A student’s return to Taiwan shows what a serious government response looks like

On March 6, Alice Chen was told by her study abroad program in Italy that she had three days to move out of Venice, Italy and return home to Taiwan. 

For her connecting flight home from Frankfurt, she boarded China Airlines, the national airline of Taiwan. She noticed that she and the other few passengers from Italy had their own row. The flight attendants identified Chen by name, and periodically checked on her, asking her to refrain from walking around the aisles and to use a separate bathroom. 

As she got off the plane, a nurse was waiting with a sign that said, “Alice Chen, please come with me,” and handed her a mask. 

Chen was led to customs to fill out some forms. After she reported she had a fever about 10 days prior, the agents leapt into action. “‘They apologized and told me, ‘By our procedures, as you had symptoms within 14 days prior to travel, we have to send you to the hospital immediately,’” she recalled.

Taiwan has been in the global spotlight lately for its low coronavirus infection rate and handful of deaths, despite its close proximity and ties to China and the early report of cases there.

The island has benefited from a robust, transparent and tech-forward health system as well as the cooperation of citizens like Chen, who comply with quarantine orders.

Taiwan’s rigorous quarantine system is coupled with health information systems that allow health officials to track cases of infection spread. The government, which operates a single-payer health care system, combined its health insurance databases with immigration and customs databases beginning in late January, enabling it to better monitor the health and quarantine status of citizens in real time. 

Over 99% of its citizens are enrolled in government health insurance, and each enrollee has a health insurance chip card that when accessed, pulls up the patient’s medical history and prescriptions. Since the outbreak began, doctors can also obtain information about the patient’s travel history and occupation to help determine their COVID-19 risk. 

In Chen’s case, a nurse in full protective gear, security guards and flight attendants cleared the way for her as she walked through the airport to an ambulance, which took her, sirens blaring, to the hospital. There, she remained quarantined for three days. She was provided three bento box meals each day and tested for COVID-19 twice (on the first and third day) as well as for the flu. The tests all came back negative.

As she was discharged, the nurse provided Chen with instructions to fulfill the rest of her 14-day quarantine at home: She was directed to stay in her room, wear a mask when she left her room, and wash her hands constantly. If she couldn’t have a separate bathroom from her family members, it should be bleached three times a day. Authorities would track her phone to ensure she wasn’t leaving the house. 

The nurse also handed Chen a bill for the 3-day hospital stay and COVID-19 tests, which amounted to about $3.30 in U.S. dollars. 

After Chen arrived home, a staff member from the magistrate’s office dropped by with further instructions and a large bag of snacks, canned goods, instant ramen, masks, a thermometer, and disinfectant spray. Every morning, staff from the magistrate’s office would call her to ask if she had any symptoms, and whether she was abiding by the rules of home quarantine. One day, she was quizzed on important COVID-19 information — the three best practices for prevention, the COVID-19 hotline number, the usual signs and symptoms. On another day, they asked her to press her doorbell intercom to speak to a field officer from the Taiwanese CDC. The field officer apologized for waking her up, and told her, “If you’re still sleeping, you’re welcome to just wave from your window then go back to bed.” 

On March 19, Taiwan closed its borders to all non-citizens, and imposed 14-day self-quarantine measures for travelers — with fines up to $33,000 for those who break the rules. 

These strict quarantines are made possible by comprehensive government benefits. Residents under quarantine are given $33.35 per day, free Wi-Fi, care packages including food, surgical masks, and disinfecting supplies (the assortment and quantity of goods varies by city). If individuals live alone, the government can provide services such as food and medicine. Quarantine taxis are available to take people from the airport to their homes as they are banned from public transit. 

A bill passed in late February also ensures that employers cannot penalize quarantined individuals and designated caregivers. Families of the quarantined are often required by their workplaces to quarantine with them; some choose to stay in subsidized hotels in order to keep working. If family members have to take unpaid leave to care for the quarantined, they will also be compensated the $33.35 USD a day. 

The story of COVID-19 in Taiwan is still unfolding. Chen’s quarantine is over, and the country has not yet implemented any official form of shelter-in-place. But for the most part, she chooses to continue staying at home, as many Taiwanese have been doing.

“I just want to do my part, and not put anyone at risk,” she said. “There is a sentiment in Taiwan that we have to all cooperate and take these measures to protect our vulnerable communities and our community as a whole… I’m really scared of a chain reaction that could happen, because it really takes one (case) that could bring everyone down.” 

Chen tunes into the national news everyday with her family, listening to the 2 p.m. press conference with Dr. Chen Shih-chung, director of Taiwan’s CDC. Once, a reporter asked Dr. Chen if the CDC would consider banning Taiwanese students studying abroad in Europe and North America from returning to Taiwan, since many of the emerging cases are linked to these continents. 

“These are our citizens and our family,” he said. “Instead of denouncing them, we must have empathy ... In the face of danger, their only thought is of their motherland. How can the motherland abandon them?”