Taiwan’s digital capabilities have played an important role in strengthening its COVID-19 response.
However, while digitalization has strengthened Taiwan’s response, the coronavirus has also exposed a number of ethical and human rights questions that must be addressed.
A cloud computing system to conduct mask rationing
Face masks have become a crucial preventive tool against COVID-19. Accordingly, Taiwan’s government has built up the capability to produce masks domestically. It has also developed a rationing system whereby each adult resident is able to purchase three masks per week. To ensure all residents comply with the rule, masks can be purchased at designated pharmacies, drugstores, and medical centers. These locations have the facilities to digitally scan National Health Insurance (NHI) cards, which allows the government to record purchase history.
Rationing in this way could be implemented because of the PharmaCloud system developed in 2013, which stores medical records in the cloud to aid in decentralizing health care. To ensure that this National Health Insurance Administration (NHIA) cloud computing system could “handle the additional load during the peak sales period,” engineers added 20 servers to NHIA’s network for a total of 32. This also ensured that the mask sale system “would not compromise the main function” of allowing health care institutions smooth access to medical records.
Citizen scientists develop real-time maps of mask stocks at pharmacies
Taiwan’s mask rationing program resulted in long queues at the pharmacies. Although the Ministry of Health and Welfare released a list of pharmacies and the stock of masks that would be available at each store, this did not solve the problem of long lines.
The online civic and tech community g0v took on the task of addressing the mask distribution problems. Citizens with IT skills and engineers used NHI data on pharmacy locations and mask stocks that were released by minister without portfolio Audrey Tang (herself a part of g0v) to create maps with real-time mask availability information.
Even before mask rationing was set up, Howard Wu, an engineer, had developed application programming interfaces (APIs) to provide data on pharmacy locations and mask supplies based on reported data from the public. The opening of NHI live data allowed Wu’s system to be further refined.
Online mask purchase trials
Taiwan is also conducting trials for an online mask ordering, or a “name-based rationing system.” Residents with NHI cards would be able to preorder masks online and collect them at convenience stores. The three masks per week restriction remains in effect. Due to its immediate popularity, web traffic initially overwhelmed the system despite undergoing reliability testing. After the first trial, the system was adjusted to enable people to collect their masks within a shorter time. The trial system will also be reviewed weekly for modifications.
A crowdsourced website to dispel misinformation
Taiwan’s Ministry of Justice Investigation Bureau (MJIB) has determined that 70 percent of the cases of misinformation surrounding COVID-19 have IP addresses from China. In order to fight misinformation, Taiwanese and Hong Kong netizens have also developed a website with the g0v community in which information can be found concerning where to find masks, travel information, explanations of individual cases, disease-related statistics, government announcements, and academic papers. The website allows anyone to update the content, as long as the content is verified with links to supporting materials.
Integration of health and immigration databases to track travelers with COVID-19 symptoms
Stringent testing protocol is currently the most effective way to contain COVID-19. The Central Epidemic Command Center (CECC), which was activated to coordinate inter-ministerial responses, decided to integrate travel history data from the National Immigration Agency (NIA) with the PharmaCloud system to allow doctors to have access to travel history.
Patient travel history helped doctors determine if patients with respiratory symptoms should be tested for the coronavirus. The database integration also enables the back tracing of patient records and travel history for retrospective testing.
Privacy concerns
This integration of data has raised questions on the privacy of individual travel history. Some patients have raised concerns that doctors would gain access to their travel history, though this is the only information available to the doctors. Nevertheless, patients are required to inform doctors of their travel history, regardless of whether the databases were integrated. The data integration therefore is seen as a measure to protect doctors against patients who choose not to divulge their travel history, otherwise which patients who test positive later on would not only result in the doctor and relevant healthcare workers having to go into quarantine, but be also potentially exposed to infection.
Use of phones to track individuals in quarantine
Home quarantines are another line of defense to fight COVID-19. To ensure that people given home quarantine orders do not leave isolation, Taiwan’s Department of Cyber Security has worked with Taiwan’s telecom carriers to track location using phones. The “electronic disease prevention platform” was developed by Chunghwa Telecom in February; it was enabled in mid-March. Taiwan’s Centers for Disease Control (CDC) first compiles a list of people who have been placed under isolation or quarantine orders. The list is then reviewed by local health and civil departments to ensure the individuals could be contacted at the mobile number and addresses they provide. These numbers are then sent to one of Taiwan’s five telecom companies. GPS data from the user’s mobile phone is used to track their movements based on the triangulation of base station data. If the quarantined person leaves their home, an alarm is triggered on the phone and sent to local police, health, and civil affairs agencies. The authorities also call individuals twice a day to ensure that they do not leave their home without their phone, and individuals who do not have GPS-enabled phones are given one.
Privacy concerns
Although the government has claimed that the Communicable Disease Control Act and the Special Act on COVID-19 Prevention, Relief and Restoration gives the CECC the authorization to enforce disease prevention measures, privacy remains an issue. Specifically, GPS tracking would give the government access to user data, though the National Communications Commission (NCC) has denied that this constitutes a violation of privacy, stating that the “use of the platform would not infringe upon people’s privacy.”
Disclosure of travel history data of confirmed COVID-19 cases
An undocumented worker was Taiwan’s 32nd COVID-19 case. She was a caregiver to the 27th case, a man in his 80s. It took authorities four hours to locate and test her. However, the government decided to release her movements on CDC’s website to remind people who visited relevant locations to conduct self-health management for 14 days, on the basis that she had made “frequent visits to train stations and MRT stations,” and that it was therefore difficult to trace the people who had close contact with her.
Privacy concerns
The release of the travel history of the migrant caregiver sparked media inquiry into how data was obtained. Another aspect of the controversy is the “social stigmatization of migrant workers. It also revived the debate on the working conditions of migrants, and how the “increased scrutiny” during this time is also a barrier for them to seek medical help. Taiwan CDC deputy director Chuang Jen-hsiang said in response to these criticisms that that was not the first time they had released the travel history of confirmed cases, as it was also done to a Taiwanese businessman who was confirmed to have COVID-19 in January.
READ MORE: Audrey Tang Praised for Coronavirus Prevention Tactics
TNL Editor: Nicholas Haggerty (@thenewslensintl)
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