What you need to know
Singapore has adopted decent preventive measures for the coronavirus outbreak, yet the lack of public trust in the government still trigged panic buying. What can Singapore learn from Taiwan?
Singapore reported signs of panic buying due to the novel coronavirus (COVID-19) this week. How did this happen in a city generally known for its perceived stability? How is it that Taiwan, a close neighbor of China, has managed the crisis with more grace?
To a certain extent, the Lion City’s public health management of the coronavirus outbreak has been satisfactory. The health ministry adopted some practices that deserve attention and might even be worth replicating. For example, health authorities made a swift decision in January to test all patients with pneumonia for the coronavirus, a key to uncover cases of infection in people who had no recent travel history to China. It’s no small feat, considering that Singapore has 500 to 600 patients diagnosed with pneumonia per week.
Professor Kenneth Mak, the ministry's director of medical services, told The Straits Times that the testing capacity isn’t going to be an issue. “In fact, we have sufficient capacity to test these individuals (and) those who come on as suspected cases further downstream as well,” he said.
Taiwan’s current preventive strategy, however, remains to only test people with close contact with confirmed patients, including those who are asymptomatic, based on recommendations by the United States’ Centers for Disease Control and Prevention.
Free treatment and drugs
The Singaporean government also made a surprising move to pay for “the hospital bills for all suspected and confirmed cases” given the coronavirus is an “emerging disease.” This came as a surprise because the government has a notorious reputation of burdening its citizens with a costly healthcare system, both in terms of the country’s total health expenditure and purchasing power parity.
Free treatment has been used as an effective health prevention strategy for certain diseases globally. The World Health Organization, for example, adopted a free treatment strategy to eliminate tropical diseases such as malaria in developing countries, which has contributed to an 18-percent decrease in malaria cases between 2010 and 2017.
Meanwhile, Taiwan is also providing “free antiviral drugs to patients with flu-like symptoms, regardless of their nationality.” Although this is not as encompassing as the free treatment offered in Singapore, Taiwan’s healthcare is affordable to begin with and it’s ranked among the best in the world.
The free anti-viral drugs are also provided to any patient with “flu-like symptoms” in Taiwan, not just for “suspected and confirmed cases,” as is Singapore’s case.
Under the National Health Insurance program, Taiwanese patients only have to pay 5-percent co-insurance for chronic conditions under 30 days of hospitalization, with a cap of NT$39,000. Singapore does not have such a cap in place to protect the patients’ financial interest. In 2012, more than 2,400 patients paid over S$10,000 (NT$216,200) for their hospital bills.
Different approaches to mask distribution
On January 30, the Singaporean government announced that each household would receive four masks each, reporting that it had stocked up 5.2 million masks for its 5.7 million inhabitants. A household of four would exhaust its mask supply in a single day.
Flyers distributed in the community centers informed citizens that masks should only be worn if they have a fever, cough or runny nose, or if they are recovering from an illness. Yet, Parliament member Cheng Li Hui was seen distributing masks to residents while wearing one. She said that she did so on the advice of the country’s National Environmental Agency to “protect other residents and volunteers.” The contradictory message sparked outrage online.
To add to the public anger, Trade and Industry Minister Chan Chun Sing said, “Singaporeans cannot react well in times of crisis […] we will undermine the international confidence in our system”. Netizens fired back that only the confidence in the ruling party is being undermined, due to its lack of foresight in handling the epidemic.
Taiwan's face mask distribution differs vastly, with the key difference being that Taiwan actually has the capability to manufacture surgical masks. From the get-go, Taiwan's Economic Affairs Minister Shen Jong-chin came out to assure the public that Taiwan has a reserve of 45 million surgical face masks, and that the country’s daily production of masks could be increased from 1.88 million to 2.44 million if necessary.
A few days later, Premier Su Tseng-chang announced that 23 million masks would be released into the market and new production lines would be built to increase daily production to 4 million. At the end of January, the Cabinet also approved a proposal to build 60 assembly lines to produce 6 million surgical masks a day, with future plans to increase daily production to 10 million.
Ironically, Taiwan’s low-cost manufacturing model has enabled the island to quickly respond to this crisis and to make up for the shortfall of the face masks.
Taiwan’s Centers for Disease Control (CDC) also devised a mask rationing system where each person was only allowed to buy two masks at each convenience store for a flat price of NT$5 per piece. The Central Epidemic Command Center (CECC), which was set up to coordinate the epidemic response, also said that it would prioritize the distribution of masks for hospitals and other medical institutions, as well as for people with chronic diseases and patients with special needs.
Taiwan’s government has even repeatedly warned sellers not to hoard masks or inflate prices, or they would face fines of NT$50 million or up to seven years in prison. The Aviation Police Bureau has also been on the watch to confiscate masks that were being sent overseas and contravened the export restriction.
In contrast, no such measure for mask rationing has been announced in Singapore.
Singapore’s lack of transparency breeds distrust
Compared to Singapore, Taiwan’s government has been transparent and has communicated every decision clearly to the public at every step, from the number of face masks available, to the production plans, distribution, and rationing strategy. This helped create some form of certainty and trust between the government and the public.
Although queues have formed to buy masks and toilet paper (the latter due to rumors), Taiwan has not seen the same level of panic buying in Singapore. Taiwan’s government has also been quick to nip rumors in the bud, questioning suspects for spreading disinformation about toilet paper being a substitute to the material used to produce face masks to stir fears of toilet paper shortages.
While the Singaporean government is being slammed by its citizens, Bloomberg published a perplexing article heaping praise on Singapore’s epidemic management after Prime Minister Lee Hsieh Loong’s speech. It was out-of-step with what people were feeling on the ground.
In his speech, Lee said that the Ministerial Task Force has been “holding regular press briefings to keep Singaporeans informed every step of the way.” He said Singapore is not locking down the city, and there is no need to stock up food or toilet paper, as if he was mocking Singaporeans for the frantic response.
However, Singaporeans netizens pointed out that panic buying happened due to a lack of awareness about the outbreak. The government’s communication about the coronavirus measures have been one-sided, and a lack of public trust in Singapore’s farce democracy was evident in the widespread panic buying.
Taiwan’s democracy manifests into civil resilience
The latest Economist’s Democracy Index places Taiwan at 31st globally, while Singapore ranks 75th as the worst-performing developed country.
This is one reason the response in Taiwan has been far more resilient than Singapore and China – it is a democracy that has greater transparency and accountability. Keeping information transparent is not only important during a crisis, but also in times of normalcy, to build confidence in a system and encourage citizens to trust that the government is equipped to handle a crisis.
Singapore’s political persecution of its citizens in the last few decades – I was one of them – breeds fear in the system. When a crisis occurs, the immediate response among the citizenry therefore contains a stronger fear-based element.
Will Taiwan's or Singapore's system win out in the long term, in terms of societal longevity? I'm going to put my bets on Taiwan with this one - as long as its democratic progress continues.
TNL Editor: Daphne K. Lee (@thenewslensintl)
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