Coronavirus in Taiwan, Part 3

In Part 1, I write about Taiwan’s brush with SARS in 2002-03, the beginnings of the crisis in January, and Taiwan’s initial reactions that put us on a path to getting ahead of the virus.

In Part 2, I write about the extended school closure in February, voluntary self-distancing, and the Diamond Princess.

Part 3:

Though three weeks of extended break seemed like forever, they ended quite abruptly. On Monday, February 24, we went in to school for a fever screening training, which I was promptly excused from by my supervisor and our Head Nurse. Fortunately, school was not so short staffed that we needed a pregnant woman to man the stations! To speed up the entrance of over 2,300 students and 500 faculty and staff members into school every day between 7 and 8 am, nine stations were being set up around school at regular entrances, and teams of 2 people would take their positions at each station. One person would be responsible for using an infrared gun to take temperatures, and ensure that everyone registered below 37.5 Celsius. The best place to take the temperature was over the right or left eyebrow, and we were instructed to ask people to pull aside bangs to make it simple. The other person would be responsible for making sure that that person also stretched out their hand for a spritz of sanitizer, and if a student had a temperature of 37.5 Celsius or above, to take them to our quarantine room where they would be given a mask and instructed to wait until a parent could take them home. Both persons working the stations would wear a face mask for the duration of their time, and the nurses demonstrated the correct way to put on (and then NOT TOUCH) a face mask to make sure that it was working as necessary.

The next day, we headed to work for the first time in a month. At school, most people were enthusiastically greeting each other, and I remember walking up to colleagues in my department with a very big smile as they exclaimed over how big my belly had gotten since we had seen each other. However, it did seem much quieter than usual, with no parents sitting in the cafeteria talking to each other over a cup of coffee, and fewer people lingering about the school. Some Taiwanese staff wore a face mask even inside at school, and as a result, sometimes I could barely tell who was coming up to say hello and exclaim over my pregnancy and ask about my due date! Back in the office, my co-worker and I spent a good week trying to figure out our new workload, as the nature of my job had definitely changed, with fewer events to figure out and coordinate. Over the next two weeks, school also made other changes as the Ministry of Education gave guidelines: no gatherings over 200 people, school-wide events or events with off-island schools and organizations were canceled or postponed until the fall, and the cafeteria changed the operation of its usual salad and yogurt bars to leave fewer items in the open and to have all our bakery items entirely shrink-wrapped. Even fewer visitors were allowed on campus, and all who came had to declare their travel history to the school.

Despite those changes, normalcy had begun to settle in again in Taipei as schools re-opened and families resumed their daily schedules. We still made food at home several nights out of the week, but took alcohol wipes with us to restaurants when we ate out. At each restaurant or store, staff would invariably have a bottle of alcohol or sanitizing spray on the counter so that people could help themselves. On the MRT and public transit, we wore face masks, but out in the parks or on the street during the day, it was more like 50/50. People had either taken to heart the CDC’s reminders that masks were not necessary if you were healthy, or the rationing that had continued was taking its toll: either way, people were only wearing them where they needed to. And of course, we donned them for our monthly visit to the doctor’s at our hospital for my pregnancy check-ups.

Meanwhile, a different sort of shift had taken place as the COVID-19 situation continued developing around the world. On February 22, a friend shared an article on the pending pandemic nature of COVID-19, throwing the entire crisis into a different relief for me. According to the authors, “containment” is a strategy that cannot defeat an outbreak, only delay it. At this point, we were seeing that the situation in South Korea and Japan meant travel bans, quarantines, and contact tracing could not stop the epidemic, only slow it down. So what should communities and individuals be doing about this now? How should governments communicate about it to their citizens? I quickly realized that it really is better for the public to be prepared and ready which make them feel empowered, rather than to place all your faith in governments that say they have it “under control” or “on lockdown”, and later on see that trust betrayed. That’s what’s happening now, as the masses in Italy and the US and other nations experience the whiplash of everything changing in a mere week or two. Their countries had not prepared them adequately for the magnitude of the change that was coming, and because of the lack of containment and mitigation, their crises are even larger. As a result, instead of closing for three weeks, schools and universities in the US and Europe are now looking at closing for three months, an entire spring semester truncated.

As Steve noted, Taiwan has fared so well so far because it has continuously looked ahead to what will be needed in the future and made plans for that now. Similarly, we had prepped our pantry and was in good shape despite the toilet paper panic. As we started calming down about the situation in Taiwan, we started wondering, what if COVID-19 did make inroads into the United States? What about our families? On February 25, we sent a few messages to Steve’s parents to see how they were doing, and they responded that there were no reported cases in South Carolina, where they lived, and that “it doesn’t seem to be a big concern here”. During our next Google Hangout chat, we sent on an NPR article on getting prepared for coronavirus, which was filled with very commonsense advice, like stocking up on prescription medication, non-perishable food supplies, and working through emergency plans. What was the worst case scenario? Who were the most vulnerable people? What would Steve’s parents do if his 90-something year old grandmother caught the virus? What if either of his parents got the virus? Who would take care of their two dogs? Talking through each scenario gave us all some clarity and sense of control over the situation. Being prepared, we impressed upon them, was the key difference between panicking when the situation hit the fan and being able to calmly execute the steps that would keep us and our loved ones safe. Later that week, I had my weekly video call with my parents and urged them to do the same thing. Without even realizing it, Steve and I had pivoted from worrying about ourselves and considering evacuating back to the United States to worrying about our families and hunkering down in Taiwan.

Steve had continued his voracious reading of COVID-19 related reports every single morning, and was starting to speak constantly about “the sigmoid”. The sigmoid is mathematical jargon for what is also commonly known as the logistic curve. Everyone and his mother has now heard about “flattening the curve”, but this video by Three Blue One Brown explaining the logistic curve and the exponential growth behind it that drives the spread of diseases like COVID-19 is worth a second look for everyone. (I felt so much smarter after watching it, and you will too!) He was worried that Japan and South Korea were on the sigmoid already, and that Italy and Iran were as well by the waning days of February. It’s worth noting that the United States was not at that point, and despite the number of cases in Taiwan, we weren’t either. Starting in early March, the world had begun to pay even more attention to coronavirus and gratifyingly, to what Taiwan had been doing. News outlets started reporting on the concrete steps that Taiwan had taken to jump on this crisis early. We were resting on our laurels a little bit. I had started hoping that this could be a great demonstration of soft power that would enable Taiwan to get an observer status back in the World Health Organization, or if we could start exporting face masks to other countries, oblige them to remember that in times of need, Taiwan stepped up.

But in the first few days of March, we started seeing the numbers creep up in the United States, and the lack of direction on a national level became downright alarming. Why wasn’t the United States testing in large numbers? Why had they turned down the WHO’s offer of test kits in favor of developing their own, which turned out to be initially faulty? Why weren’t they at least temperature screening anyone who came in, as had been done in Taipei since mid-January? Why could hospitals not test for anyone who had symptoms of COVID-19? It was mind-boggling, as we had just learned that South Korea was pioneering drive-thru testing, and Taiwan was testing thousands. Steve noted that it was not a good sign when the US CDC stopped reporting testing numbers around the beginning of March. “You never want to hide the good numbers,” he pointed out. (Though the CDC has started reporting this information again, it’s not in line with the way the rest of the world does it, which is largely by number of people tested, not samples – most people need two samples to be verified, and may be tested multiple times.) We started seeing the first few Twitter reports of empty shelves, people voluntarily quarantining themselves in San Francisco, and the NYC subway system getting sanitized every 72 hours (for comparison, the Taipei MRT which runs 18 hours a day has been getting sanitized every 4 hours). We started feeling powerless despite all our warnings to family and friends, and worried over the fact that no one seemed to be in charge with a central strategy. One evening over dinner, we just spent time brainstorming things we would do if we were heading up DHHS or the CDC, and almost the next day, I laughed to see that Nicholas Kristof of the NYTimes had done the exact same thing in “12 Steps to Tackle the Coronavirus” (March 11, 2020).

Given everything we thought, it was still a shock to me the next week when the situation really started to hit the fan. In retrospect, I thought everyone was on the same page as my parents and Steve’s parents. They had been informed about the seriousness of COVID-19, because we had all been talking on a weekly basis since mid-January. But obviously, not everyone had family in Asia who had been going through it. In fact, friends informed us with disgust that some people had thought this was a Chinese-engineered virus or simply a hoax to keep their attention from the impeachment process. From this side of the ocean, the tendency of fellow Americans to see such incidents as hoaxes or hollow threats is more laughable than ever. We’ve been wrapped in such a blanket of security that allows us to believe we’re immune (sometimes literally) to all the ills that affect other nations, that we never even saw this one coming.

So last week, the panic in the United States just began taking over our social media timelines and news feeds. There were nonstop pictures of empty grocery store shelves, from Whole Foods and Trader Joe’s to Kroger and Target. There was a run on toilet paper (of course!). People started hoarding hand sanitizer and worse, price-gouging by selling those supplies on Amazon and eBay for many times what they were worth. It was overwhelming and awful, and I started feeling my eyelid start twitching again. As the cascade continued, schools and workplaces started shutting down. Friends who were teachers started brainstorming ways to translate their courses online, and friends who had families were looking at how to entertain and take care of their little ones while dealing with the impending dread and fear of having their parents and older relatives taken from them. It was everything we had experienced last month all over again, and it was the rest of the people I cared about who were going through it now.

At this time, I was outraged like many were in the United States to find that the system was failing its most vulnerable people. To be clear, there are multiple instances of the system failing to protect vulnerable people right now in the US, from people who are facing eviction, high medical bills, and food insecurity, just to name a few problems. But the one that is close to my heart is higher education, and I was absolutely enraged to find that universities were beginning to close and kick out students from their campus without a backward glance. This was happening at some of the most well-resourced, well-heeled, private non-profit institutions that the US had to offer. The US CDC had put out some clear educational guidelines on how to prepare your student body for containment and mitigation of COVID-19, but universities saw much bigger risks. Spring break was coming up for a number of schools, and the worry was intense that students would not obey travel recommendations and inevitably bring back cases of COVID-19 to these crowded campuses. I can’t say in all honesty that it was the wrong decision to make because that is a lot of unknown and a lot of risk, but universities went about it in decidedly the wrong way. Schools like Harvard sent out emails giving students mere days before spring break and stubbornly kept classes in session, setting off waves of panic as students struggled to pack their belongings and move out to perhaps more unsanitary conditions than those in student dorms, increasing the number of people traveling by planes, trains, buses, and automobiles at a time when social distancing was supposed to be adopted widely. There was a huge disparity in information and resources available to students who were dealing with a cascade of problems that came with being forced off campus: where would they stay? Could they get any financial assistance with buying plane tickets or finding storage at the same time as 5,000 of their peers? What about the income they were depending on from their work-study or campus job? Would they receive refunds for room or board or tuition? How could they be expected to figure this all out and then still pay attention in online classes? Sad to say, but I don’t think universities even considered the number of local adults whose lives they’re throwing into economic disarray by taking away their blue-collar jobs as cooks, cleaners, janitors, and generally everyone who keeps a campus up and running. It didn’t look like UChicago did, anyway.

As disappointing as this was, I saw mutual aid groups (UChicago, in Greater Boston, Harvard, Tufts, MIT) beginning to emerge when students and alumni realized that the universities were unable to facilitate this change in a meaningful way for their student bodies. Where they failed to step up, people came forward to offer sublets and rooms and couches as well as food, face masks, supplies, and comfort when institutions threw them out. The silver lining is that people are forging closer connections with each other, which we sorely need in these trying times. But the more damning downside is that colleges and universities were given the chance to shine in this, and they threw it away. While the a few schools were able to provide laptops, airport shuttles, free storage, pay students who were supposed to work on campus, and in general, throw some of their resources at the problem, most schools disappointed their students completely.

What’s the argument in favor of what the universities should have done or how they carried it through? The only real argument I’m willing to accept is that universities have been caught completely flat-footed, duped just like the rest of the US was, into thinking this wasn’t a big deal at first. According to VOANews, “In most cases, U.S. universities and colleges followed similar trajectories, first announcing they would move classes online but that campus facilities would remain open, and then either all at once or through a rapid series of announcements, finally deciding the campuses would close entirely.” The speed with which things escalated indicates to me that behind those rapid announcements were hours of panicked meetings as high-level administration had to quickly come to grips with what America is figuring out – it’s not enough to get hand sanitizer and food and be prepared yourself, it has spread too far, so you must take that next step of cancelling schools, events, and social distancing.

To play devil’s advocate, Steve pointed out pragmatically that higher education is really just a service, and people are paying for courses and a diploma. It just sucks in times like these to be forking out a quarter of a million dollars and to get shafted like this. But I think it sucks on a very different level that is much more damaging. Colleges and universities in the US have long been selling a different product than a diploma: they have sold to us the promise of a community that you will be a part of forever, a brand that you can be loyal to because it lives up to its pure ideals of growing knowledge and enriching lives and helping the world. But this reaction is beyond disappointing, because nickel-and-diming your students and refusing vulnerable populations the right to stay on campus and eat in your halls does not look like this. Speaking as someone who has worked in higher education and philanthropy and has donated to all the schools she has attended, I don’t think higher education is going to recover from this for a long time.

In Part 4, I write about the second wave of COVID-19 cases hitting Taiwan, just when we thought it was starting to get better, and maybe, what lies ahead for the future.

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