As news of a new corona virus began to firm up in the run up to the Lunar New Year from my vantage point in Taipei, I found myself often thinking about my first years in Taiwan. As a fairly fresh arrival I had watched the SARS epidemic play out back in 2003 with an imperfect understanding of a culture I had barely grasped. For information I was reliant on Taiwan’s physical English language newspapers, plus snippets from colleagues and friends to navigate my way through.
Fast forward 17 years and the experience is very different. It’s not just me who has changed but the whole experience largely thanks to technology. This time round I was tracking the emergence of a possible new virus from early January thanks to Twitter. As the news broke globally the week before Lunar New Year, Twitter was alight with observations about a vast increase in air travel centered around China compared to 2003, and theories that this could lead to a more rapid global spread. But air travel is not the only change: Smart phones and smart cities have changed way that the public lives and communicates, and these factors make possible pandemics a fundamentally different experience.
A key element in controlling pandemics is the rational behavior of people and their adherence to recommended measures to thwart the outbreak. Simply put, panic is the enemy that can throw the whole operation awry; leading to hoarding of essential supplies, increased cases of infection and in the worst-case scenario, an overwhelmed system. Put to the best use, technology can rise to the challenge and help governments and people navigate tricky terrain, at worst it can fuel rumors that spread like wildfire.
Taiwan offers an interesting case study in how the government has used technology to try to retain calm and limit panic-led behaviors in the first month of COVID19.
One strong advantage, besides being an island, is that Taiwan boasts 92.8% Internet penetration and has the second highest data consumption in the world on cell phones in 2018. Most adults own a mobile phone and 77% of over 12-years-olds access the internet on cell phones. This high level of connection allows Public Service Announcements sent over messaging apps such as Line to reach a large percentage of population in next to no time.
Taiwan already uses the mobile networks to issue earthquake alerts which can arrive moments before a tremor reaches you depending on where you are in relation to the epicenter. It can be quite eerie to be in a room with multiple people when everyone’s phones start blaring the warning for a strong earthquake. However, on Feb. 7th the same system was used to issue an unprecedented health warning. The message was sparse and linked through to a google map of the places that passengers on the Princess Diamond Cruise ship, which then had 41 confirmed cases of COVID19, had visited in Northern Taiwan while docked in Keelong on Jan.31st. The message asked people who had been in those areas that day to limit their activity and self-monitor their health until Feb. 14th and inform the Center for Disease Control (CDC) hotline if they had symptoms.
While the message caused a momentary flurry, especially among people who didn’t read Mandarin or hadn’t been keeping up with the news, it appears to have been effective. Social media showed many people discussing the message and their whereabouts that day. Additionally, the format meant that the government stayed ahead of the news cycle. Everyone was informed at the same time once the government had gathered the information, fostering a sense of open governance which is vital to public calm. The google maps format also meant that anyone who keeps location history on could quickly cross-check their locations on that day. Finally the advice for people who may have symptoms to call the CDC further limits possible spread through patients attending local clinics.
Taiwan already has some systems in place that can help control an outbreak. Infrared thermal scanner stations have been a feature at the international airports here for several years. As far back as 2008 I recall being flagged by the station and being required to fill out a CDC form, including a contact phone number. A week later I received a check-up call as at the time there was an outbreak of avian flu. Currently the government is requiring all tourists to complete travel history questionnaires as an extra precaution.
For residents and citizens Taiwan has tweaked its National Health Insurance (NHI) system, which is accessed through an IC-chip embedded card, to include travel history in order that medical staff can quickly identify high-risk cases if they attend a clinic. The NHI cards are also being used as ID for people to buy masks under a ‘real-name’ rationing system which was rolled out on Feb. 4th in response to panic buying and hoarding which was threatening supplies for frontline staff in medical centers and public services. This quick adjustment of an existing digital infrastructure was combined with a flurry of digital memes about when masks were considered necessary and real-time maps showing which pharmacies and distribution offices had stock left.
As many countries struggle with the supply chain and price gorging which can leave the most vulnerable at risk, such moves undoubtably help calm the public in Taiwan. Although the measures are not without their critics, as one would expect, it is notable that Taiwan has managed to keep a handle on the situation with hospitals, clinics and public service and frontline workers supplied directly with masks.
Taiwan boasts a flourishing digital society. Coders and hackers have long worked together to try to solve civic issues. An example is CoFacts which allows social media users to flag stories and posts for verification. Once the team has investigated the case, they issue a statement on the veracity which is then posted to the groups it is being shared in. The potential of having a mature, independent system in place to verify or discredit rumors should not be underestimated. Naturally, some elements of society will remain stubbornly convinced that they are being misled, but factcheck services that post directly into conversations help to keep those conversations from spiraling out of control.
A successful public health campaign can be defined as one in which aware, informed and competent people feel they have timely access to information that they can trust from authorities. This helps to reduce chance of panic and encourages people to act in a socially cohesive manner to reduce the spread of the virus. While Taiwan’s reaction cannot be viewed as flawless – for example early inconsistency of messaging led to confusion about appropriate mask usage – the efforts toward open messaging and use of technology have been impressive. Giving people timely and accurate information leaves less space for rumors, and inspires the type of rational behavior among them that is vital in the time of a possible pandemic.
Written by Phoebe Cassidy, writer and long-term resident of Taipei, Taiwan.