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What India should learn from Taiwan?

India reported its first case of coronavirus on 31st January, 2020. We can say that other countries closer to China were at higher risks and we can understand the measures they took. Taiwan, on the other hand, is a very small country, very close to China. All signs pointed to the novel coronavirus being bad news for Taiwan. The island of 23 million is just 81 miles from mainland China, with frequent flights back and forth and hundreds of thousands of Taiwanese citizens who live and work in China. Taiwan had 2.7 million visitors from China last year.

But as of March 8, Taiwan has just 45 coronavirus disease (Covid-19) cases, and only one death. Health experts do not expect that Taiwan is overlooking many cases, either. That’s many fewer than its neighbours like Japan and South Korea and one of the best containment track records in the world so far. The Netherlands, with a comparable population, has five times as many cases despite having much less frequent direct travel with China.

What is Taiwan doing right, and can we copy them?

The response started in 2004, after the last SARS epidemic. The most important thing about crisis management is to prepare for the next crisis. And so Taiwan started to do that. They set up a command center, the National Health Command Center, and integrated different agencies. It was a 24/7 command center. There’s the media room, there’s the data room where the data from different local governments could come in, there’s a place for people to rest, so you could actually sleep there. And so you get data analysts there, you have different experts there, you have people talking to the media, the information center, people managing logistics. The lesson for India is I know we have a task force now, but I don’t know if there’s a physical command center that’s in operation. If not, it should happen quickly. We have 28 States & 8 Union territories here, and the local governments, and so we need to be able to get the data very quickly. We need to test people for Covid-19, and refer that data back to the command center so we have real-time reporting for action.

What’s interesting is that when there were only a very few cases reported in China, Taiwanese health authorities already went onto every airplane that came from Wuhan. Health officials came on the airplane and checked people for symptoms. They were testing on December 31. As soon as they heard there were suspicious cases of a new type of virus, they were nervous. They were like, “Oh, we wonder if this is SARS again.” And so they were proactive. I think that’s the way we ought to treat these kinds of epidemics. It’s okay to be overly cautious. You can relax afterward, if it turns out to be nothing. But when you don’t know what something is and how serious it is, you want to be very cautious. There’s a right balance between not underreacting and not causing a public panic. We don’t want to be alarmists because we don’t know what this is.

Taiwan government very quickly began hosting a press conference every day, sometimes more than once a day. They would tell people "we’ve identified one case and then we’ve identified two cases, and they were all travellers from Wuhan". They had like maybe 10 cases before there was spread between the travelers to the relatives that were taking care of the traveler. So we knew which ones were imported cases and which ones were domestic cases that were contracted from the traveler. You could track everybody. So then you’re not that nervous because you can say, “Oh yeah, she got it because it’s her husband. He’s case number 10, and she’s case number 11.” So you will know for each case in Taiwan, how they contracted the virus. The way community spread here in India right now is going, there are definitely cases where we don’t know where a person got the virus from.

We need to educate the public, communicate with the public a lot more, at the moment. Because most people have no idea. If you ask a typical person how many cases there have been, they have no idea. If you ask them if there have been cases in their community, they say, “Oh, maybe, I don’t really know.” So you really need to have people be more knowledgeable — and look, it’s quite possible. For example, text people, and say, “There have been three cases where you live.” It’s quite possible, right? We all have phones, right? If there is some burglary, a fire, or something like that, I get a message, I get Amber alerts and all that. Well, why can’t we create some alert system like that where you say, “Look, there’s been a hot spot in this mall. Try not to go there”? And then everybody who was close to the mall would get this message. People will know to self-quarantine. And if they have symptoms, they should inform an official. They shouldn’t just go into the hospital because they could spread to other people. So anyway, these are all possible. I think there needs to be a more proactive approach and the government will prepare everyone of us for it.


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