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COVID-19: Hard-Learned Lessons From Taiwan — Does Singapore Have Much to Emulate?

Lauded as the world’s ‘poster child’ in the global fight against COVID-19, Singapore has done extraordinarily well where cool, calm, and collected efforts are concerned. Even the legendary Barbara Streisand herself has commended PM Lee Hsien Loong for “speaking common sense” and doing “everything that’s needed to be done to be ready for this virus”. That, however, was two weeks ago, and a lot can happen in a span of a fortnight.

Fast forward to 19 April 2020, the date of writing. Singapore has since seen a total of 11 deaths—eight more than what was reported at the time of Streisand’s tweet. We’ve had a second wave of active COVID-19 cases due to Singaporeans returning from overseas, as well as sudden clusters such as the ones in migrant worker dormitories.

And now, in a sobering milestone for Singaporeans, our record for the highest number of cases in a single day stands at a staggering 942.

The Taiwan Effect

Now, allow me to shift your focus to a nation not that far away—Taiwan. As of late, our neighbouring island has also been quickly gaining recognition and credit for their diligence in keeping COVID-19 cases and deaths low despite their proximity to China, the initial epicentre of the coronavirus outbreak.

With only 420 active COVID-19 cases as of 19 April 2020, Taiwan has approximately fifteen times fewer cases than Singapore despite having a population size of close to five times more. To achieve this, Taiwan relied on a combination of preparedness, decisiveness, and swiftness, which I will proceed to unpack.

1. Acting fast with a free pass

From as early as December 2019, back when we still referred to COVID-19 using the archaic term, “Wuhan Virus”, Taiwan took no chances and didn’t wait for things to play out. They had the foresight to treat the illness with utmost seriousness and caution.

Very early on—way ahead of everyone else—Taiwan had already started inspecting incoming plane passengers from Wuhan starting 31 December 2019, banned visitors from Wuhan on 23 January 2020, and suspended tours to China on 25 January 2020. Eventually, they imposed a ban on all Chinese visitors on 6 February, essentially cutting contact with Chinese nationals altogether.

While drastic, these measures weren’t the toughest to execute, given the pre-existing long standing tension between the two countries leading up to this outbreak. COVID-19 simply gave Taiwan a free pass to do so with valid reason.

2. Learning from SARS

Aside from halting visitor flow, another course of action that was paramount in keeping COVID-19 under control was how quickly the Taiwanese government took control of the healthcare situation. Learning from their lack of preparedness during the SARS pandemic, Taiwan later created a centralised decision-making body—the Central Epidemic Command Center (CECC)—which proved more than useful when COVID-19 came knocking this time around.

This CECC was activated very early on, on 20 January, which worked hard to carry out the aforementioned preventive measures.

3. Masks Up

A Taiwanese citizen getting 2 face masks after swiping her NHI card | Credit

Since 22 Jan, the early days of the coronavirus, the Taiwanese government had already begun encouraging citizens to mask up and wash their hands frequently to strengthen their defence against the virus. The haste to take action quickly prompted Taiwanese citizens to take precautionary action very early on, slowing the spread of the virus.

Starting 31 January 2020, the government took charge of face mask distribution from the private sector in order to prevent supply hoarding or exploitative pricing—sounds familiar yet? Where consumers were concerned, Taiwan implemented a purchasing policy on 6 February 2020 to limit the number of masks each citizen could purchase per week in order to prevent a mask shortage. Now, they even have a rationing system that allows citizens to pre-order their masks online, and picking them up at a later date.

3a. That controversial mask export ban

Because Taiwan currently does not import masks and is thus, self-reliant on their local supply of masks, they made the decision to impose an export ban on masks on 24 January, initially set to run until 23 February. However, as the spread of the virus persisted in both Taiwan and across the globe, health authorities announced on 13 February that it would extend the ban until end April.

Credit – CNA

While critics might deem this a selfish act, let’s back up to the fact that Taiwan relies on no one but themselves where its face mask supply is concerned, and so for the sake of their own public health, this was a move that was difficult, yet necessary.

And this ban has, indeed, proven effective in ensuring adequate masks for the Taiwanese public—coupled with the fact that factories have also ramped up mask production, producing 8.2 million per day in March, as compared to 7 million per day in February.

In fact, as soon as they had managed to establish a steady supply of masks locally, Taiwanese health authorities lifted the mask export ban on 12 March, stating that the export of cloth face masks will be allowed. The fact that all this happened within a span of two months only serves to depict how quickly success can be achieved when efficiency meets decisiveness.

3b. On the other hand, Singapore discouraged mask-wearing

Reeling from the shock of panic buying on the day we declared our DORSCON Orange status, the Singaporean government’s next steps were to discourage citizens from wearing masks unless they were unwell, which remained as status quo for the bulk of the coronavirus fight so far.

This stand comes from a place of scientific advice and guidelines from the World Health Organisation (WHO), as stated clearly in point 24 of the Ministry of Health’s Circuit Breaker updates page.

Following this, rumours were rife that the government was discouraging mask usage because of a stock shortage of masks. This piece of news was hot on the heels of Taiwan’s announcement that they would be temporarily banning exports of face masks, all the more fueling such stories.

This claim, however, was promptly and thoroughly debunked by Senior Minister of State for Health Lam Pin Min, when he reassured citizens that there are enough masks available for all.

While I completely understand the initial stand regarding mask-wearing, this left Singaporeans with much to discuss when authorities suddenly reversed their stand on 3 April 2020, stating that “the situation is now changing”. It is now compulsory for everyone in public to wear a mask or risk being fined.

Mask notice aside, we could also have done better in rationing supplies—which wasn’t in place until very much later, when NTUC Fairprice introduced a purchase limit on 17 March 2020.

The lag period gave panicked citizens time to hoard ridiculous amounts of food, toilet papers, and masks. This also drove mask prices in Singapore up, and a box of 50 surgical masks can cost as much as a whopping S$45 now.

3c. Errrr……

On 14 April, Taiwan reported no new cases of the coronavirus for the first time in more than a month—reaping yet another benefit of their early and effective prevention methods. Hoping to extend their success to the world, the civic-mindedness of the Taiwanese has prevailed yet again.

Taiwan has extended donations of a million masks to 15 diplomatic allies—including Singapore.

To which, our First Lady, Ho Ching, had gotten herself in quite a kerfuffle due to her ambiguously-worded response to such a generous offer.

4. Quick to shut borders

Despite also being heavily reliant on tourism as a stimulus for their economy, the Taiwanese government made the decisive move to ban all foreign visitors to “keep the coronavirus out” for good. This was important due to Taiwan being most at-risk due to its close proximity to China.

It led to a ban on inbound travel from many parts of China and stopping cruise ships from docking at their ports. They also strongly advised citizens against all non-essential travel. Singapore, on the other hand, only began closing our borders to foreign visitors close to a full week after Taiwan did.

5. Big Data & Technology

Using state of the art technological resources, Taiwan took advantage of big data for analytical uses which allowed them to carry out case identification by generating real-time alerts during a clinical visit based on travel history and clinical symptoms.

As soon as the virus’ known incubation period was revealed to be 14 days, Taipei immediately utilised Quick Response (QR) code scanning and online reporting of travel history and health symptoms in order to classify every traveller’s infectious risks based on their flight origin and travel history in the last fortnight.

Those who were found to have travelled to high-risk areas were sent off to be quarantined at home and were tracked through their mobile phones to ensure that they adhered to the stay-home notice during the incubation period.

6. Taking full and firm control of air traffic

From as early as 31 December 2019, when the World Health Organisation (WHO) was first notified of an unknown case of pneumonia in Wuhan, China, Taiwanese officials wasted no time in boarding planes and assessing passengers on direct flights from Wuhan for fever and pneumonia symptoms before passengers could deplane.

Suspected cases were screened for 26 viruses, including SARS and MERS—both upper respiratory tract infections that were once pandemic-inducing.

Given Taiwan’s close proximity and connectivity with China, one could almost consider it a miracle that Taiwan has managed to keep the COVID-19 situation under stable control. But in truth, it’s far from a miracle.

In fact, it can be attributed to these very factors that have yanked officials and authorities off from a place of complacency, and driven them to take even more precaution.

But, it’s not that simple

Ah, cue the floodgates of boomer comments and complaints—I can already smell them: “I don’t understand why Singapore still hasn’t gone into full lockdown, other countries are doing it, what”.

Hold your horses, Uncle Greg, and allow me to explain.

Granted, the aforementioned reasons I’ve listed were major contributing factors to Taiwan’s success. I’m proud of our Asian counterpart’s vigilance and decisiveness surrounding this whole matter, and it’s comforting to see a country heave a sigh of relief as things start looking positive for them. So then begs the question:

Why didn’t Singapore replicate Taiwan’s action plans?

As we’ve long studied in our Economic books, there’s never a cookie-cutter, one-size-fits-all solution for anything—what more a nation-wide strategy. Singapore’s economic, demographic, geographic, cultural, and fiscal climate are vastly different from Taiwan’s, and so adopting their measures wholesale for our own just wasn’t going to cut it.

Being the little red dot that we are, we lack the resources, goods, and materials that many larger countries have. It is common knowledge that we rely heavily on tourism for economic growth, and imports to sustain our goods and services flow. We just don’t have the same manufacturing capacity as other giants out there.

Being the world’s fourth-best financial hub also has its price to pay, with much at stake in the event of a complete lockdown. So no, it’s not as simple as shuttering our doors and completely cutting off in-flow of precious resources.

What Singapore Did Well

There are, however, several measures Singapore enacted that showed consideration for its populace as well as firms, workers, and households who have been negatively affected by the worsening COVID-19 pandemic.

Chief of Singapore’s generosity comes in the form of a stimulus budget that was revised not once, not twice, but three times to reflect the constantly evolving situation in the country. With each budget announcement, the financial measures meted out are further refined and are now estimated to be worth S$60 billion.

The Unity, Resilience, and Solidarity budget aims to provide support in the form of tax rebates and loans for SMEs, support local businesses through the deferment of taxes, tax rebates, and loan schemes, and supporting low-income workers and self-employed persons through new training programs and cash handouts.

The latest round of spending announced on April 6 is aimed at saving jobs through wage subsidies and rebates on foreign worker levies, in addition to increasing fiscal incentives for Singaporeans.

Financial incentives aside, Singapore has also enacted strict Circuit Breaker measures that started on 8 April in the hopes of flattening the curve before 4 May which is the targeted end date. There has also been another round of free mask distribution as well as swift action taken to curb the sharp increase in transmission of COVID-19 amongst migrant workers living in dormitories.

And the winner is…

Truthfully, the winner here is the millions of people who were saved from being infected by the COVID-19 virus due to governmental intervention. Some may argue that the current measures taken by the Singapore government are too little too late, while some laud efforts being undertaken right now as bold, firm, and timely.

Perhaps it’s time to take a step back and reflect. Can we as a nation rise above our differences and confront the difficult truths that hamper our efforts at combating this disease? Are we able to put aside our reliance on expecting the government of the day to completely eradicate this problem without inconveniencing us regular Singaporeans?

To date, Taiwan’s efforts seem to bear fruit with no reported cases on 14 April 2020. But they are now facing a new round of challenge as Taiwanese overseas return home from hard-hit COVID-19 countries such as Europe and North America. Taiwan will be tested once more, but if their initial measured response is anything to go by, we can be sure that yet again, in the fight against COVID-19, Taiwan will surely emerge victor.

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