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The Right Response to Pandemic: How Taiwan Has Gone Five Days with Zero Coronavirus Cases

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Screenshot of homepage PPT Boards. The newspaper reads, “Thank you for your contribution to the effort to combat the coronavirus pandemic.”

April 30, 2020 – On the last day of 2019, “No More Pipe,” a user on PPT Boards, Taiwan’s version of Reddit, reposted a message by a Dr. Li Wenliang that warned about a respiratory disease spreading in Wuhan, China.

At around the same time, Luo Yi-jun, was unable to sleep. The deputy director for Taiwan’s Centers for Disease Control got out of bed and logged into PPT boards to surf trending posts.

He launched Taiwan’s first health inspections the following day, the start of a new decade and the beginning of a new normal.

Dr. Li has now died from the mysterious “respiratory disease” amidst the now-scorned approach that the Chinese government took to the novel coronavirus.

But partly because of Dr. Li, Taiwan has been hailed as one of a handful of success stories for how it has effectively halted the spread of coronavirus within its borders, with the country now celebrating its fifth day of zero confirmed cases.

The keys to Taiwan’s response have been rather inconspicuous to everyone except its citizens. That is, until H.E. Audrey Tang, Taiwan’s Digital Minister, detailed the different aspects that gave rise to its success in a webinar hosted Wednesday by the Atlantic Council.

Unlike neighboring China, Taiwan took an approach of ‘humor over rumor’

Even beyond taking early action (perhaps the earliest public action of any nation), there’s a lot that went right in Taiwan’s response to the pandemic.

Taiwan has been here before. The 2003 outbreak of SARS ravaged the island nation, infecting 668 people and claiming the lives of 181. In addition to being the Asian country in which SARS spread the fastest, Taiwan also endured the humiliation of having a strategy of “barricading an entire hospital” backfire.

Many needlessly died, and some argued that the government violated constitutional rights in the process. Since then, Taiwan has upped its disease detection capabilities and been on high alert.

Taiwan has opted for the soft power approach

Taiwan has also used creative means in countering misinformation about the virus. In February, Taiwan’s health ministry introduced citizens to its cartoon “spokesdog,” a Shiba Inu named Zongchai who helped counter coronavirus rumors and promote safe habits.

The Zongchai strategy “went absolutely viral” according to Tang, dwarfing the original rumors about a toilet paper shortage (the government successfully traced back the conception of the rumor to a toilet paper reseller).

This “humor over rumor” strategy contrasts sharply with Taiwan’s rival across the Formosa Strait. There, the Chinese government has relied on Maoist-era messaging and populist propaganda that taps into a sense of national duty. Slogans from different parts of the country vary include “to visit each other is to kill each other,” and “to get together is to commit suicide.”

But Taiwan has also taken a few hardline measures

The Taiwanese government has also embraced a form of communication that aims to build trust with the public. Since January 20, 2020, President Tsai Ing-wen has hosted an “ask-me-anything” style press conference that does not adjourn until all press questions have been addressed and answered.

“We emphasize opening our mind to new and novel ideas,” Tang said, saying that government officials and the public have worked as a “collective intelligence system,” where transparency and the exchange of ideas are key.

The government’s embrace of creative solutions doesn’t end there. Tang related how when a young boy complained at one of these conferences of being teased for wearing a pink mask to school, government officials posted pictures of themselves wearing pink masks to work on social media to prevent a snowball effect of mask abstentions.

Of course, Taiwan also achieved success by taking some hardline measures.

Taiwan’s version of the Centers for Disease Control early on decided that “everywhere else on earth is on high risk” and banned all incoming flights in the early stages of response, according to Tang.

Later, all incoming travelers to Taiwan had to be assessed and ranked according to threat level.

All high-risk incomers were sent to centralized quarantines run by the government. Low-risk incomers were sentenced to self-quarantine in their houses, where a “digital fence” was created to notify authorities and neighbors whether that person had left a designated quarantine area.

Communitarian culture played a strong role in holding individual’s accountable, as the population demanded to play the role of “co-detective” and report neighbors suspected of breaking quarantine protocol. Tang called community enforcement in general “really effective” in helping contain the disease.

Digital Minister Audrey Tang

Face masks, geography and projections that Taiwan would be ‘second worst-hit’

Taiwanese citizens early on were limited to buying two face masks a week to ensure that the nation would not run out, which was tracked and enforced by a national health insurance that covers “99.9 percent” of the people, according to Tang.

In addition, open source maps partly run by civil hackers, or “civil engineers” as Tang called them, collaborate to publish the supply level of masks at every pharmacy in the country every three minutes.

Tang admitted that geography played a huge role in Taiwan’s successful response. There’s no way for a wanderer “to accidentally stumble on Taiwan,” Tang admitted, referencing Taiwan’s island geography.

However, she did not let that detract from Taiwan’s efforts. For effect, she said: “81. That’s how many miles Taiwan is from mainland China,” the ground zero and long-time epicenter of the COVID-19 disease caused by the novel coronavirus.

In fact, Tang referenced an early Johns Hopkins study predicting that Taiwan would become the second worst-hit country in terms of coronavirus cases, behind China.

That was wrong.

No contact tracing app – but an app to donate masks to the rest of the world

Even though Taiwan never launched any contact tracing apps, it has used a different app to mitigate the spread of COVID-19— for other countries.

A new government-sponsored app allows citizens of Taiwan with extra masks to donate them to other nations. Including other governmental efforts, Taiwan has donated “tens of millions” of masks.

“Currently Taiwan feels calm” due to how well it has responded, Tang said. Now it is “in a stage where people are feeling generous.”

Photo of Kaoshiung’s 85 Building celebrating “ZERO” cases for three straight days

 

Health

Providers Call for More FCC Telehealth Funding as Demand Grows

‘I think obtaining funding from the Universal Service Fund would go a long way.’

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Photo of FCC Chairwoman Jessica Rosenworcel

WASHINGTON, July 26, 2022 – Health care providers in parts of America say they are struggling to deliver telehealth due to a lack of broadband connectivity in underserved communities, and recommended there be more funding from the Federal Communications Commission.

While the FCC has a $200-million COVID-19 Telehealth program, which emerged from the Coronavirus Aid, Relief and Economic Security (CARES) Act, some providers say more money is needed as demand for telehealth services increases.

“The need for broadband connectivity in underserved communities exceeds current availability,” said Jennifer Stoll from the Oregon Community Health Information Network.

The OCHIN was one of the largest recipients of the FCC’s Rural Health Care Pilot program in 2009. Stoll advocated for the need for more funding with the non-profit SHLB Coalition during the event last week. Panelists didn’t specify how much more funding is needed.

Stoll noted that moving forward, states need sustainable funding in this sector. “I am hoping Congress will be mindful of telehealth,” said Stoll.

“The need for telehealth and other virtual modalities will continue to grow in rural and underserved communities,” she added.

Brian Scarpelli, senior global policy counsel at ACT, the App Association, echoed the call for FCC funding from the Universal Service Fund, which subsidizes basic telecommunications services to rural areas and low-income Americans. “I think obtaining funding from the Universal Service Fund would go a long way.”

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Health

Artificial Intelligence in Healthcare Has Benefits, But Also Challenges That Must Be Rectified: Experts

The technology needs to be examined to ensure it doesn’t create inequities in healthcare, panel hears.

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Screenshot of the Atlantic event in late June

WASHINGTON, July 11, 2022 – While the use of artificial intelligence in healthcare has been lauded by some, experts said at an Atlantic event late last month they are concerned that inaccurate data can also hamper progress in the field.

Artificial intelligence has been used widely across the medical field to analyze relationships between medical providers and patients to improve equality of care, including providing patient risk identification, diagnostics, drug discovery and development, transcribing medical documents, and remotely treating patients.

Carol Horowitz, founder of the Mt. Sinai Institute of Health and Equity Research, argued that while AI plays a substantial role in diagnosing health problems at earlier stages, diagnosing patients more quickly, providing second opinions in diagnoses, enhancing scheduling abilities, stimulating hospital workflow, and finding drug availability for a patient as in dermatology, therapeutics, or population health, it’s not a golden ticket.

She reasoned that it “can reflect and really exaggerate inequities in our system,” negatively affecting healthcare equity among patients.

She stated that AI tools have led to inaccurate measurements in data that have proved harmful to individuals’ health. Horowitz shared the example of faulty AI technology during March 2020 meant to allow individuals to self-monitor their own oxygen levels as a precautionary method to the COVID-19 pandemic but led to inaccurate pulse readings for those with darker skin, and inaccurate data gathering, resulting in delayed treatment for many in need.

Michael Crawford, associate dean for strategy of outreach and innovation at Howard University, added that if these certain mismeasurements and flaws in the technology are not addressed, “AI could increase disparities in health care.”

Alondra Nelson, head of the White House Office of Science and Technology Policy, said when it comes to assessing AI technology innovation for the future, there are both cost and benefits, but we must find “where can we move forward in ways that don’t harm human society but that maximize human benefits.”

As we grapple with how to implement this technology, “we must do science and technology policy that always has equity at the center” for future innovation, said Nelson.

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Health

States Lagging on Bills to Implement 988 Suicide Hotline Mandate as Deadline Approaches

As of June 7, 20 states have passed legislation to implement the 988 suicide hotline mandate, according to FCC data.

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Screenshot from the FCBA event on June 8

WASHINGTON, June 15, 2022 – Only 20 out of the 35 states that have introduced legislation for a new suicide hotline have made the legislation law as of June 7, according to information from the Federal Communications Commission, as the July 16 implementation deadline nears.

States are required to implement the infrastructure and the funding for a 988 number that will go to the National Suicide Hotline, but only four states have passed bills to finance it, Emily Caditz, attorney advisor of the Wireline Competition Bureau under the FCC, said at a Federal Communication Bar Association event last week. Those states – Colorado, Nevada, Virginia, and Washington – fund the implementation from fees on cellphone lines.

James Wright, chief of crisis center operations at the federal Substance Abuse and Mental Health Services Administration, suggested that “key partnerships between state and local governments” will be necessary to help states meet this deadline.

Laura Evans, director of national and state policy at Vibrant Emotional Health, said this funding will “make sure we have robust capacity for the anticipated 9-12 million contacts we expect to come in that first year.”

The commission ordered the adoption of the nationwide line nearly two years ago, on July 16, 2020.

According to the National Suicide Hotline Designation Act of 2020, “988 is designated as the universal telephone number within the United States for the purpose of the national suicide prevention and mental health crisis hotline system operated through the National Suicide Prevention Lifeline.”

“America’s suicide rate is at its highest since World War II,” said former FCC Chairman Ajit Pai at an FCC event in December of 2019. “A simple three-digit code for a suicide hotline can reduce the mental stigma surrounding mental health and ultimately save lives.

Caditz said the implementation of text messaging “is especially popular with groups that are at heightened risk of suicide or mental health crises, including teenagers and young adults and individuals who are deaf, hard of hearing, deafblind, or speech disabled.”

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