Taiwan, like Hawaii, is using quarantines and other emergency measures to control the spread of COVID-19.
Recent surges aside, both have been lauded for low coronavirus infections and deaths. But Taiwan, an island of about 24 million people off China, appears to have had more success in battling its worst outbreak since the pandemic began.
Bi-khim Hsiao, Taiwan’s de facto ambassador to the U.S., shared insight Tuesday on how Taiwan has managed to control COVID-19 spread and the strategies, especially around travel, that were used to keep the local economy open.
Hsiao met with the Honolulu Star-Advertiser during the first day of a three-day visit to Hawaii, which included plans to give a keynote speech at a conference organized by the Pacific Forum. She said COVID-19 disrupted her plans to engage in activities that explored the cultural, historical and ethnic connections between Taiwan and Hawaii.
It was Hsiao’s first official visit to the state in her current capacity. In July 2020 she became the first woman to head the Taipei Economic and Cultural Representative Office in Washington, D.C. She is a former Democratic Progressive Party legislator and senior adviser to Taiwan’s National Security Council.
“In our scenario, the rigid quarantine plus contact tracing has been key to enabling the rest of our society to function, but then, we aren’t as dependent on tourism as Hawaii,” Hsiao said.
Taiwan’s COVID-19 case counts rose dramatically in May. But on Thursday Taiwan’s Central Epidemic Command Center reported one death and five new coronavirus cases including four imported infections and one local case. There have been 16,006 infections in Taiwan and 837 deaths since the pandemic began.
On Thursday, Hawaii reported four new coronavirus-related deaths and 1,068 additional infections, which included a backlog. Since the start of the pandemic, Hawaii has reported 65,025 cases and 606 fatalities.
Hawaii currently requires a 10-day mandatory self- quarantine for domestic travelers, who may bypass it by completing the requirements for a vaccination or pre-test exemption.
Hawaii does not allow international travelers to use a vaccine exemption to bypass the quarantine, but travelers from select nations including Taiwan are eligible for a pre-test exemption.
Recently, the state has struggled with COVID-19 cases linked to returning residents who are unvaccinated and have chosen to self-quarantine instead of taking a pre-test.
Taiwan still requires all travelers, including returning Taiwanese nationals, to provide a negative COVID-19 test within three days of departure, and to quarantine for 14 days.
Hsiao said Taiwan first allowed at-home quarantines, which were monitored through digital fencing. Those in quarantine were required to pin their cellphones to local cellphone towers. Travelers who did not want to pin their own phones could request loaner phones.
“That worked until we had a surge, so now the quarantine requirement is more rigid. You have to quarantine at designated locations including hotels or quarantine centers run by the government,” she said.
Hsiao said those staying at hotels quarantine at their own expense.
“Initially, to encourage the public to cooperate with the quarantine program, we also issued a daily stipend to people who came under the mandatory quarantine regime domestically, and that included people who had come into contact with individuals who had tested positive,” she said.
Hsiao said Taiwan’s rigorous quarantine and contact tracing have been worth it, especially “if you consider the economic cost of having to have all of society locked down if you can’t control COVID.”
“I think the benefit of being an island is that you can control your inbound travelers and you can create that bumper, and that was the strategy that we took.”
Hsiao said some of the COVID-19 containment policies have been hard on some sectors of Taiwan’s economy, especially international travel.
“However, the rest of our economy managed to stay open and normal,” she said. “We had a positive economic growth last year — it was 3% last year, and we expect continuing growth this year, too.”
Up until May, Hsiao said, Taiwan had very few domestic COVID-19 cases. Hsiao said Taiwan is still investigating “the loophole” that caused the most recent surge.
“The British variant, the delta, you know they all got through this very rigid wall that we built,” she said.
At the apex of the surge when Taiwan had several hundred COVID-19 cases per day, Hsiao said, contact tracing grew more challenging.
“But it had to be done because you need to know who else might be at risk, and you need to protect the rest of society,” she said. “We go as much as we can in terms of contact tracing and isolating or containing the spread in our communities.”
Hsaio said those actions have allowed Taiwan to bring COVID-19 under control.
“Over the past week, on average, we have had fewer than 10 new cases a day,” she said.
Hsiao said that since the surge Taiwan also has temporarily halted inbound foreign travel except for humanitarian emergencies.
Hawaii’s borders are open to inbound travelers, although international travelers continue to face more robust entry requirements.
Hawaii in April added Taiwan to the list of international nations that are allowed to pre-test out of the travel quarantine.
Through the first seven months of 2021, only 449 visitors from Taiwan came to Hawaii, compared with 3,468 visitors in the first seven months of 2020, versus 16,512 visitors in the first seven months of 2019, according to data from the state Department of Business, Economic Development and Tourism.
Hsiao said there are still several challenges for travelers from Taiwan who want to visit Hawaii.
She said that the pan- demic has “disrupted the direct flights between Taipei and Honolulu.”
“The second challenge is our own quarantine regime, which is very rigid,” Hsiao said.
A third obstacle is that Taiwan is still working to access more vaccines, she said.
“We’re grateful for the U.S. donation of vaccines to Taiwan, and that has gone a long way — 2.5 million doses of the Moderna vaccine,” Hsiao said. “We are about 40% vaccinated with the first dose, but still we have some ways to go. And that’s partly why we are very careful about our border controls. But the other aspect is that I know a lot of our citizens would prefer to travel after they are fully vaccinated and with vaccines that are recognized.”
Hsiao said Taiwan has created and produced a domestic vaccine called Medigen, which is now in use. Taiwan’s president and vice president have both received it, she said.
“We hope that (Medigen) will also be recognized from the perspective of U.S. travel protocols. That would be comparable to the other vaccines that you use here in the United States. I think that would also help to facilitate the ease of travel,” Hsiao said.