What Can We Learn From Taiwan’s Quarantine Experience?

What Can We Learn From Taiwan’s Quarantine Experience?
Photo Credit: Reuters / TPG Images

What you need to know

A study from Academia Sinica adds to our understanding of the psychological burdens of quarantine.

When Ching Wen Huang’s college campus closed in March due to the pandemic, she returned to Tainan. In her first 33 days after arriving in Taiwan, she had 313 virtual and in-person contacts with 55 individuals. She had difficulty falling asleep on four separate days. Most of her stress came from her school work, though some came from quarantine and other Covid-19 safety requirements, too. There was one lonely day in April. Surprisingly, she was more satisfied with her health — and sex life — during quarantine than after.

Huang, 23, was one of 140 quarantined participants in the Epidemic Prevention Diary (防疫日記) study from the Institutes of Statistical Science and Sociology at Academia Sinica. The goal of this longitudinal survey study, which ran from late March to early May, is to understand the extent to which participants have adjusted their social interactions and changes in their emotional well-being. The preliminary findings were published in June in an International Journal of Sociology (ISJ) article, “Daily Contacts Under Quarantine amid Limited Spread of COVID-19 in Taiwan.”

The study found that those in quarantine found daily social contacts to be more meaningful, both during and after quarantine, compared with a control group not in isolation. A small portion of the quarantined group — 5% — deviated strongly, however, having no contact with anyone in their daily lives, even weeks after quarantine. On the one hand, social interaction was valued more by those who experienced isolation due to quarantine; on the other hand, for a small number of study participants, social isolation dominated.

Taiwan’s public health interventions during the pandemic have drawn international attention, but there has been little focus on how these policies have affected people psychologically. Addressing the personal reception of these policies is one important piece of the model Taiwan is offering to the world in its response to Covid-19.

Cultural context to the pandemic and quarantine in Taiwan

“Quarantine is a very special demographic in Taiwan,” Hsuan-Wei Lee said. Visible through a window behind Lee is the lush greenery surrounding the campus of Academia Sinica, where he is a researcher. He is also the project lead of the Epidemic Prevention Diary study and co-author of the ISJ article.

The study began at the height of fear over the pandemic in Taiwan, not long after the government instituted a mandatory 14-day quarantine for anyone entering the country from March 19. This fear was especially potent within Academia Sinica’s own walls, with four confirmed cases of Covid-19 by March 22.

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Photo Credit: CNA
Academia Sinica pictured around the height of the outbreak on the campus, March 21, 2020.

Meanwhile, those under quarantine in Taiwan were judged on social media for perceived irresponsibility — for having to quarantine in the first place, or possible irresponsibility for not adhering to, or completely violating, quarantine. From March 19 to April 1, Taiwan’s CDC fined 318 people for quarantine violations. The culture of stigma, according to Lee, added another unique factor to understanding the quarantine experience in Taiwan.

Understanding social connectedness during quarantine, apart from its effect on loneliness as a public health issue, as the article purports, has a secondary implication. This is the effect of loneliness on compliance with quarantine and other pandemic prevention protocols. With this goal in mind, Lee’s study contributes to the academic literature studying the relationship between the pandemic and loneliness.

Surprising findings and future research

Apart from the published preliminary findings, Lee and his team are still astounded by some of the results of their study. The desire to leave quarantine is greatest near the end of quarantine, rather than at the beginning, as Lee would have expected. The data also suggests that the desire to leave quarantine increases when participants are more knowledgeable about public health. The findings are statistically significant, but Lee can only speculate as to why before doing more analysis.

One of the statistically significant findings the team is combing through is the 60% of quarantined participants who showed risk of developing Acute Stress Disorder (ASD). Further analysis can reveal how many actually develop ASD, which along with social isolation, may paint a more nuanced picture of emotional well-being under quarantine.

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Photo Credit: Reuters / TPG Images
Airport staff holds up information regarding passenger health declaration and home quarantine information at Songshan airport in Taipei, Taiwan July 2, 2020.

The team also found that 99% of the participants react positively — with a “Like” or “Love” — to the government’s posts about Covid-19. There is an opportunity to understand how this response compares with their general social media behavior, and the extent to which they feel supported by the government during uncertain times.

Global context

Lee developed a simplified version of the Epidemic Prevention Diary in collaboration with researchers from Japan, Singapore, and the United States. Launched in September, the Social Distancing Survey is available in 12 languages and is ongoing until March 2021, with the goal of providing comparative insights.

The Epidemic Prevention Diary and Social Distancing Survey both take a more quantitative approach than a “diary” might suggest. It is part of other academic, journalistic, and artistic efforts around the world to understand and document life during the pandemic, providing an intimate glimpse into the subjective experiences underlying the news headlines. Wuhan Diary, a WeChat diary from Chinese writer Fang Fang, documented the beginning of the outbreak in China in January. CoronaDiaries, a study by social scientist Michael Ward at Swansea University in the UK to record daily life during the pandemic, was inspired by citizen diaries documenting life during World War II.

With fears of winter spikes in Covid-19 cases and anticipation for the vaccine, the pandemic will continue to be a part of people’s lives in Taiwan and internationally in one way or another. While Lee’s study specifically concerns Covid-19, it has bearing on our understanding of all situations of isolation due to infection prevention. While it may not offer a playbook on how to keep sane or socially connected during this time, it reveals the peculiar costs and adaptations people make for a life suspended from normal.

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TNL Editor: Nicholas Haggerty (@thenewslensintl)

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