SARS Fight in Taiwan Is Impeded by Resistance to Segregation
May 12, 2003
By DONALD G. McNEIL Jr.
TAIPEI, Taiwan, May 11 - In theory, Taiwan is the perfect
laboratory for quarantines.
It is separated by a hundred miles of water from the
Chinese mainland, the epicenter of the severe acute
respiratory syndrome epidemic. Its vigorous economy
produces all the thermal-imaging cameras, cellphones and
electronic bracelets that a high-tech health authority
might covet. Although martial law is a thing of the past,
it still keeps lists of every resident of every apartment
on every alley.
To control its outbreak, Taiwan has largely cut itself off
from the world. Noncitizens may not enter from the Chinese
mainland, Hong Kong or other affected areas. Citizens who
do must stay home for 10 days, wear surgical masks and call
in their temperature twice daily. Anyone arriving with a
fever greater than 100.4 degrees Fahrenheit is taken away
by ambulance.
Yet the authorities here are struggling to keep their
citizens in quarantine, especially when almost all the
23,000 people in home quarantine are fine. In response,
Taiwan's Interior Ministry said today that it had spent
about $350,000 for 2,000 video cameras to be installed in
quarantined homes. It may also employ satellite tracking
devices, or house offenders in military camps.
In contrast to authoritarian Singapore, Taiwan is a model
of how hard it can be to set up an airtight quarantine in a
democracy.
"In Taiwan, a guy who's caught drunk driving will refuse
the breath test and curse the policeman to the third
generation," said Loh I-cheng, a jovial former deputy
ambassador to the United States. "Everyone in Taiwan thinks
he's special and smart - why should he observe the rules?
He knows the police won't strike him or arrest him."
Last Monday, the Interior Ministry released figures showing
that 42 percent of people arriving at airports who were
supposed to register with their local health authorities
had not. On Thursday, the figure dropped to 21 percent.
On Saturday, the World Health Organization reclassified
Taiwan as a place where the SARS outbreak is spreading in
unknown ways, because doctors cannot say how 6 of the 184
people with SARS here became infected. Thus far, 18 have
died.
Meanwhile, the institute that serves as the de facto
American embassy here said dependents and nonemergency
staff could fly home at government expense - a step that
the United States Embassy in Beijing took six weeks ago in
response to the growing epidemic there.
"Any case with an unidentified source means there could be
more transmissions out there and people could be at risk,"
said Dr. Cathy Roth, leader of the two-person W.H.O. team
advising the government here. "So there's great urgency to
clarify how much of a problem there is. It might be a small
number, but even if there's only one, it's imperative to
determine exactly what the situation is."
Despite alarmist local headlines, the situation here is
more reassuring than that in Beijing, where 54 new cases
were declared today, and a representative of the World
Health Organization said that the source had not been
traced for about half of them. The total number of reported
cases for the Chinese mainland is now 4,885, with 235
fatalities.
When cases in Taiwan are tracked by the onset of symptoms,
rather than by when they are reported, new ones here have
been steadily declining since the mid-April outbreak at
Hoping Hospital, where a misdiagnosed patient infected at
least 35 others.
"The next few days are critical," Dr. Roth said. "Most of
the cases from Hoping are out of isolation or almost out.
We'll be able to tell if there's a fresh wave of
outbreaks."
In and around Taipei, where most cases are, an unknown
number of people have broken quarantine. Angry officials
warned that they face fines of up to $2,000 a day. A Taipei
housing project was closed on Friday after a body and two
people suspected of having SARS were found inside. About
200 project residents have disappeared, authorities said.
On television, Mayor Ma Ying-jeou of Taipei ordered
everyone not at home when the police swooped in to come
back, but some fled. A motorcyclist who asked health
workers about fines sped off when they tried to question
him. A young resident with two children told reporters at
the cordon that she was too frightened to go home.
The Wan Hua district around the housing project is one of
Taipei's oldest and poorest. Cab drivers call it "the SARS
quarter" because Hoping Hospital is nearby, and because it
contains many hard-to-trace homeless people and illegal
immigrants smuggled here aboard fishing boats.
In one apartment, a 30-year-old unemployed man who answered
his door without a mask was warned to wear it or be fined.
A few blocks away, a young woman who normally designs dolls
at a mainland toy factory said she was bored of watching
TV. But she did not regret fleeing her job. "Transmission
was very bad among the factory workers," she said. "Many
Taiwanese are dying over there."
Another shut-in, a retired military officer, said he
resented being isolated for spending "one day in Macau on
private business."
But people often slip away to pursue their professions. A
car thief arrested in a parking lot turned out to be one
such evader. A missing businessman was closing a deal,
though it turned out he had his ward office's permission
because he agreed to wear a mask and use his own car rather
than the subway. A well-known television journalist who
often works in Hong Kong has been accused of dodging the
law by flying via non-SARS cities.
Taiwan's most infamous quarantine violator is a high school
junior identified only as Hsiao. He is now hospitalized
with SARS.....
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adopted from www.nytimes.com
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