How Taiwan used simple tech to help contain Covid-19

Image source, Getty Images

It's hard to find someone who will talk about Covid in Taiwan.

The island has had some of the lowest case rates in the world, lasting more than 200 days without a single case.

During the worst outbreak in May 2021, it had a daily case load of hundreds of local cases.

Local case numbers have remained relatively low since the Omicron variant hit Taiwan.

There is a stigma attached to catching the virus. The Taiwanese man who caught Covid-19 did not reveal his name or many details because he was afraid of backlash from other people.

He told us that he was sent to an isolation ward after testing positive for a drug. The police investigated his movements for 14 days before they found out he was positive.

The tracing system came from a relatively low-tech and crowdsourced development process.

A largely anonymous group of tech workers - designers, programmers, activists - has been key in starting ideas.

The collective is best known for its bi-monthly hackathons and forking, which is a concept taken from programing.

Image source, Audrey Tang

g0v began to crowd source solutions to emerging problems when Covid-19 arrived in Taiwan.

The best ideas were brought to Taiwan's digital minister, who would share them with Taiwan's cabinet.

Several proposals to create a robust contact tracing system were too cumbersome.

The group came up with a solution. The 1922 hotline at Taiwan's Central Epidemic Command Centre (CECC) can be reached using quick response codes and a corresponding 15 digit code.

Ms Tang explains that the system was originally designed for public transport only.

In the first week of the launch, more than two million businesses hung up the codes on their walls. In case of a community outbreak, customers are required to fill out an old fashioned pen and paper form when entering a business.

Thanks to some of the lowest case rates in the world, local health authorities have been able to work backwards in order to retrace a person's movements when a positive case is detected.

Image source, Getty Images

According to data from the Central Epidemic Command Centre, authorities have still investigated six million potential contacts despite strict border controls.

There have been 20,156 confirmed Covid-19 cases in Taiwan since January 2020.

Taiwan's cell phone networks were used to trace people who may have been exposed to the virus.

More than 627,000 people may have come in contact with covid-positive passengers after they disembarked from a Japanese cruise ship.

Contact tracing raises some important questions over an individual's data privacy in many countries, a concern that Ms Tang says was factored into the creation of Taiwan's own systems.

Ms Tang says that cell phone tower data was chosen over global positioning system data because it can only provide an approximate location. Contact tracing data is deleted after 28 days and kept out of prosecutors' hands.

She says that the phone company, venue and QR code maker only have information about each individual.

These different parties are storing only part of the puzzle, and without putting them together, a cybersecurity breach or something does not reveal anything useful.

Image source, Getty Images

Since early 2020, strict travel restrictions barring most foreigners have kept the virus out of Taiwan and itsoutlying islands. Visitors who do arrive are tracked.

The travel data is sent in batches to the National Health Insurance Administration, Taiwan's answer to the UK's National Health Service.

They must be in a hotel for 14 days and then at home for 7 days of self-health management.

Taiwan faced major vaccine shortages due to delays in the production of Covax and the slow development of a home grown alternative jab.

After Taiwan was hit by its worst Covid outbreak in a year, vaccine donations from the US, Japan, Lithuania, Slovakia, and the Czech Republic arrived. The next challenge was how to efficiently distribute them.

Taiwan followed a vaccine rationing system based on age, occupation and other health risks to ensure as many people as possible received their first dose.

g0v remained involved as members helped develop a centralised website to find nearby vaccination centers.

Cofacts, an existing g0v project to fact check fake news also began to publish posts debunking a surge in misinformation about Covid-19 and various vaccines.

Taiwanese people are mostly receptive to immunisation. Vaccination rates for the first dose are 80%, the second is 75%, and the third is 30%, as of mid-February.

Digital certificates can be printed out or added to apps, but jabs are recorded in vaccine booklets.

Image source, Getty Images

Taiwan's Covid success would not be possible without a society that continues to use QR-based tracking and follows other government guidelines.

Most people in the United States don't want to be tracked, but in Taiwan, most people will accept that, according to the Professor of Paediatrics and Health Policy atSTANFORD University.

Many Taiwanese lived through severe acute respiratory syndrome 20 years ago, which is one of the reasons why Mr Wang says a key factor is willingness to cooperate. The government and society were more willing to act when Covid-19 came along.

She says that people were scared of what happened during the outbreak of Severe Acute Respiratory Syndrome, and there was a sense of self-preservation.