Fast and furious: Seoul and Taipei fight virus via central command

Linda J. Dodson

SEOUL/TAIPEI — South Korea and Taiwan have won praise and attention for fast and effective responses to the novel coronavirus that have so far allowed them to avoid the sort of damage seen elsewhere despite their proximity to the disease’s original epicenter of mainland China.

South Korea has seen over 10,600 confirmed COVID-19 cases so far but reported just 13 new cases on Monday. Taiwan has just over 400 cases in total, with six deaths. Authorities in both places say they consider the outbreak to be under control.

Both share similar approaches to combating the outbreak, based on strong central authorities born of lessons learned after the deadly severe acute respiratory syndrome (SARS) epidemic of 2003 and 2004, and the Middle East respiratory syndrome (MERS) in 2015 that killed 38 people in South Korea. 

The Korea Centers for Disease Control and Prevention is a ministerial-level government arm that is legally authorized in a public health emergency to request action from government agencies. The requests, in effect, carry the same weight as government directives.

The KCDC has sought police help with contact tracing and pushed the Ministry of Food and Drug Safety to speed up approval of coronavirus test kits developed by private-sector companies.

The food ministry wrapped up the normally yearlong approval process in just a week and granted its first authorization for emergency use of the kits on Feb. 4, opening the door to large-scale testing by private-sector medical institutions.

In Taiwan, the government has invoked legislation from its SARS response to establish the Central Epidemic Command Center. The cross-agency body has broad legal powers of the sort normally reserved for governments, including authority to shut down schools, restrict events and gatherings, and control public transportation and the production and sale of face masks.

Taiwan has also been willing to penalize residents who fail to abide by its anti-coronavirus measures. People who do not self-quarantine after returning from abroad, for example, may be fined up to 1 million New Taiwan dollars ($33,300). About 460 people had been arrested for such violations by mid-April.

In the U.S., the Centers for Disease Control and Prevention is also given strong powers. Under the secretary of health and human services, who has statutory responsibility for preventing the introduction, transmission and spread of communicable diseases, the CDC is empowered to fulfill these goals, with the authority to run quarantine stations at ports of entry and conduct medical examinations of people entering the country.

In January, the CDC installed a mandatory 14-day quarantine for Americans returning from Wuhan, China, the first such order in half a century.

But, even with the legislative muscle, the CDC is under criticism for mishandling the initial response to this outbreak. Instead of using test protocols published by the World Health Organization on Jan. 17, based on German research, the CDC insisted on using its own test, saying that it was important to guarantee the quality of testing.

As a result, the development and production of the tests took time. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, a key figure in the Trump administration’s coronavirus task force, admitted in a congressional hearing that the initial testing system was a failure.

Unlike its Asian neighbors, Japan largely avoided the brunt of the SARS and MERS epidemics. As a result, domestic debate over bolstering pandemic preparedness has lagged.

Japan has no central command post filled with experts to manage epidemics, like what can be found in the U.S., South Korea and Taiwan. The closest thing to such an agency is the National Institute of Infectious Diseases.

But the NIID is mostly concerned with research, with no authority to determine or implement a wholesale plan of action against an epidemic. The institute is basically a collection of public-sector researchers under the umbrella of the Ministry of Health, Labor and Welfare.

“The NIID is limited in terms of budget, staffing and the law,” said Chihiro Sasakawa, director of the Medical Mycology Research Center at Chiba University. “It may be functional during normal times, but during a ‘wartime’ situation like now, it’s difficult to fully take up countermeasures.”

Some are calling for the Japanese government to set up an agency identical to the Centers for Disease Control in the U.S., since it operates largely independently from the Department of Health and Human Services, to which the body is attached. Critics say simply increasing the NIID’s staff and budget would not be as effective, and would amount to pork-barrel spending benefiting the Japanese health ministry.

Additional reporting by Taisei Hoyama in Washington and Yosuke Kurabe and Ryo Nemoto in Tokyo

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