The President of Taiwan, Tsai Ing-wen, described her government’s response to the Covid-19 pandemic in a recent article in the Time Magazine. Very interesting is the statement that, as of April 14th, there were only 400 confirmed cases (not deaths) in the whole of Taiwan. The government achieved this by tracking travel and contact history of every patient, and by isolating to prevent a local outbreak.
While this is an impressive achievement, the question is whether this is the best approach. Without herd immunity it is necessary for the government to continue these preventive measures for an indefinitely long time. The two conditions that allow a stop to these rigorous measures are herd immunity in all other countries, or the development of a vaccine. Both are unlikely to apply any time soon so that the Taiwanese government’s emergency measures must continue for quite some while.
Only time will tell which is the better choice, both in terms of economic and social costs: the shorter, more painful, herd immunity approach, followed by most other countries; or the longer Taiwanese approach, with social distancing, continuous testing, but not a complete lockdown.
If, eventually, it turns out that the Taiwanese approach is as effective as it seems, then this should be a lesson learnt for future pandemics. I see two particular constraints that make it difficult to introduce the Taiwanese approach in European countries: firstly, most European countries are not an island and a significant degree of international trade is delivered via trucks. For some countries, such as Luxembourg, cross-border commuters make up a large share of the labor force. Closing these borders, or testing every person that enters the country, would introduce immense problems and delays down some supply chains.
Secondly, the European culture is much different compared to the Taiwanese one. Europeans tend to adhere less to governmentally enforced measures such as lockdowns or are also more adverse to wearing masks. Whether this is something that might change with more exposure to pandemics is an open question. In Taiwan the costs of breaking the quarantaine have been up to 33,000 USD. In most countries in Europe this amounts to several hundred euros at most. No wonder then that in countries such as Italy there are more than 100,000 individuals that have been caught breaking quarantaine.
It may be particularly difficult for developing countries to follow the Taiwanese approach. They often do not have the infrastructure to undertake this extensive testing as is the case in Taiwan. Furthermore, they lack medical equipment, masks, or often even the means to track down the social contacts of those who have been infected. Here it is going to be absolutely vital that the WHO opts up its game and helps developing countries with achieving an infrastructure that would minimize the economic and social costs of future pandemics.