODMAN: Explain what it was that Taiwan did, how it managed to get PPE to all its frontline — to, I can’t say all, but most of its frontline workers, and the issue of tests, why the U.S. has fallen so far short and Taiwan surged ahead, again, next door to China.

DR. C. JASON WANG: Yeah. So, I think, early on, they know that the importance of managing capacity and also to distribute the resources appropriately. So, really early, in January, they had a quick count of all the stockpiles in the country. And they said, you know, “We have 44 million surgical masks.” And so, there’s 23 million people in Taiwan, so there’s less than two masks per person. So, immediately they said, “No export of surgical masks outside of Taiwan right now, because we need to make more.” So, then they quickly got together all the suppliers of the three different layers of materials for the surgical mask and say, you know, “You can’t sell this right now. We’ve got to make more.” So, then they quickly established 60 different lines of production just for masks. Within three weeks, they ramped up the production from 2 million a day to 10 million a day. Now, today they could probably make 11 million to 12 million a day. They are donating 10 million masks to the United States and also to Europe.

So this is a case of, during special times, the government started to manage the capacity of critical supplies for people who are fighting in the frontlines. And I think this is very important. I think it’s because of experience. They experienced SARS, so they know that there’s going to be a shortage of PPEs very soon, and people are going to start hoarding masks. So, right now if you are in Taiwan, you could take your National Health Insurance card, and you could get masks. You could get 10 masks per week. So normal citizens could get 10 masks per week. So you could still go to school. You could go to work. You could take the Metro. And you can’t hoard masks, because you have to use your insurance card to get the masks.

AMY GOODMAN: So, can you talk about the importance of public education? We only have a few minutes. While President Trump was saying there were 15 cases in the United States, sure to go down to zero, and now admitting that in the United States what we’re likely to see is between 100,000 and a quarter of a million people die of COVID-19, talk about what Taiwan was saying to its people. But also talk about something that’s troubling a lot of people, the surveillance of its citizens, of the people who live in Taiwan, the kind of surveillance technology that they’re using to track people.

DR. C. JASON WANG: Yeah. So, first of all, the public education component. So, early on, after SARS, they recognized that, you know, you need an informed citizenry in a democracy. So, government needs to have policies, but the citizens need to comply and help out the government. So it’s a joint effort. So they spend a lot of time telling people what quarantine is, why is it important to stay at home when you’re on quarantine, and how to wash your hands. And so, you know, the vice president is an epidemiologist who used to be the former minister of health during SARS. So, he, from the podium of the president, basically was teaching the public how to wash hands and when to wear a mask, So, that — they did a lot of effort over the last two or three months — is daily. This is daily on all the public service announcements.

The other thing, about the tracking device, is that they — it’s a balance between privacy and protection of the public. So, basically, when you’re under quarantine, they don’t want you to go and take the Metro and infect other people. So now they are using less and less invasive technology, including Bluetooth, so that you can’t go out of that vicinity, because they don’t want you to go infect the public.

AMY GOODMAN: So they’re tracking you by Bluetooth.

DR. C. JASON WANG: They are changing it. They used to track you by GPS — right? — around your home. But now they are changing it to a less aggressive form. So they are adjusting, as well. And also, you can’t track people forever. Under their Communicable Disease Control Act, this is a special power given to the government only during the crisis, and it expires. And so they have a law to govern that kind of use of technology. It is not random that the government decides to implement. It’s a bipartisan effort that amended the Communicable Disease Control Act after SARS. So this is something that the whole population agreed on.

Let me tell you, so in terms of the democracy, in January of this year, 75% of the eligible voters voted in the presidential election. Seventy-five percent voted in the presidential election. So, if you don’t have the public support, you can’t do what you want. And right now the current administration and the minister of health has 90% of public support in the polls, 90%.

AMY GOODMAN: Dr. Wang, we have 30 seconds. What can the United States and the rest of the world learn from Taiwan? Its schools open now. We’re talking about five COVID deaths altogether?

DR. C. JASON WANG: Yeah. So, I think the U.S. has enormous capacity. Right now the local, state and federal government has to act together in a coordinated way very quickly to contain the virus. And this includes setting the right tempo. You need to go fast. You need to pull all of the resources together. We have more talent here and more capability than anywhere else in the world. I’m totally confident, if we pull ourselves together, that we could do this. And we need to.

AMY GOODMAN: Dr. Jason Wang, director of the Center for Policy, Outcomes and Prevention, associate professor of pediatrics and medicine at Stanford University, speaking to us from his home in California to protect against community spread.

When we come back, we look at the tens of thousands of immigrants detained in immigration jails and stuck in encampments on the U.S.-Mexico border. The Congressional Hispanic Caucus has called for ICE to release its detainees. ICE detains close to 40,000 people. Stay with us.

[break]

AMY GOODMAN: “Waiting” performed by Zero Eviction. They recorded the song in response to Philippines President Rodrigo Duterte’s oppression of the poor who are demanding rice promised them since the Philippines went under lockdown amidst the pandemic.

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