Sweden and Taiwan: Fighting Coronavirus With Different Strategies

On March 11th 2020, three months after the outbreak was first revealed in Wuhan, China, the World Health Organisation (WHO) officially announced that the coronavirus COVID-19 is a pandemic. Several weeks later, the coronavirus has reached almost every corner in the world. 210 countries and territories around the world have reported confirmed cases of the coronavirus. However, the preventions and measures that governments and the general public take to deal with the virus vary from country to country. 

Two interesting examples are Taiwan and Sweden, two of the last six countries in the world where schools are still open. On one side, Taiwan, a country located just 130 km from China, has stood in the front line of the coronavirus battle and managed to contain the virus with extra caution from the very beginning. With relatively low confirmed cases, not only in the region but also in the world, the Taiwanese government continues to closely monitor the situation and carefully practice its policy. On the other hand, Sweden initiates a rather different approach than most other countries. Despite the number of confirmed cases skyrocketing from 14 to 4,832 within one month, the Swedish government has only implemented social distancing through recommendation. Although Taiwan seems to succeed in the first stage of containing the virus, Taiwan’s representative to Sweden, Dr. Daniel Lia, reminded that Taiwan’s policies cannot be implemented directly in Sweden due to the cultural difference.

Photo source: Courtesy of CNA/ Infogram

Taiwan has taken a hardline approach to coronavirus for historic reasons. In 2003, the island nation was hit with  Severe Acute Respiratory Syndrome (SARS). As a result, Taiwan learned to take measures early. As early as December 31st 2019, as soon as news of a new virus is coming out, the Taiwanese government started to inspect plane passengers coming from Wuhan. Taiwan then banned people in Wuhan from entering Taiwan on January 23rd, suspended tours to China on January 25th, and eventually banned all Chinese visitors on February 6th. After the virus began to spread around the world, the Taiwanese government barred all foreign nationals from entering Taiwan on March 19th and implemented quarantine for all travellers who have visited regions hit hard by the disease. 

Taiwan was not only quick to implement border control, but was also one of the first to ban exports of surgical masks to prevent the country from facing inadequate supply of medical equipment. To ensure there would be no hoarding of supplies and exploitative pricing, the government also took control of face mask distribution from the private sector on January 31st and implemented a purchasing policy on February 6th, in which every Taiwanese can buy three masks per week for only NTD$5 (USD$0.17) each.

To ensure the good coordination and transparency, on January 20th, the day when the total number of global cases surpassed 200, Taiwan set up a unified command centre, the Central Epidemic Command Center (CECC). The CECC is to allocate resources and hold daily press conferences to update the public about the coronavirus, including case identification and policies. With the real-time integration of national health care databases with customs and travel records and the use of government-issued cell phones to remotely monitor quarantine orders, the Taiwanese government also can easily track down travelers or people who should be in quarantine.

Photo source: Pixabay

Meanwhile in Sweden, Paul Franks, Professor of Genetic Epidemiology at Lund University, and Peter M Nilsson, Professor of Internal Medicine – Epidemiology at Lund University, have commented that the Swedish authority seemed to assume that overreaction is more harmful than under-reaction. 

Following the first signs of community infection, the Public Health Agency of Sweden changed its policy from testing all possible cases to prioritising the hospitalised patients and people that work in healthcare or elderly care with the suspected coronavirus. Since not all cases were accounted for at this point, contact tracing would no longer be as effective. As the number of confirmed cases continue rising in the country, the Swedish government took a further step to ban gatherings of more than 50 people. This ban excludes places like primary schools, workplaces, public transportations, squares, shopping centres, private parties, business events, libraries, and swimming pools.

Unlike social distancing strategies implemented by other countries, the Swedish government is focusing on social distancing among the known risk groups, such as the elderly. “We try to use evidence-based measurements,” says Emma Frans, a doctor in epidemiology at Sweden’s Karolinska Institute, “We try to adjust to everyday life. The Swedish plan is to implement measurements that you can practice for a long time.”

Cultural differences between Taiwan and Sweden drive their policy designs in diverged ways. Firstly, the threat of SARS put Taiwan and its people on high alert for future outbreaks. Although healthy individuals do not need to wear face masks, people still follow the advice to have a mask on when they visit crowded places to protect both themselves and others. In order to contain the virus, people also allow special powers to integrate data and track people during this kind of crisis under the provisions of the Communicable Disease Control Act. Without previous experience with these types of epidemics, it is difficult to require the Swedish society to act as fast and as extreme as the general public in Taiwan in the first place.

Secondly, the demographics in Taiwan and Sweden are different. While Taiwan is densely populated with many urban areas, Sweden is a large and scarcely populated country with only one metropolitan city. While there are three people living in each household in Taiwan on average, more than half of all Swedish homes are made up of only one resident. The assumption of living patterns in Sweden might help stem the spread of the virus can be another reason that leads Sweden to react differently from Taiwan.

Thirdly, the constant threat from China keeps the general public alert and breeds a strong sense of solidarity in Taiwan. When the information of the outbreak first leaked to Taiwan in the end of 2019, people have already switched on their alarms, which has raised social consciousness about collective action. “When the collective will support the government, then all of the strict measures implemented by the government make sense,” wrote Wang Cheng-hua, a professor of art history at Princeton. Since Sweden does not share the same sentiment as Taiwan, it is hard to duplicate the collective action.

Through a combination of early response, contact tracing and the adroit use of technology, Taiwan is able to keep the number of confirmed cases under 400 individuals, three months after its first case was confirmed. Though Taiwan’s preventions and measures have shown its significance, the same policies cannot be implemented directly in Sweden due to the cultural and geographical differences. The disparity of infection rate between Taiwan and Sweden may also turn the application of Taiwanese measures ineffective in the current situation in Sweden. However, containing the virus can be a long-lasting battle. If the coronavirus has more than one wave or lasts longer than expected, only time will tell if  Taiwan or Sweden change their attitudes and directions for their policy implementations.

Yi-Chia Chen

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