Coronavirus in Taiwan, Part 4

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.

In Part 3, I write about going back to school, watching the COVID-19 situation explode in Europe and the US, and why US higher education has made an epic mistake.

Part 4:

When I started writing my updates about COVID-19, I didn’t think there would be a Part 4. It seemed clear to me that the story of the coronavirus in Taiwan was a three part story, and it was holding steady. The focus would now be on the rest of the world, and anything I could write to help friends and family now encountering the same thing would be a good idea. Really, we must never think these things, because “That doesn’t apply to me or my country (anymore)” is exactly what got everyone in hot water in this pandemic. (The sheer hubris!) In short, last week, Taiwan has been battered by a new “second” wave of COVID-19 cases, imported from Europe and the US, and in response, has locked down its borders with all other countries, accepting no foreigners who do not already hold residence here. Those moves have definitely alarmed people, and now, supermarkets are busy right up until closing time, with much more empty shelves. We even saw an hour-long line for getting face masks at the local pharmacy. It took some of us by surprise, but it shouldn’t have, because among the many lessons to be learned in the COVID-19 pandemic is that the unexpected can, has, and will happen.

How did it happen? Even the Minister of Health Chen Shih-Chung has admitted that the authorities should have seen this coming earlier. On March 12 and March 13, the CDC reported two imported cases, the second case being an American man who had been infected by four friends from the US. Steve reported to me this grim evidence that the virus was much more widespread in the US than previously thought. The next day, the CDC imposed Level 2 restrictions on California, New York State, and Washington. On March 15, six new cases were confirmed in Taiwan, all of them imported. One of them was a high school student who had just come back from Greece. His homeroom at school was quarantined as a precaution, and when several days later, a second case was reported at his school, the entire school was shut down. These sorts of policies have enabled Taiwan to get ahead of the virus clusters, but as a result, several municipalities started announcing a policy which was quickly taken up by the entire Ministry of Education on Monday, March 16: no students or teachers at elementary through high schools were allowed to travel off-island until the end of the spring semester. On March 18, Taiwan moved the US, Canada, Australia, and New Zealand onto its Level 3 warning list, and at the same time also closed its borders to foreigners completely. Now, even Taiwanese citizens and those with residence certificates like us had to undergo an obligatory 14-day quarantine if we were traveling back to the island. The same day, 23 new cases were reported. And on March 20, Taiwan moved the entire world up to Level 3. The same day, 27 new cases showed up in Taiwan, with another 18 new cases diagnosed the next day on March 21. Finally, on March 20, we received one of only three emails we’ve gotten from the American Institute in Taiwan throughout the COVID-19 outbreak, tersely announcing a rare Level 4 Advisory, basically saying, “Come back to the US or stay abroad indefinitely.”

In the space of a single week, the quarantine and travel restrictions had changed with dizzying speed, keeping pace with the doubling of cases to a total of 169 as of Sunday, March 22. In fact, rather than wait for further restrictions to who could and could not enter school, with just such a mobile population, our school decided to start spring break early by a few days, and we left school on Wednesday, March 18, hoping to resume everything next Monday, March 30. Currently, that’s still the understanding, but with everything that’s happening, a week seems like a very long time. All of a sudden, even our trip on island to Yilan later this week is starting to look slightly irresponsible, and Steve has been going back and forth on whether we should make the 30-minute trip by cab, hotel shuttle, or public bus or train.

On March 19, Taiwanese president Tsai Ing-wen went on record as saying the next two weeks are a crucial test for Taiwan. Given that the borders have been effectively shut down and all incoming travelers must complete a mandatory quarantine, if the jump to community transmission happens, it will be right now. So how is quarantine being enforced? Here is a FAQ for passengers just arriving in Taiwan, and a flowchart showing what happens to passengers (though it’s outdated). When they get here, Taiwan has arranged for quarantine-ready taxis to take them to their residence anywhere on island or a pre-arranged quarantine hotel. The government is even helping with subsidies for travelers or family members of travelers who need those hotel rooms. (This is a pretty ingenious move given that the entire travel industry in Taiwan is suffering badly, just as their global counterparts, so giving them business that also facilitates safe entry into the country is a great idea.) Once at home, the government will use your cellphone to track your movements, and may call you several times a day to ensure that you’re where you said you would stay for 14 days. In fact, this tweet from a Taiwanese college student has gone viral (I’m so sorry) this week, showing the speed and seriousness of the quarantine policy:

To alleviate further stress, people are being offered NT $1,000, which is just over USD $30 per day to stay in quarantine. While some have expressed unease over these regulations, I have come around to the notion that it’s worth avoiding the risk of infection from these travelers, whether Taiwanese or foreign, because people are going to take risks! Early on in January, one man was found to have avoided quarantine and shown up at a Kaohsiung dance club, and eventually he was fined nearly USD $10,000 for not disclosing his symptoms. In March, after the COVID-19 pandemic was already broadly known, one man evaded quarantine and was actually found at the Kaohsiung International Airport trying to fly out of the country. He was eventually fined to the full extent of the regulations, for USD $33,000, which is a pretty penny indeed. Right now, telecom providers are working closely with the government to make this sort of tracking possible, but I feel pretty confident that if any country’s government is going to give up this sort of power later, it’s going to be Taiwan.

Though community spread looks unlikely given the strict quarantine procedures, there are other concerns for foreigners like us. Many expats here, including a lot of friends, take advantage of Taiwan’s generous visa waiver policies, which have long indicated that if you just transit in and out of Taiwan every 90 days (or 3 months), you can basically stay here indefinitely. No one in immigration bats an eye seeing your passport full of blue exit and entry stamps. On our very first trip to Taiwan in 2013, we met a British man who bragged about having spent 20 years here, while never getting legal working or living status. It’s very common for people to talk about going to Hong Kong or Okinawa for a day on a “visa run”, even though it’s not very accurate because you don’t have a visa. Given Taiwan’s new policies last week, though, that was starting to look like an untenable situation. What if you couldn’t come back after your next run, and that was due to happen in another 10 days? Where would you go with so many flights cancelled? What if your home country was Italy or Iran or the United States? Those visa-exempt expats aren’t even the largest population of foreigners in the country. That would be the migrant worker population of over 700,000 people, primarily caregivers and domestic workers from Indonesia, Vietnam, the Philippines, Thailand, and Malaysia. It’s possible that those workers if infected with COVID-19 would not choose to get care or come forward in time (thus putting more people in danger) if they were worried about being caught for overstaying their visa or working without papers; the National Immigration Agency currently estimate 48,000 plus of those migrant workers have overstayed. So the government also had to step in and make changes to their immigration policies, reinstating an amnesty program that softened penalties and fines to the minimum, and a day later, gave a 30-day extension to those who were caught in the situation of having to make another visa run. More kudos to the Taiwanese government for making these pragmatic changes.

Given all the news in Taiwan, the mood in Taipei is decidedly a weird mixture of the apocalyptic and nonchalant, not unlike what is going on in the United States. On Thursday, just after the border shutdown was announced, a friend warned me on Thursday not to go to Carrefour, our large local supermarket. “The scene in there might make you go into labor right away,” she joked dryly. We ended up going around 9:30 pm anyway, just before closing, to pick up a few staples. Toilet paper was pretty low, and the shelves of rice were half empty. Astonishingly, all the canned soups and beans were gone, as were instant noodles. While produce shelves were full of fruits and vegetables, the meat section was practically wiped out. On the other hand, on Saturday, Steve and I ventured downtown to a few destinations and found shockingly large amounts of people out in the parks, definitely not social distancing. While the 80-degree temperatures certainly encouraged hanging out outside and the risk of transmission is much lower in non-enclosed spaces, we were still surprised to see Huashan Creative Park full of people with many dogs, kids, and picnic blankets. After hitting up a yarn shop downtown, we made our way to Dadaocheng Wharf, thinking it’d be a nice outdoor place to have dinner from some of the boutique food trucks that have sprung up there in the past year, and we found a similar scene of hundreds of people mingling, few of them with face masks on. “Are these the same people who just filled their entire cart with twenty packs of instant noodles?” I asked Steve blankly. With a grimly set jaw, all Steve would say was that the next case was probably in the crowd in front of us. We left the park and took a taxi to a favorite pizza restaurant where we washed our hands and sprayed them with alcohol before eating, contemplating the mixed messages we were seeing this week.

Last week, Steve predicted that just as there was a before-9/11 and an after-9/11, there would be a before-COVID-19 and after-COVID-19. The best article I’ve seen so far that outlines what the future looks like is in MIT’s Technology Review: “We’re Not Going Back to Normal” (March 17, 2020). The silver lining is that it may lead to a better future, as Taiwan’s history has hinted. For the past four years, we have lived on this small island of 24 million people, which has had to become pretty darn scrappy in a constant fight for survival. Since 1949, Taiwan has faced the constant threat of annexation by force from China, and survived bombing crises and American derecognition, and become increasingly marginalized by the world. This constant vigilance against its larger neighbor has become a way of life here. I mean, this island still has an annual national air raid drill, when everyone has to stay off the street or risk a very hefty fine, which is something I’ve never experienced anywhere else. (I rode out last year’s in my favorite hot pot shop behind school.) That survival instinct is part of what has kept Taiwan alive and ready to respond. When in late December, Chinese social media started showing a buzz about a mysterious respiratory disease in Wuhan but then went dark quickly. Among other things, I think Taiwan picked up on that censorship and the fact that something might be going on in China. That helped them start fever screenings right away on flights to Taiwan from Wuhan on December 31, the same day that China informed the WHO there were cases of a severe, unknown pneumonia in Wuhan.

Meanwhile, in a place like the US, people keep writing articles with callbacks to the Spanish flu, to World War II, to the last time that the entire country mobilized around a single cause like this, instead of milling around aimlessly like insects. During a video call this weekend, a friend in Chicago stated soberly, “The United States is melting down.” What we’ve seen in the past two weeks with the worsening of situations in Europe and in the US makes me mortally afraid for the lives of people in the US and the lives of friends, family, and close acquaintances who are now doctors and nurses. We’ve stopped making plans three months out, after the birth of our child, or even six months out. Nothing seems so sure anymore. Previously rock-solid companies and organizations have wavered in the face of this disaster. It is incredibly difficult not to despair, however. California, New York, and Illinois only began enacting state-wide stay-at-home orders this week. It seems like authorities have just been dragging their feet, overly fearful of disrupting the economy or restricting travel (in this land of the free) that they have not been able to call for more swift and widespread action to save lives. We are incredibly grateful to be living in a country which takes health and such threats very seriously, with responsible and swift leadership at the helm, but what will happen to the country that we love when this is all over? What about our families? Who will be left? The future looks very uncertain to us. As articles repeatedly say, Taiwan has lessons to share with the rest of the world, but the US must first pull through this and be in a position to learn and change in the future. That is what seems up in the air right now.

This post brings us up to the present, just two months since the crisis began raging in Asia. As the situation changes in Taiwan, I hope to keep writing. For friends abroad, if this has been helpful to read, I hope you’ll also consider also writing down your story, with or without frequent citations to CDC press releases! As an inveterate blogger and note-keeper since fifth grade, I have always found it useful to write down my daily thoughts about small and big things happening in my life. I think we all realize now that this is a global event, something that all of us will look back on and remember where we were and how we got through it all together. Maybe it’s through a blog like this, or through art and poetry, or even through a family podcast. Perhaps we’ll reminisce in a better world where countries have learned how to become more resilient and robust, like Taiwan after SARS. Or perhaps we’ll recall these times while sitting in an apocalyptic wasteland toasting our dinner over an oil barrel fire. At the same time, misinformation and bad faith actors are pushing their agendas the world over, using this pandemic as an opportunity to seed doubt, fear, and hatred around the world. By writing my little bit of truth from my perspective to the best of my ability and preserving it for the rest of the world to see, I hope to combat that. You can too.

In Part 5, I write about what happened in Taiwan between March and May 2020, from domestic controls to loosening up and the subsiding of the first wave of the pandemic in Taiwan.

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