As the coronavirus that spread out of Wuhan, China, late last year has now infected nearly 110,000 people in 93 countries and is overwhelming nations as far away as Italy, there’s one place where the infection rate has been minimal so far. Just over 80 miles away from China, Taiwan has logged only 45 known cases of Covid-19 as of Sunday. That’s a small fraction of the more than 500 cases – and over 20 deaths – now discovered in the U.S. And yet Taiwan is close not only geographically to the mainland, but also historically, economically and politically.
But unlike the U.S. and other nations, Taiwan acted quickly, aggressively and strategically to prevent the kinds of outbreaks and death rates seen in faraway places such as Europe and now the United States. It’s been using a combination of disaster preparedness set up following the SARS crisis, a strong health care infrastructure, big data and technology to combat the spread there, according to a new paper published in the Journal of the American Medical Association. And the small self-governed island acted quickly, by as early as Dec. 31, while much the world was carefree.
For insight into how Taiwan is handling the threat of the virus, TheStreet asked the JAMA paper’s main author, Dr. C. Jason Wang, associate professor of pediatrics and director of the Center for Policy, Outcomes and Prevention at Stanford University School of Medicine, by email. Dr. Wang was also a management consultant with McKinsey and Company and served as the project manager for Taiwan's National Health Insurance Reform Task-force. Following is an edited version of the exchange.
TheStreet: Taiwan has 45 total cases. It appears from your team's work that the low number is not because of a lack of testing, but instead illustrates the "proactive" approach to dealing with the outbreak. Would you agree?
Dr. Wang: Yes. In the early stages of an epidemic, setting up or having a command center, early recognition of the crisis and swift action can mitigate the impact of the viral spread.
TheStreet: Talk about about some of the steps that impressed you about Taiwan's quick response?
Dr. Wang: The policies and actions go beyond border control, because they recognized that that’s not enough.
Stopping infections (also) requires case identification and monitoring of close contacts, and Taiwan used new integrated data and technology to accomplish that.
Also quarantine of suspicious cases is difficult, so they treated individuals with care and dignity. They also proactively find new cases by retesting those who tested negative for flu.
Then there is the question of resource allocation -- assessing and managing capacity -- to make sure frontline workers and those at risk have masks and protective gear, to reassure and educate the public while fighting misinformation, to negotiate with other countries and regions, formulate policies toward schools and childcare, and (offer) relief to businesses.
TheStreet: Some of those steps appear to have relied on the nation's existing health care system. How do you feel other nations such as the U.S. could have used some of those steps to be in a better position than they are currently?
Dr. Wang: Yes, having universal health insurance is a good foundation and a social safety net. However, individual countries (including their local, state, or federal or central governments) can still take proactive actions to integrate their existing data for case finding or for intervention. This is a time for innovation in public health, given the prevalence of cell phones and the use of artificial intelligence and machine learning techniques.
TheStreet: Do you feel the lack of a national insurance program in the U.S. could pose problems for handling our current outbreak and if so, how so?
Dr. Wang: I don’t think it’s a question of having “national health insurance.” The U.S. needs to find a way to create more “integrated” data systems, so it can integrate different data to react to crisis more quickly.
TheStreet: The U.S. now finds itself in the position of an "old" outbreak, in which it is trying to combat what appears to be community spread that was ongoing. Do you feel it can reasonably handle this outbreak?
Dr. Wang: I believe if the federal government can get the big tech companies, governors, and federal government agencies to work together, the U.S. can handle the crisis. We have enormous capabilities in the U.S.
This story has been updated.