Taiwan COVID-19 entry requirements: Entering is like being stuck in Squid Game

For the first two years of the pandemic, its strategy of closing the borders to all but citizens and permanent residents, and even then, demanding strict 14-day quarantine for all arrivals, saved thousands of lives and the economy until vaccines could be created and distributed.

But the highly infectious omicron variant which has surged around the world has made this 'zero COVID' policy impossible to maintain.

While China has doubled down, barricading entire streets in Shanghai and confining people to their homes - sometimes even bolting them in - Taiwan is embracing this new reality, slowly reopening and grappling with how to safely switch from suppressing the virus to mitigation.

Experts say there is little point in keeping border quarantine as omicron sweeps the nation and dwarfs incoming cases - an argument that was acknowledged by Chen Shih-chung, Taiwan's health minister on Friday, who said the country would start to relax its border controls gradually in June.

'The CECC cares for you'

The quarantine mandate was already lowered from 14 to seven days earlier this month, and Mr Chen said Taiwan had reached the point where the risk of domestic infection was the same or higher than the risk coming from outside.

On the day we arrived just 28 cases were found at the airport, compared with 57,188 within the local community. On Friday, confirmed domestic infections were 94,808 and 47 overseas arrivals.

Among the arguments to reduce or scrap border quarantine are the precious resources it consumes that could be used elsewhere.

I felt guilty as we were given two rapid home tests at the airport, knowing that people were queuing outside Taipei chemists for hours for short supplies.Travellers still have to test on day seven of quarantine and report the results to the Central Epidemic Command Centre (CECC) or face a fine of up to £4,000.

For the seven-day period, we were assigned a CECC liaison officer - the helpful Mr Chen - who offered advice on the rules and arranged for the special collection and disposal of our household garbage.

Every day at 10.02am a text message arrived asking us to report if we had symptoms or not, signing off with the charming phrase: "The CECC cares for you."

It's an efficient system that functions like clockwork, but Taiwan has other priorities now.

In reopening, it is now following the path of regional neighbours South Korea and Singapore, who in the past few months abolished quarantine for fully vaccinated travellers as they try to learn to live with the virus.

"At this stage of the pandemic when the virus is less virulent and more transmissible, the risk vs benefit ratio of quarantine is substantially altered," said Singapore-based Prof Paul Tambyah, President of the Asia Pacific Society of Clinical Microbiology and Infection.

"In other words, the benefits of retaining quarantines are small compared with the costs. These costs include indirect costs which could have an impact on healthcare well beyond COVID," he said.

"The diversion of resources to maintaining and enforcing quarantine was not sustainable in Singapore and I suspect will not be sustainable for long in Taiwan. These resources are better spent ensuring that the vulnerable among the local population are appropriately diagnosed and treated."

Chunhuei Chi, director of the Centre for Global Health at Oregon State University and a former policy adviser to Taiwan's National Health Insurance Administration, agreed that while Taiwan had made the right decision to face the Omicron wave, it needed to bring its quarantine policies up to speed.

"It is contradictory to require quarantine at the border for longer than those who are infected domestically," he said. "Taiwan has been losing its international advantage since this Spring because most parts of the world already opened up for tourists and visitors."

Differentiating between the vaccinated and unvaccinated was an important public health message, he argued. Not least to persuade some 20 per cent of the 75+ age group who remain unvaccinated of the benefits of the jab.

Taiwan, like China, Hong Kong and some Pacific nations, faces a form of vaccine hesitancy unique to countries that followed a zero COVID policy - when the vulnerable elderly perceived there was no chance of domestic infection, they calculated the risk of vaccine side-effects would be higher.

But while the government had been under-prepared for the sudden surge, it was adapting fast to the new reality, he said.

"I am amazed how they constantly change their procedures," Mr Chi said. "They realised facing Omicron, Taiwan can no longer practice zero COVID."

Chia Wang, an aerosol scientist and Director of the Aerosol Science Research Centre at Taiwan's National Sun Yat-sen University, urged the government to update its advice on airborne transmission as the primary pathway of the virus and to emphasise precautionary measures.

"People should pay more attention to air cleaning because they pay more than enough attention to cleaning surfaces or handwashing but [this] is one key part that has been missing," she said, recommending ventilation in indoor spaces and HEPA filters.

"This is one of the most important keys to mitigate the pandemic in Taiwan," she said.

Taiwan is undergoing a huge mindset shift as it moves from its virus-free status as one of the world's only safe havens to a disconcerting vertical trajectory of infections, albeit largely mild or asymptomatic.

Travel between Taiwan and the UK is like entering parallel universes. It was mentally liberating to see people get on with their lives without fear of infection or stigma in Britain.

But Taiwan's caution and acknowledgement that the pandemic is far from over has, and continues, to save many lives. As we navigate this next phase, it somehow feels like East and West could meet in the middle.

The Telegraph, London