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Taiwan resistance segregation { May 12 2003 } Original Source Link: (May no longer be active)
http://www.nytimes.com/2003/05/12/international/asia/12TAIW.htmlhttp://www.nytimes.com/2003/05/12/international/asia/12TAIW.html
May 12, 2003
SARS Fight in Taiwan Is Impeded by Resistance to Segregation
By DONALD G. McNEIL Jr.
AIPEI, 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.
Because his mother was a nurse at Hoping Hospital, and fell ill with a high fever and breathing problems, he was asked to leave the Chien-kuo School, Taipei's most demanding, on April 25 and stay home. But on April 29, worried about his final chemistry exam, he went to his cram school — private teaching facilities used by many students — for extra work.
The next day, he too fell ill. As a result, his cram school was closed, and 47 of his Chien-kuo classmates and 14 teachers were sent home into quarantine.
He was "just regular, not a freak, not a troublemaker, a mid-top-level student," said Lu Tseng-tsiang, the school's dean of academic affairs. "Teachers liked him."
Mayor Ma, a graduate of both Chien-kuo and Harvard Law School, said Hsiao, assuming he recovers, will be fined $2,000. "I had to make that decision to make sure everyone obeys the rules," Mayor Ma said.
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