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I’m in Taiwan, doing hotel quarantine at the moment. [laughs] I had to talk to you quite a bit. Now that I’m here, I’m very interested in what you’re doing.
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Great times.
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(laughter)
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For this story, I’m working on a story a lot of people have written already about Taiwan’s success with the COVID response. I want to talk to you in particular about the digital side of it, the innovation side of it.
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Just to start with, broadly thinking, how big a role has technology played in the COVID response of Taiwan?
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It’s all technology but not all digital technology, because mask and soap are technologies too, physical and chemical respectively. These are the most important ones. Digital technology plays an assistive role. For example, ensuring that there is fair, equitable mask access.
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Or that when people go to, assuming you are in a quarantine hotel. If people choose to quarantine at home, then digital also helps that we can turn their home into a quarantine hotel of sorts using the digital fence technology and so on.
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It’s not about collecting any new data that we’re not collecting before the pandemic, but it’s about creatively innovatively using that data to ensure fair and equitable quarantine policy and mask availability. These two are the flagship products. For these two digital are only in assistive role.
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When was there an awareness that the existing digital technologies weren’t enough, that you needed more like the digital fencing and that sort of thing?
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The retrospective we did in 2004, right after SARS 1.0, is about the communication difficulties between the municipal and central government setting up of the central epidemiology command center, or the CECC with its daily 2:00 PM live press Ask Me Anything conferences.
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It’s also about the unannounced lockdown of the entire hospital for an indefinite amount of time, the Hoping Hospital, which is barely constitutional – almost unconstitutional. The Constitutional Court charged a legislature to find out better ways of quarantine that are fixed in time lengths, have a very precise privacy profile, and do not endanger people who are after quarantine, either financially or socially and so on.
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I will say that this preparation has begun since 2004, since which we have yearly chose until, of course, SARS 2.0 starting earlier like January, or in our case, December 31st.
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You’ve mentioned privacy concerns a few times. That’s been an issue around the world. In some countries, people have not accepted things that are far less invasive than what occurs here in Taiwan.
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How were the privacy concerns addressed early on, and why do you think that people have been more accepting of that sort of intrusion than they have been in other countries?
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If you do not collect new data in the name of a pandemic, and all the data collection points are already collecting the data anyway, that means that people are more familiar with the privacy budget for lack of a better term.
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For example, two examples, one is that the digital fence itself is built upon the signal strength in the telecom towers. The telecoms already have the signal strength data anyway. They are already collecting it in order to provide that roaming service. That’s how we can continue a call in a high speed rail. That data they already have.
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It’s not like they sell this data to someone else in order to do the digital fence. No. They reuse the existing same SMS message infrastructure that sends SMS warnings. When an earthquake comes, for example, you get those warning a few seconds before based on your rough vicinity to the cellphone towers.
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The resolution, the precision, is very rough. Even in the most densely populated urban areas, it’s just 50 meters in radius. It doesn’t know which room you are in, but it does know the street you are in, for example. You get those earthquake warnings, or advanced flood warnings when a typhoon comes, which it hasn’t come this year.
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If the typhoon comes, you get those sort of warnings. People understand that this SMS has no way to, for example, read your email, or know their Bluetooths, or WiFi, or whatever connectivity. It’s much easier to comply if people understand that these data collection and SMS, in this case, is not only sent to the phone, but also sent to the local medical workers and so on.
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Again, it’s the same thing that people are already familiar with. Mask availability map is built out of the pharmacies collaboration. Pharmacies understood that when people come with their national health insurance card and get their masks rations is exactly the same experience as getting their refilled prescriptions and so on.
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Basically, we piggyback our existing data collections channels, but still, there were like nine percent of people who are wary of the measures that I just described. Many legislators set up an interpolation, a hearing session. This is important because we never declared a state of emergency. Everything we do must be subject to the congressional approval.
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In the hearing, the Department of Cyber Security explained in very fine detail how exactly the system works, and then approval rates came from 91 to 94 percent. We still thank the other 6 percent for holding us accountable and honest.
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When you’re talking about the foreign towers triangulating and that sort of thing, is that the technology that was used after the Diamond Princess cases where they alerted people who had been in the same area using Google Maps over the course of two weeks?
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It’s not using Google Maps by the way. It contains a link to Google Maps where you can check whether your whereabouts intersect with the Diamond Princess Trail, their itinerary. At no point do we collect the whereabouts of the people receiving the SMS. That’s why I emphasized that these SMSes are a onetime thing.
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It doesn’t know whether you have intersected or not, it just do this broad swath of SMSes exactly like flood warnings. We do not know where there will be floods, but we know the kind of potential of flood. Out of abundance of caution, we send everybody in a potentially flooding area an SMS. That’s exactly the same thing.
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You’ve mentioned the use of it in quarantine and use of it in mask supply. What are some of the more innovative creations or surprising creations that have struck you during this time? Not necessarily the most significant ones, but the ones where they’re thought outside the box a little bit.
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The use of traditional rice cooker to reuse the mask to disinfect them. [laughs] The medical masks are designed to be one-time use. Of course, there was a shortage of supply, and still is in many corners in the world. There is a person Lai Chane-yu who experimented in his university lab.
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They’ve used those traditional rice cookers, with emphasis on traditional because it doesn’t have a steam vent. If you put some boiling water in it, the steam goes to the top of the rice cooker and there’s clank, clank, clank. That’s when you know that it’s in the boiling temperature.
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If you use that sort of traditional rice cooker and put a mask in it, but crucially do not add water and measure the time to be very precise, then after eight minutes or so, it will actually go up to 110 Celsius and go down very quickly within the rice cooker.
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In which case the virus is killed, but the fabric is not damaged, or minimally damaged. Turns out you can ruse a single medical mask for three or five times using this method. Of course, additionally, the CECC doesn’t really believe it because it’s very counterintuitive.
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(laughter)
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The Food and Drug Administration replicated that experiment, found it to be very sound. Then the next thing we know, Lai Chane-yu is asked to appear on the daily CECC press conference explaining the theory while Commander Chen Shih-chung tried to cook some masks, and eventually put it on his face.
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Then later on from peer review journals, we will learn that this also works for N95 masks as well. I personally filmed a lot of videos, in a lot of languages, explaining this.
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That’s fascinating. One of the key things about Taiwan’s response seems to be the government’s willingness to listen to experts, which is not universal in government’s responses to this around the world.
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Can you tell me, is that something that was unique to the last couple of years, for instance, having an epidemiologist and your Vice President that time, what was the political environment at the time of the outbreak, that your response was respectful of science in a way that other governments haven’t been?
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It’s science, but it’s also citizen scientists. Professor Lai Chane-yu counts as a citizen scientist, even though he’s a professor, but he wasn’t part of the CECC expert team. The point is that with this hotline, 1922, anyone with any expertise can call in and volunteer into the expert panel, so to speak.
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That is much more important than the initial handful of experts. If the CECC assumes this attitude that we know everything, that is actually not true. Because SARS 2.0 is not the same as SARS 1.0. They may know everything there is to know about SARS 1.0, but SARS 2.0 is an exploratory, epistemically speaking, it requires everybody’s input.
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For the episteme to work, for knowing where to work, everyone needs to trust each other. I’m sending you a blog post that I wrote of this particular matter about how trusting the citizen part works.
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I want to highlight that, of course, it’s true that the VP to convince the President, who just need to maybe walk 10 seconds to the next office, and a top epidemiologist if he want to convince the VP he just looks into the mirror. [laughs] Of course, that really helps.
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There is a larger culture that basically says that we trust the collective intelligence, the wisdom at the edges, at the frontline. When a pharmacists says the mask availability app isn’t designed to one hundred percent fit the way that they work, some of them even go as far as to say don’t trust the app because they are even to take a number systems.
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It’s never their problem, it’s always our problem. We always change the system to reflect better how the pharmacists are actually doing their work. This is much more important because this then is the expert panel of not 32 people or 23 people, but rather 23 million people.
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One of the other successes in Taiwan has been the economic survival and recovery compared to the rest of the world – obviously there’s been no mass lockdowns in Taiwan, shops have remained opened, that has made a big impact – what else do you think has driven that success?
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In economy recovery you mean?
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Mm-hmm.
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During the more serious month of COVID, of course, I built up this new habit of contactless ordering food, placing outside of the door, and so on. Of course, that’s a habit that still remains to this day for me, and I assume for many other people.
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While the e-commerce side, of course, increased a lot, that really hurts the commerce that relies more on face-to-face interaction. This is true for pretty much all the countries.
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That’s why we wrote out this idea of triple stimulus, where people can take their credit card, but they cannot use it at their home to qualify for the TSV.
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Rather, they have to physically go outside to the shop, use the credit card, look at a shopkeeper saying that singular, meaning that I understand you have suffered during the past few months, and then after swiping for 3,000 NT dollars they can, in the nearby friendly automated teller machine, withdraw two thirds of that in cash back program.
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Because it’s cash back, likely they’ll also spend it on fact-to-face settings. Because of that, we rebuilt the habit of spending outside of one’s own home. We rebuilt economy based on the transaction that more face to face like in night markets and things like that.
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If you search for triple stimulus vouchers, you’ll see how exactly it works. It did work. This quarter, not only the GDP is recording a positive growth, but also all the face to face shopping actually some of them broke the quarterly records in this quarter of the year. It really works pretty well.
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The last question I have for you is, the new things that have been brought in to Taiwan’s society now for COVID response, are there ones where you think will stay?
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Yes. All the thousands of people, more than one thousand who get a Taiwan gold card, [laughs] which is people who have some ties to Taiwan, or maybe they return back for the Lunar New Year, or they went here for hiking of surfing.
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Suddenly, the virus came and they discovered they can convert their tourism visa into a gold card, which means that they can still continue to work with whichever organization they’re working internationally, but then they enjoy the same health benefits, their spouse and family enjoy the same health benefits, and they can stay in Taiwan for up to three years just as a resident.
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It’s a really nice program that we’ve rolled out, but we did struggle to get people notice that there is such a program in the first place. There’s not many people registering for Taiwan gold card before the pandemic.
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Nowadays, each person that register for the gold card, on average spread to one person or more giving it higher than one, but one basic transmission rate. It went viral.
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(laughter)
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Last month, we’re celebrating the 1,000, but at the end of last month is 1,367, and I think we’re more than 1,500 at this moment. [laughs] It’s recording exponential growth.
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There is more people who are willing to entertain the idea of being also Taiwanese without giving up their existing passports, of course, and just staying in Taiwan longer and contributing to the new more transcultural Taiwanese innovative scene. This is great. Most of them will stay.
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That’s fantastic. Thank you so much for your time Minister Tang. I really appreciate it, especially so early in the morning.
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Yeah. Thank you for working with the hotel quarantining procedures. [laughs]
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No problem. No. It’s been fine. It’s been very smooth. I’m excited to get out tomorrow. I’m nearly done.
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Awesome. Cheers.
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Thank you so much. I’ll talk to you later.
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Live long and prosper. Bye.
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Bye.