Speed, decisiveness, cooperation: how a tiny Taiwan village overcame Delta

Fangshan's workday begins before dawn and ends at noon. In the shade, farmers or fishers of onion and mango sit together and share a bucket of cooked shrimps and bottles Taiwan beer.
Fangshans, Taiwan's president, is the hometown. It consists of a stretch of coast, four villages, and approximately 5,500 inhabitants. The borders are sandwiched between mountains, oceans, and mountains. It is quiet and beautiful, but it is not on most tourist routes, which instead concentrate on Kenting national parks to the south.

Over the last few months, however, something extraordinary has taken place here. This community is one of Taiwan's poorest, and has defeated the Delta variant.

Its success can be used as a model for countries trying to stop an epidemic.

An unexpected visitor

Authorities in the southern county Pingtung noticed a surge in cases in Fangshan in June, as Taiwan was experiencing its worst Covid pandemic.

Fangshan was a rural community with low density and a high level of community compliance. It also had many problems. Fangshan's health system was listed as inadequately resourced. 20% of the population are over 65 and there weren't protocols for becoming Delta ground zero. Nearly everyone was not vaccinated.

It was not extraordinary, but it was amazing to see what happened next. It worked and the outbreak was ended in 19 days. With one death, the cluster was stopped at 17.

Chang Feng-nan (63 years old), was the first to be identified. He was one of his three or four village taxi drivers. Another early case was a 56-year old woman and her eight year-old grandson. They were both recently returned from Peru, and quarantining at their home.

Three of them had some travel history. Therefore, Shy Cherng Guei, the director of health for the area, requested genomic sequencing.

Two days later, the results were back: Delta.

"I was certainly in shock," recalls Pan Men-An, the county's political leader. Pingtung was the one who did it first. All preventative measures were taken for Alpha. We didn't have any reference point or anyone to ask.

Delta spreads quickly. As close contacts or cases, 667 people were hospitalized or quarantined. Changs contacts were identified by a notebook that he kept. It included friends, family members, and their friends.

Chang is believed have contracted the virus while driving to hospital. His passenger caught it from Chang, and Chang's partner caught it while he was taking out the trash and having a brief chat with the boy next to him, who had previously been to Peru. Fangliao's 50km-distance couple are believed to have contracted the virus while they were waiting in the same hospital as the Peruvian pair. The 72-year old wife died 21 July.

One view of a house in Pingtung, province Photograph: Daniel Cengshou Yi/The Guardian

We felt like soldiers

The key components of Pingtungs' response were speed, determination, overwhelming community cooperation, contact tracing, and restrictions. Shy believes that a local response combined with central government resources was crucial as it reduced bureaucratic delays. We had plenty of time to respond due to the cooperation of the people and existing pandemic hygiene (masks, handwashing),

Pan, the magistrate, announced a three day soft lockdown of Fonggang/Shanyu villages. He used the community loudspeaker to announce the order. Each household received boxes of food and other daily necessities before the genomic test results returned. Pan, Shy, and senior health officials met nightly to discuss new measures and establish a command center. Lu Meng-lun, the commander of the command center, said that we felt like soldiers were being assigned missions.

Over 14,000 people were tested. Some reportedly lined up for miles. For adults who had failed to pass, the central government directed 1,200 doses of vaccines. The villages were disinfected for three days.

Tai Fengchin, Fangshan's chief nurse and who conducted contact tracing investigations, said that people were afraid. She says that people in villages continued to call the centre to inquire about the status of the virus, to find out what they could do to stop it, and to get advice on how to prevent it from spreading. Tai continued to receive phone calls from home, and it reached a peak of 2-300 per day.

Chang, a taxi driver, was first to be identified as a Delta variant carrier on Taiwan Photograph: Daniel Shou Yi/The Guardian


Lin Jung-ji, a village warden, said that he was proud of Fonggang's Buddhist temple and its willingness to look after one another. However, he felt there should have been more government support. He says he wishes there was more support for those who were affected by the virus, or lost their income. Many local farmers were devastated when the outbreak and lockdown occurred at the same time as the critical annual mango harvest.

Although leaders and officials are quick to praise the efforts of people to come together for the greater good of the world, questions about formal financial compensation are frequently ignored.

Shanyu taxi driver Chang is furious at being home. His elderly mother remains ill and he is still experiencing some of the lingering effects of Covid. He claims he hasn't heard from anyone since his discharge two months ago.

After helping investigators in the middle of the nights while he was sick, he feels annoyed and is now being abandoned. Because people are afraid to ride in his taxi, he can't make any money.

Fangshan residents blame the government Central Epidemic Command Centre for the outbreak. They allowed home quarantine for residents, much like those returning from Peru. Taiwan bans most non-citizens entering the country and places most people in quarantine at hotels. However, eligible residents were allowed to remain at home.

Huang Lung-sien (head of Fonggangss development organization), angrily stated that the CECC owes people a huge apology.

Since then, the CECC has reversed this policy and requires all guests to be isolated in hotels. The CECC has adopted additional measures similar to Pingtung. These include second testing of quarantined patients before discharge and expanded testing.

In March 2020, Dr Michael Ryan (executive director of WHO's emergency program) warned the world that countries should not hesitate.

Don't be slow, and don't regret it. Be the first to move. If you don't move quickly, the virus will always take you.

It is unlikely that Taiwan's first encounter with Delta will be its last. Authorities were currently quarantining students from a northern school as close contacts for a suspected Delta case, the child of a pilot.

Although Pingtungs' response was not perfect, it was better than most.

Shy, director-general, states that he didn't believe the transmission could be stopped so quickly. The outside transmission of Delta has been frightening. It was like I was in a dream when we had the virus contained.

Chi Hui Lin also reports