﻿“When you land,
the quarantine process immediately begins.
They spray down all your bags...
You have to take a quarantine taxi,
specifically designated to take you from where you were going, to your quarantine.
I got to this hotel, and we went down into, like, the cargo entrance,
and in it is this screen, with a person on the other side of a webcam,
and they just basically told me, Take that elevator, don't touch anything,
and we'll program it to go up to your floor.”
This is Ed.
I wanted to talk to him because, in 2020,
he was one of more than half a million people who went through a mandatory two-week quarantine,
and then walked out into Taiwan.
Ed has dual citizenship in Taiwan and Canada.
But he lives in New York.
I do, too.
And for most of 2020 in New York,
The streets were empty.
Venues were closed.
But Taiwan was normal.
“It's as if the pandemic had never happened.
You could go into restaurants, the subway...
Civil society had essentially stayed exactly the same.”
Through all of 2020, Taiwan had a total of seven Covid-19 deaths.
Seven.
Among the lowest in the world.
And then, in May of 2021,
something changed.
“Taiwan is now experiencing rising daily infections.”
“Huge surge--”
“Largest wave--”
”Taiwan is now grappling with its worst outbreak.”
After more than a year of normalcy,
Taiwan faced its biggest covid outbreak ever.
So I wanted to understand:
How did Taiwan stay so safe from Covid-19 for so long?
Why did it stop working?
And what can we learn from it?
“Through the streets of Taipei,"
“A martial parade symbolic of the fighting spirit of Nationalist China’s army….”
Taiwan started out relatively poor and under a military dictatorship.
But by the 1990s it had become a democracy
and was experiencing an economic boom.
The government developed the National Health Insurance system,
which provided universal health care to 99 percent of the population.
This put Taiwan on par with wealthy countries around the world.
Well, other than the US.
In 2001 they began to implement "smart cards"
that stored patients’ medical information digitally.
That combination, of universal healthcare and a digital infrastructure,
would come to be regarded as one of the best healthcare systems in the world.
Then, in 2003, China began reporting an outbreak of Severe Acute Respiratory Syndrome.
By March 2003, SARS was in Taiwan.
Cases started rapidly appearing in hospitals,
primarily in Taipei.
In April, a large cluster of cases was reported at this hospital.
In response, the Mayor of Taipei abruptly decided to seal the hospital off,
preventing anyone from entering or leaving.
More than 150 people trapped inside became infected.
Of the more than 80 people who eventually died of SARS in Taiwan,
31 had been locked in that hospital.
The government‘s response to SARS was chaotic.
To handle the logistics of the outbreak,
they’d set up a temporary agency called the Central Epidemic Command Center.
But when it came time to figure out who had been responsible for locking down the hospital,
officials at all levels of government disagreed on whose decision it had actually been.
“We’ve had a lot of problems of state and municipal governments saying one thing,
and the central government saying another.”
So in 2004, the role of the CECC was clarified.
When activated during an outbreak,
this agency would now become the central public health authority,
with access to information across government agencies.
“We've got a lot of public infrastructure that's made like Lego blocks,
where people can very easily recombine it to produce new functionalities.”
Over the next 15 years, the CECC was activated during 3 smaller outbreaks.
But the real test was yet to come.
On December 31, 2019, Taiwan‘s government learned
that at least seven atypical pneumonia cases had been reported in Wuhan, China.
And on January 20th, they officially activated the CECC.
Because the CECC could share information across agencies,
it was able to integrate citizens’ travel data with their health data.
Together, that combination allowed them to assess risk at the level of the individual.
People who had recently traveled to countries where they could have been exposed,
were considered high risk.
People with no underlying health issues who hadn’t traveled abroad
were considered low risk.
Everyone in Taiwan had that information sent to their smart card.
Altogether it created a system that looked something like this:
Low-risk people were instructed to buy a weekly quota of masks
allocated by the government.
But they’d continue to live in a functional, normal society.
High-risk people went into a two-week quarantine,
after which they’d become low-risk, and could join everyone else.
Because of this, Taiwan didn’t have to go into lock down.
Community spread among people in Taiwan was very, very low.
But in March, cases coming into Taiwan began to rise.
So Taiwan came up with an additional strategy:
It started considering everyone flying in to be high-risk,
no matter where they were coming from.
And most foreign travelers were banned completely.
That meant a lot more mandatory quarantine.
To enforce this, the CECC used cell phone location data
to see if any travelers left their quarantine block.
“The moment you close the door, you see on the back,
there's like this huge, red, scary sign, that says
you're going to be fined a lot of money if you leave your quarantine.
You would get texts from the neighborhood police officer,
whose job it is to call and check in on you every single day.
Actually, twice a day."
For two weeks, the only human contact Ed had was through a peephole,
when someone came to drop off food, or collect his trash.
But then, he got to join the nearly 24 million people in Taiwan living normal lives.
“This was an alternate universe of what America, and the rest of the world, had seen all year.
The Taiwanese people had been able to just live their lives,
as if nothing had happened.
Like, to me, that's freedom.”
When I started making this video, it was a story about how Taiwan managed to beat Covid.
But, in May of 2021, a new wave of cases suddenly put Taiwan's success in question.
“The total number of cases has actually doubled...”
“More shops are going to be forced to close...”
“Do not become complacent in the face of a pandemic--
a lesson learned for Taiwanese..."
Taiwan had gradually loosened its quarantine system,
which meant incoming infections started to go unchecked.
As of this video, Taiwan is still getting its outbreak under control.
Thousands of people have been sent through new rounds of quarantine.
But even Taiwan won’t be truly safe,
until the system it built to keep the pandemic out
is no longer necessary.
And the best way we know of to get there, is to vaccinate.
On the flip side, after a very hard year, New York looks kind of normal again.
But it’s not because we finally figured out how to contain Covid.
It’s because of the vaccine.
“This will happen again.
And we can't just be like, Oh, well, there's a vaccine, so it's all good.
At the end of all this, even once we're all vaccinated and going to parties again,
we should look at, what did Taiwan do right?
So that we don't have to have this same conversation in the future.
Because it is coming.”
For more than a year, Taiwan stayed safe and free during a deadly pandemic.
But, in a fight against a pandemic, mistakes are going to happen.
The trick is to learn from them.