5/11/03            What It’s Been Like—Taiwan during the Scare

 

            SARS seemed to have snuck up behind us in Taiwan and suddenly exploded in our face—from being something we heard about in the news, something that compelled only the most paranoid Taiwan locals to wear masks occasionally in the subway—to a pervasive presence in our everyday lives, on our lips in every conversation, every greeting and farewell and email (“See you soon, and stay safe—don’t get SARS!”  or “Take care, and stay away from SARS!”  as if infection’s so completely voluntary).  We foreigners who first laughed at the masks—finally gave in and are all wearing them too.  All a little worried about being barred from our trips home.  Many of which, coincidentally, have all been shoved up weeks earlier than planned.

 

            Since the first cases in mid-March for about a month, Taiwan was boasting its all-0 record:  0 deaths, 0 within-country transmissions (all cases were from travelers who were infected in Hong Kong or China).  The numbers climbed, but slowly, and the word on the street was a little worried, but “Taiwan hai hau.”[not too bad].  This I kept reassurring family and friends at home.  Then, in April at Heping Hospital (where Agong stayed once and I went to see him in March), SARS broke loose.  And thus so did hell.

 

            Within that week, it seemed to me mask-wearing went from about 10% of pedestrians to about 40-50%, and stores sold right out of the “N-95” masks and their similar counterparts (supposed to filter out 95% of all contaminating particles, made by 3M), everyone and their second cousin was trying to get their hands on one; you could only get one if you had a “connection”—it’s an N-95 mask black market, I no kid.  I finally asked my coworker Evil if he knew where to get them, sure that NTU must have some in their medical store—but they were sold out there, and he laughed the first time I asked:  “[Why, are you worried?]”  But in a few days he’d bought a bunch through a connection, I paid him for a couple.  Still I carried it in my bag everywhere and never wore it, only once when I had to go to the old NTU hospital for a doctor’s appointment (making sure to renew my prescriptions with the super-cheap insurance I have here, before going home).

 

            So the whole Heping hospital was quarantined and the news channels had a field day.  The non-SARS patients inside protested in a panicked frenzy, holding signs up to the windows:  “Let us out, if we stay here we meet OUR DEATH.”  One of the patients attempted suicide to escape “the horror of SARS.”  Yes, better to meet certain death by killing yourself, rather than face the risk of possibly getting an illness from which you, with relatively low probability, may die.  The head of DOH, widely praised weeks ago for her good work in keeping SARS under control in Taiwan, was suddenly cursed and denounced from all sides.

 

            When Gulf War 2 started, the news channels were reporting about ½ the time on the war, ½ the time on SARS.  The precipitation of SARS events in Taiwan coincided with the wrap-up of the war, so naturally the media has to take their one remaining newsy thing left and milk it for all they’ve got.  What a ball they’re having; the old newscasts were always about fistfights in political meetings, extramarital affairs of celebrities, and Taiwanese women’s attitudes on ideal breast size.

 

About every week after the Heping incident, another hospital was reported with an “outbreak” and quarantined, people would stop passing anywhere near the area, and the surrounding businesses and restaurants would suffer huge losses.  When the second one broke out shortly after Heping, we Fulbrighters got an email from AIT (we’re getting at least twice-weekly emails from them on “Travel Advisory Warning to [fill in the blank with Asian country or Canada],” for SARS precautions; or “Travel Advisory Warning to [fill in the blank with anti-American-terrorist ridden country],” for terrorism precautions.  I no longer read them long enough to distinguish which is which) advising against going to ANY hospitals in Taiwan unless for a medical emergency.  I read this email while at NTU MC—where I was still going daily, for doing my very non-emergency, not extremely necessary, Fulbright project.  I finally started getting a tad concerned.

 

More so when, last Friday of April, I came in around 3PM (was getting in later each day, enjoying long lunches with the slackers-with-lots-of-time-on-their-hands, a.k.a. Ginger, Niclas and Tricia), and Evil and XiangGiun exclaimed, “[Grace, you shouldn’t have come!  They’re disinfecting the whole hospital and med school at 3:30 and we have to leave.]”  Say what??  I immediately thought that a NTU worker had come down with it.  [“Um, why are they suddenly doing this, did something happen?]”  Evil chuckled and said because of the Heping incident, all the hospitals are just taking precautions.  We kept working to wait for word that we had to leave.  Suddenly, mid-conversation with ChiYuan about applying to PhD programs, we heard a noise like a huge vacuum cleaner out in the hall and were ordered out immediately.  A foul chemical smell filled the air and everyone with masks put them on and ran out—my psuedo N95 worked pretty well at keeping out the odor.  I called my English student to tell her I’d “gotten off work early today” and could come for an earlier lesson.

 

When going to work everyday I used to waltz into the hospital lobby front door and cut through to the med school.  Later I changed it to walking all the way around the block to the side med school entrance to be safer.  I’d always known from the start of SARS that the first main isolation ward was in NTU hospital and there were SARS patients inside.  Who knows how many other hospitals were holding some, but the list wasn’t released to protect the hospitals’ privacy.  I’d stopped eating food from the hospital cafeteria.

 

 I’d started noticing SARS signs on buses and MRTs, said they were disinfected for SARS regularly and safe for traveling.  Some stores and restaurants had signs saying something like “[Because of concern about SARS, if you have a fever, please don’t come in.”]  Rumors abounded--why SARS wasn’t spreading to other Asian countries like Korea (all the kimchee/spicy food and garlic gives immunity against it!) and how it might be spread by cockroaches (in which case, we’re all screwed).  The WHO and CDC websites kept having the same vague information, only updating the statistics of cases in countries each week, never said anything about recommending facemasks, but people kept trusting in masks, they’ve become the symbol of SARS protection.  Even though it’s been said that only the N95’s are effective at protection, or that it’s more important to wash your hands, or wear gloves rather than a mask, or that masks only help prevent an infected person wearing it from transmitting to another person, not the other way around.  And naturally, fake 3M N95 masks of all kinds abound.  Most even take the trouble to print the 3M logo on top, but if they’re blank and you ask about the logo, the vendor will say, “[Since they’re so high in demand right now, production is so fast they don’t take the time to stamp the logo.]”

 

Taiwanese people watch TV and the news (which I’ve established, is so professional and high quality—they love writing “SARS!” in scary font and with scary background music, and their Chinese accent pronounces it “Sa-si”, which in Chinese also means “to murder”) all day, and sit around gossiping about hearsay, and worrying, and making other people worry with them, especially older people like my aunts, who don’t go out in the first place, and drive cars and have kitchens, so they can’t believe people are actually still daring to use public transportation or eating in restaurants.  And thus I get late night calls from my worried mother who, if she were peacefully watching the U.S. news would never even know Taiwan has a problem (or that Taiwan is a country, not a city called “Taiwan, China”), and who tells me she heard such-and-such horror stories from my aunts.  Because certainly, she doesn’t worry enough about me on HER OWN, she has them to ADD to her worry, which pleases me enormously. 

 

“It’s best not to go to places with lots of people,” she says, which in Taipei is about as possible as seeing a patch of grass. 

“But Mom, I can’t just stay holed up at home all day.  I have to use the MRT and bus to get around.” 

“Well, it’s best not to eat out.” 

“But Mom, I don’t have a kitchen, I can’t cook, I have to get food outside.”  Finally, for lack of other suggestions:  “Well, before you eat—always PRAY!  Just PRAY!!”

 

One day I did notice another increase in mask-wearing, especially when I transferred at Taipei Main Station MRT.  I haven’t been watching the news because of disgust over the media melodrama, so I wondered if something new had been reported that day.  Well the past few days security guards stationed at the med school entrance had asked why I wasn’t wearing my student ID and I just made stuff excuses since no one ever understands what my researcher status is.  I decided to avoid the hassle and go through the front hospital door.  But security was everywhere, the doors were closed and they were turning people away.  I told him I just wanted to go to the med school and he told me to use the med school entrance.  When I got there the guard told me I needed to get a visitor ID made from my department.  My last week in Taiwan, and I finally got an NTU ID.  Also, there was now mandatory mask-wearing in the hospital and lobby, and everyone wore them in the elevators.  A week before I’d felt weird and a little embarrassed to be wearing one—now I felt weird if I were the only one barefaced.

 

The Department of Health began transferring SARS patients from the quarantined hospitals to other clinics, and set up special SARS clinics in more remote areas.  The places who were receiving them would protest (“You bring death to our homes and children!”)  and the mayor of one city even barred them from entering until the feds forced him to give in.  The airports tightened, taking temperatures (one man, traveling around Taiwan, to Hong Kong and back, refused every time to have his temperature taken, and had to be restrained, security struggling with him on the floor.  Yep, the news was all over it).  and stopped granting visas completely to visitors from China, Hong Kong, Singapore, Vietnam, then Canada—seen as the strictest visitor policy of all the countries.  Canada denounced Taiwan for being so unreasonable--around the same time they were on their knees trying to pay people to come watch ballgames in Toronto. 

 

To clarify:  I have never been worried about actually getting SARS (and am still not—sort of).  I have always been (and am still) vocal about the fact that statistically speaking, in Taiwan the best way to put your life in danger is to cross the street. 

 

But somewhere among the media frenzy the main concern turned from fear of SARS itself, to fear of being suspected of having SARS, and thus getting locked up, outcast, pariahed, branded…and me, barred from boarding my plane when I was looking at only three weeks away from home.   I had originally booked my tickets for the 20th with the express purpose of being home in time for Brown reunion and Dave’s graduation.  If, by chance, NTU had an outbreak, I’d be stuck—not like you can make a run for home when they decide to suddenly seal the place off—and miss both events that I’d been planning since the beginning of the year. 

 

End of April.  Made a quick decision to ask Northwest about moving my plane ticket earlier, hoping the change fee wouldn’t be too bad.  To my surprise, they changed it in a snap, no questions asked.  I wasn’t about to ask, “Aren’t you forgetting you’re supposed to charge me a fee?” but they said that they were now allowing a one-time free of charge change of date (normally is $150US) because of the “military action.”  I wasn’t sure what that meant or maybe her English was off, but wasn’t going to question her.  Whoohoo!  And suddenly I had under two weeks to go—excited, but at the same time the felt the first real pangs about leaving.

 

May 1st .  I burned my data on CDs, packed up my desk at the office, and explained to Dr. C my concern about coming to NTUMC, getting quarantined here (just the slight possibility), how the timing is bad when I’m almost about to go home.  He understood, but it’s rather awkward to have to explain this to them when they still have to come in here to work, every day, all day.  That was also the day CDC put Taiwan on their travel advisory list.  We got the email from AIT:  “Travel Advisory Warning to:  Taiwan.”  It rang with a sort of finality—after all those countries, all those emails, finally now it was us.  And typically brilliant of AIT to send a mass email to all the expats living and working in Taiwan, a travel advisory telling them best not to go there.

 

The WHO sent over a couple representatives supposedly to express their concern and support for Taiwan (and make up for listing it as “Taiwan, China” on their SARS website).  Anyone could see from miles away Taiwan would throw all their weight behind SARS as leverage for their long-standing argument to be allowed to join WHO at least as an observer—pretty much a no-brainer decision that would long ago have been unanimously granted if not for China (where SARS stands for Safe, Accurately Reported Statistics).  This is somewhat akin to… Well say you have this school, and this one kid really wants to enroll, he’s begging just to watch the classes from outside the window, promising he’ll be quiet and won’t let out a peep.   You all decide not to let him in.  However, you approve of his desire for education and goodheartedly send him a book and a pencil.  Oh, and the reason you won’t let him in is that one out of your 200 teachers doesn’t like him.  Because the kid calls him “Mister” instead of “Teacher.”

 

But the inside scoop is that they were here to check out how the DOH was handling things, or messing up in their handling of things--given the WHO visit coincided with the point where the rate of new SARS cases in Taiwan hit a peak and CDC put it on the list.  And, the same week I got a call that AIT wanted my opinion, as a public health person, on how Taiwan was handling the disease.  The Taiwan policy of transferring SARS patients to various locations was supposedly to distribute the burden of caring so no one hospital would be unduly strained.  This was completely different from how the other countries have been handling it and WHO expressed that they didn’t recommend doing this. 

 

Four Fulbrighters that I know of, including myself are now leaving early.  I had stopped using the showers at my gym, then this past week stopped going altogether  (mostly because I was too busy).  Every school (MTC was one of the last), department store, large restaurant, McDonald’s, even Erica when I went for my last tutoring session, takes your temperate before letting you inside (using the non-accurate ear method), and some spray your hands with disinfectant.  Many people are using antibacterial hand gel all the time (which I disapprove of).  Hello, SARS is a VIRUS, but as long as we’re having a public health crisis, let’s all contribute to the problem of antibiotic resistance while we’re at it.

 

 Across the street from me in SOGO a worker and two customers she had were hospitalized as suspected cases and when the news reported it, sales dropped 70% and the managers threatened to sue the government if the cases were not confirmed as SARS.  The test results came back, and?  The entire department store is shut down for three days for disinfecting, and not a peep about suing.  Good thing I never go in there since they’re so overpriced.  In fact I think anyone who’s ever gotten ripped off there is just a little smug at their sudden misfortune.

 

The tiny mom-and-pop places, the restaurants, the vendors, especially ones near the hyped-up quarantined places, that’s who I feel most sorry for.  The economy was struggling already before, but still people were going out in swarms to sing their KTV, eat their desserts and drink their teas on the little streetside stools.  Now?  I don’t remember the last time I waited in line for the MRT or had to squeeze into a car against people.  Here in Taipei where the noisier and more crowded the restaurant, the better—it is almost unrecognizable.  Signs in every elevator say “[For concern about SARS, please no talking in the elevator.]”  The government is paying huge salary bonuses to SARS healthcare workers. 

 

Today was Mother’s Day.  It was also the first day face masks became mandatory in the MRT.  Yet no one can find them anywhere.  I passed a street vendor selling them day before yesterday and decided to come back for them later—now she’s gone.  Tricia gave me another.  People in the south of Taiwan can’t get them and are improvising—using the cups of women’s bras.  Chinese- Americans and Canadians are donating, shipping masks over by the thousands.

 

The quiet, locked, unlit front of SOGO is still hung with Mother’s Day Sale banners. 

 

We’ve had our last dinners, last drinks and toasts.  I leave tomorrow.  I’m not afraid of SARS.  Only afraid that people at home will be afraid of me.

 

 

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