How to Respond
Platform for Sustainable
Health Management
Solutions
Database
National Health Emergency System
ICT-based Response System
National Health Emergency System
Country Examples: Republic of Korea, Taipei,China, Singapore, and Uzbekistan
Comparative analysis for country cases
Governance Health Economic Social
Republic of Korea
  • National infection disease management system: previous experiences from SARS and MERS
  • Institutional arrangement: CDSCHQ, KCDA
  • Legal system: Act on Prevention of Infectious diseases
  • Strong regional response capabilities: Local Disaster and Safety Management Headquarters
3T
  • Testing: screening centers to classify cases, history check system, rapid and precise massive test(Real-Time RT-PCR)
  • Tracing: local immediate response team for quarantine & epidemiological investigation of confirmed cases, and ICT based tracing tools
  • Treatment: designated national safety hospitals (separate patients), Life treatment centers
  • Four supplementary budget proposals (285 tril. won prepared): 135 tril. for people’s livelihoods and financial stability, 40 tril. for basic industrial stabilization, and 46 tril. in additional reinforcement measures
  • Financial Stimulus Package: Korean New Deal (Digital New Deal + Green New Deal)
  • Assertive citizen participation for social distancing
  • Public mask provision: 5-day rotation system
  • Schools open under guidelines
  • Restriction stage 1 allows 2/3 and stage 2 allows 1/3 of the student body on campus at any one time
  • Wearing mask
  • Screening travel record
  • Social distancing
  • 14-day closing when confirmed cases
ICT component
  • Transparent: Cell Broadcasting Service(CBS) for emergency disaster information in Korean, English and Chinese
ICT component
  • Tracing tools
  • Smart Management System(SMS): real-time check of movements by confirmed case
  • KI-pass: digital customer register system
ICT component
  • Digital New Deal
  • Enhancing the level of technology
  • Promoting promising non-face-to-face industries
ICT component
  • Face masks: Public Procurement Service (PPS)
  • Distance learning: Learning Management System(LMS) platforms
  • Online religious activities: Drive-in worships supported by Ministry of Science and ICT.
Uzbekistan
  • Reforming the existing organizations and establishing new organizations to rapidly and effectively respond to COVID-19
  • Inviting COVID-19 National Advisory Officer from Republic of Korea to resolve the medical and technical problems
3T
  • Testing: RT-PCR, antigen and antibody testing, development and manufacturing test kits, establishment of National Reference Laboratory
  • Tracing: epidemiological investigation of confirmed cases and development of ICT based tracing tools in the early stage of the COVID-19 spread
  • Treatment: temporary triage centers, 10,000-bed purpose-built hospitals
  • Nationwide financial assistance: creating Anti-recessionary fund under the Ministry of Finance
  • Support of entrepreneurship and employment
  • Expansion of social support
  • National lockdown(two times)
  • Distance learning: free access to information and educational sites, and online classes from the national TV, online examination
ICT component
  • COVID-19 Information
  • Websites (Coronaviurs.uz)
  • Telegram bot: COVID-19 response related Q&A
  • Telegram channel: sharing COVID-19 latest news articles
  • Call center 1003: provision of the medical recommendations from teaching professors and doctors
ICT component
  • Tracing tools
  • Self-Safety: government driven GPS and bluetooth based tracing application
ICT component
N/A
ICT component
  • Distance learning: Online-maktab (“Online School”)
Taipei,China
  • Rapid and transparent response with expertise from previous experience (SARS)
  • Centralized command system and immediate action
  • Central database: National Health Insurance(NHI) system
  • Local follow-up on detecting & monitoring
  • High-tech surveillance system
  • Real-time surveillance
  • Rapid risk assessment
  • Border control & quarantine
  • Laboratory capacity building
  • Economy forecast by ADB: 0.8% growth in 2020
  • Industrial relief and economic stimulus
  • Special budget (NT$60bil.+NT$150bil) for individual tax breaks, household expense subsidies, industrial relief and business tax cuts,
  • Additional NT$210bil. Special budget for financing prevention, relief & stimulus measures, R&D vaccines
  • Social trust on leaders
  • Name-based mask distribution system
  • Normally functioning schools under the pandemic with guidelines
  • Wearing masks
  • Screening travel record
  • Social distancing
  • 14-day closing when confirmed cases
  • Dialogue between government and religious leaders for cooperation
ICT component
  • Bilingual chatbot by Taipei,China CDC supported by Google provides latest information to public including foreigners
ICT component
  • Tracing mechanism:
  • NHI-MEdiClouds system: check travel history of patients and determine potential infection cases
  • Electronic referral platform: judge infection condition of people in quarantine
  • Quarantine measures:
  • Quarantine System for Entry: travelers’ information integrated for 14-day quarantine
  • Digital Fencing Tracking System: tracking people in quarantine
  • Technical platform of COVID-19
  • Development of vaccines, drugs and rapid test kits
  • Specimen application mechanism
ICT component
N/A
ICT component
  • Mask website or the NHI App from a mobile phone
  • Distance learning:
  • Can be adopted by school’s decision: tools and training for online provided to faculty
  • Face-to-face class is prioritized
Singapore
  • Rapid and transparent governmental response
  • Strong travel restrictions to prevent imported cases
  • Multi-ministry taskforce by Health Minister and National Development Minister
  • Communication to the public: leadership of the Prime Minister
  • Large scale testing and tracing
  • Production of testing kits
  • Contact tracing operation 24/7
  • Health sector capability from experiences of SARS, MERS, and H1N1
  • National stockpiles of Personal Protective Equipment
  • Critical medications and vaccines for up to 6 months
  • National Centre for Infectious Diseases Singapore : 330-bed purpose-built facility
  • Four fiscal packages: assist workers & businesses
  • Stabilization & Support Package (S$4bill.): help business & workers
  • Resilience Budget(S$48.4 bill.): support household and specific business sectors
  • Solidarity Budget (S$5.1bill.): mitigate effect of circuit breaker
  • Fortitude Budget (S$33bill.): job creation
  • Post-COVID-19 response: Emerging Stronger Taskforce (EST) include multiple stakeholders to reset economic strategies to increase resilience
  • Civic engagement for distance learning
  • Mask: shortage of mask in the beginning, thus governmental distribution. Wearing mask when ill in the beginning, yet became mandatory
  • Distance learning: home-based learning. When on campus, mask wearing, temperature check and sanitizer required
  • Migrant dormitories have difficulties for social distancing
ICT component
  • Digital media capability
  • Facebook communication by Prime Minister
  • WhatsApp by MOH
ICT component
  • TraceTogether programme
  • Efforts for contact tracing through identifying proximity
  • Comprised of App & Token
  • Concerns on civil liberty and privacy
  • SafeEntry contact tracing system
  • digital check-in for visiting hotspots, workplaces
ICT component
N/A
ICT component
  • Distance learning: a personal laptop or tablet to all secondary school students for online learning, and lectures and tutorials at third level institutions online
Republic of Korea
Uzbekistan
Taipei,China
Singapore
Republic of Korea
The Republic of Korea has been recognized for its effective management of COVID-19 and has been studied as a potential model for a successful response to the pandemic. Through a high level of transparency and applying advanced science and ICT technology, efficiency could be maximized while effectively addressing the COVID-19 situation.
1.1 Governance
Due to its previous experience with infectious disease public health crises, the Republic of Korea has established a national infectious disease management system to effectively prevent new disease outbreaks. This system includes five main elements: 1) Declaration and report, 2) Monitoring and epidemiological investigation, 3) Vaccination, 4) Blocking the transmission of infection, and 5)Prevention.

In order to strengthen regional response capabilities, the government established local government’s Infectious Disease Control Center that consists of private experts. For wider response at a national level the Central Disaster and Safety Countermeasure Headquarters (CDSCHQ), also referred to as the Korea Centers for Disease Control & Prevention (KCDC), was established as a response system with the required expertise that is directed by the Prime Minister. Facing a second wave in late 2020, the KCDC was officially promoted to the Korea Centers of Disease Control and Prevention Agency (KDCA) on September 12th which now, among other changes, has jurisdiction over 6 laws including the Act on Prevention of Infectious Diseases along with the authority to execute them. This promotion enables the KDCA to be an independent administrative agency with greatly enhanced expertise and the ability to establish local response systems which allow local governments to cooperate in protecting local communities. This reorganization strengthens the Republic of Korea´s public health and medical capabilities (Office of the President, 2020).

The legal system, that has been developed through lessons learned from infectious diseases such as SARS in 2003 and MERS in 2015, played a significant role for the Republic of Korea´s quick response to the pandemic. The Infectious Disease Control and Prevention Act was revised in 2015 ensuring transparency and rapidness of information transfer as well as more efficient allocation of material and human resources. Legal frameworks are crucial for better management of crisis situations.

The Local Disaster and Safety Management Headquarters is operated under the authority of local governments which enables rapid establishments of teams in outbreak areas. Coordination between central and local governments is promoted through a central-local working consultation body that is organized under the deputy head of Central Disaster Management Headquarters (The Government of the Republic of Korea, 2020). Even though the general success at the initial response to the pandemic was through centralized management of national authority, what also has been critical in building a rapid national responsive framework were active collaboration of the public and private sector and public-private partnerships such as tracking infection cases and eventual development of testing kits and R&D.

The Korean government provides transparency through daily briefings, regional and national statistics of current confirmed patients, deaths, diagnostic tests, and releases from quarantine. Information that the public needs to know to prevent infection is disclosed on the website of the Ministry of Health and Welfare, by communication networks, and by press release whenever a confirmed case occurs.

As the government aims for herd immunity by November of 2021, people started to be vaccinated from February 26th of the same year. On April 1st, the government launched a pan-governmental task force. The Ministry of Health and Welfare leads the general tasks, in close cooperation with relevant agencies including the Ministry of Foreign Affairs, the Ministry of Trade, Industry and Energy, the Ministry of Food and Drug Safety, the KDCA and the Korea Customs Service to facilitate faster approval and supply or global cooperation. The task force aims to monitor an overall situation regarding introduction of the vaccine and resolve any difficulties that may arise during the procedure (Ministry of Health and Welfare of the Republic of Korea, 2021). A revision of the Act on Prevention of Infectious Diseases that was passed by the Congress in February provides a legal basis to increase the efficiency of preventive measures in long-term and assure smooth functioning of the vaccination process.

The KDCA also announced that digital ‘vaccine passport’ can be issued to nationals who get vaccinated as a kind of immunization certificate. To prevent forgery and minimize use of private information, the system utilizes blockchain technology and decentralized identity (DID). The KDCA signed an MOU with a venture company which possesses relevant blockchain technology for further development (The KDCA, 2021).
1.2 Response in health sector
The Republic of Korea´s response to COVID-19 followed the strategy of the 4 T´s: Testing, Tracing, Treatment, and Transparency.

Testing
The Republic of Korea established and operates screening centers where patients with suspected infectious diseases receive separate treatment before they enter medical institutions. Through this, large-scale rapid diagnostic tests are possible. Individuals to be tested are classified as a Confirmed Case, Suspected Case, or Patient Under Investigation (PUI) based on test results, clinical symptoms, and contact history. Furthermore, through the systems of Drug Utilization Review (UDR) and International Travel Information System (ITS) visit histories can be checked for contaminated areas at the reception stage and efficiency and accuracy of first visits can be improved. The UDR checks patients’ medication history in real time and provides service 24/7. In addition, the Open Application program interface (API) service is used to disclose the state of operation of National Safe Hospitals and Screening Centers nationwide in real time (Ministry of Health and Welfare, n.d.). In collaboration with the KCDC and the Korean Association of External Quality Assessment Service (KEQAS), the Korean Society for Laboratory Medicine (KSLM) developed a reportable mass molecular genetic test method (Real Time RT-PCR) that quickly reports accurate test results within 6 hours. After verification, the method has been used by private medical institution since February 2020 and has been approved as an international standard (DIS) by the International Organization for Standardization/Technical Committee 212 (ISO/TC 212). Using self-developed test methods the Republic of Korea built the capability to perform 20,000 tests a day in March and rapid diagnoses technology allowed early diagnoses which lead to fast isolation of confirmed cases. As of 2021 March, a new, rapid PCR diagnostic kit which can reduce the time from testing to the result derivation has started to be introduced. Originally six hours was required, but through this new test kit people can get the results within less than an hour. These test kits started to be supplied to Incheon airport first, and other supply contracts are continuously being pushed with various institutions (Kim, 2021).

Tracing
With the experience gained for the MERS outbreak in 2015 the Republic of Korea releaised the importance of quarantine and epidemiological investigation in order to prevent the spread of infectious diseases from overseas. Systematization of epidemiological investigation process, training of human resources, and investment are now conducted between the government, the KCDC, and local governments. The purpose of the investigation is to quickly determine whether or not an infectious disease has occurred and to identify the source and transmission process. In case of an outbreak, local governments form an immediate response team and take charge of quarantine as well as conducting epidemiological investigation of confirmed patients. In order to cope with the large outbreak of COVID-19 a system was needed that conducts investigations fast and accurate. The Ministry of Land, Infrastructure and Transport (MOLIT) built the Smart Management Systems (SMS) that officially started operation on March 26th, 2020. Through the system routes of confirmed cases can be checked in real time and their movements are displayed on the map that is provided to epidemiological investigators. Also, due to false stated information from people involved in cases of mass transmissions at facilities where multiple people gathered, a digital customer register system (KI-PASS) was developed that is based on a Quick Response (QR) code and enabled correct information collection. As of April 1st, 2020 all inbound travelers to the Republic of Korea are required to go under a 14-day quarantine either at home or at facilities. Exempted from quarantine are diplomats, government officials or Quarantine Exemption Certificate holders, In order to monitor self-quarantined and quarantine exempted persons, the installment of the “Self-quarantine Safety Protection App” was mandatory to record daily health statuses. Self-quarantine management was reinforced using information and communication technology (ICT) on April 27th by introducing the Safety Band, a device that operates in conjunction with the Application, which is advised to wear if a person notified of self-quarantine is found to have violated the quarantine guidelines.

Treatment
The Republic of Korea established national safety hospitals designated for patients with respiratory diseases to receive treatment separately from other patients. In order to prevent any spread of infection in the hospitals, patients are classified into respiratory and non-respiratory patients. Infection preventive activities were implemented such as obligated mask wearing by all medical staff in the hospital, safely managing medical waste, complete disinfection of hospital, treatment and operating rooms and treatment equipment. Also, hygiene products like hand sanitizer and disposable masks are stocked sufficiently. Furthermore, so called Life treatment centers are in operation. These are public facilities that manage mild patients who do not require inpatient treatment, and provides medical care, living support, and quarantine. These centers can be a very cost-effective and efficient alternative during the COVID-19 pandemic, because they relieve medical resource shortages and utilize already existing facilities.

Transparency
The fourth T is transparency, which the government of the Republic of Korea demonstrates through daily briefings of regional and national statistics of current numbers of confirmed patients, deaths, diagnostic tests, and releases from quarantine. Information useful to the public to prevent infection is disclosed on the website of the Ministry of Health and Welfare, by communication networks, and by press release whenever a confirmed case occurs. Citizens also obtain information through the Cell Broadcasting Service which delivers real time alerts to mobile phones in areas of COVID-19 outbreaks. The service can be provided in English and Chinese as well. Furthermore, with the daily provided data on the movement of confirmed cases many developers introduced technical services that convey this information to the public efficiently, such as by visualizing cases on maps.
1.3 Economic Response
The economical response of the government was dedicated to directly support people´s lives by approving four supplementary budget proposals. The first one was approved on March 17th, 2020 with a budget worth about 11.7 trillion won. The second supplementary budget was worth 12.2 trillion and was passed at the National Assembly on April 30th, 2020 (Ministry of Economy and Finance, 2020a and 2020b).. On July 3rd, 2020 the Assembly approved the third supplementary budget which was worth 35.1 trillion won. This budget usage is divided largely into four sections: Revenue adjustment, Financial Support Packages, Strengthening employment and social safety nets, and Financial Stimulus Packages. It was also used to expand social safety nets for low income and vulnerable groups through expanding emergency welfare benefits. The Finance Stimulus Packages are split into three categories: first boosting domestic demand, exports, and local economies, second the Korean New Deal, and third the K COVID-19 response model and disaster management. The government plans to invest a total of 31.3 trillion won by 2022 in order to prepare for post-COVID-19. The third supplementary budget is used as the starting point of the Korean New Deal which includes the Digital New Deal, the Green New Deal, and the strengthening of employment security aimed at digital and green transformation and strengthening the social safety net. The economy was expected to recover to some extent by the end of 2020 but faced with a re-proliferation of COVID-19 in mid-August 2020, a fourth supplementary budget was passed at the National Assembly on September 22nd, 2020 which increased the government´s support measures to 285 trillion won (KDI, 2020). This budget focuses primarily on COVID-19 relief, including small business support, unemployment support, childcare support, and emergency reliefs for low-income households. Additionally, there are 4.6 trillion-won worth of measures to support disease prevention and economic reinforcement. Compared to other countries the economic growth of the Republic of Korea is better to some extent. With 482.6 trillion won budgeted revenue and 558.0 trillion won budget expenditure passed for 2021, the supplementary budget of 14.9 trillion won was approved at the National Assembly on March 25. (MOEF, 2021) The supplementary budget includes financial support for small businesses and self-employed, job retention and creation programs, support to low-income households, and vaccine purchases.

Private sector businesses were supported through extension of loan repayment and deferral of interest repayment. The Bank of Korea (BOK) increased the limit on loans for financial brokerage assistance by 8 trillion won on September 24th, 2020 from 35 trillion to 43 trillion won. In addition, the applied interest rate at which BOK lends funds to banks was cut from 0.75% to 0.25% when increasing the limit of 5 trillion won each in February and March (Bank of Korea, 2020). TSMEs receive not only financial support but also technological support, especially through networking with private sector partners. Through this support and due to their relatively higher agility and flexibility SMEs may turn COVID-19 challenges into business opportunities. In general, the government's support and public-private partnerships in effort for mutual-growth were the key for the country’s economic recovery. The economy of the Republic of Korea declined by 1% in 2020, meaning it ranked third in economic growth among major economics in 2020, after China and Norway..

COVID-19 Vaccination in the Republic of Korea
Following the emergence of COVID-19 vaccines, the government of Republic of Korea has established vaccination plans. aiming for recovery of daily life by securing collective immunity through inoculation of more than 70% of the entire population. According to ‘Korea Vaccination Implementation Plan for COVID-19 for the 2nd Quarter, (KCDC, 2021)’ the inoculation plan considers order and time regarding the risk of serious progression, medical system and social security, and COVID-19 propagation characteristics. The 1st quarter vaccination has started from 26th of February 2021, setting the goal as injecting 793,000 high-risk citizens such as patients and staff at nursing homes and health care professionals treating Covid-19 patients.. This process has been completed all throughout March, reaching the number of 588,958 completed vaccinations, which was 74.3% of the aimed rate (KDCA, 2021). A new plan has been set for the 2nd quarter. Vaccines for 12 million people are aimed to be secured during the first half of the year. High-risk groups are prioritized again in this round, particularly those who have serious health issues. In addition, from this quarter the elderly over the age of 65 will receive vaccination priority, and vaccination will be expanded to education faculties and childcare centers.

The specific process is opened to change regarding the vaccine securement status, stating the possibility for further revision on the timing and method of vaccination. The South Korean government is also focusing on the processes of management of the vaccines, creating a public-private military and police response system for cooperating on vaccine storage and transport management. Instruction on reservation system and issuing digital vaccination certificates online is being guided to prevent further confusion during the vaccinating period (KDCA, 2021).
1.4 Social Response
As a social response to COVID-19, the control strategy of Physical (Social) Distancing which minimizes disease transmission took effect. The rules to social distancing are based on the principles of limiting spread of the disease, therefore limiting contact with others as much as possible and requiring at least 2 meters distance between people meeting in person.

Mask provision
Due to the rapidly increasing demand for face masks the government of the Republic of Korea implemented a revision of the emergency mask supply and demand adjustment measures in March 2020. To secure quantity quickly and stably the contracting entity of public quantity masks was unified as Public Procurement Service (PPS) and the production and distribution were managed by the government and not the market. The number of masks that can be purchased by a person was limited by the government to two per week from March 9th, 2020, and to three per week from April 27th, 2020. Places that sold masks where limited nationwide to pharmacies, post offices and National Agricultural Cooperation Federation.
As of July 11th, 2020, the government of Republic of Korea has terminated the mask supply measures and masks became freely purchased at multiple stores including pharmacies, marts, and online malls. However, still the government announced that continuous monitoring of the mask market will be conducted, and would maintain the supply of surgical masks that were to be supplied to medical institutions (MFDS, 2020)

Distance learning
The Ministry of Education (MOE) delayed the opening of the new semester of elementary, middle and high school with online classes officially starting from April 9th 2020. The MOE strengthened support for distance learning nationwide and designated distance classes as the regular class method so that online classes using the Learning Management System (LMS) platforms could be conducted in schools. Teachers who were not familiar with distance lessons and online classes received consultation from the MOE to improve their ability to design and use online contents. Cyber learning center as platforms were developed by the Educational Broadcast Systems (EBS) and the Korea Education and Research Information Service (KERIS). The LMS platforms currently used in the Republic of Korea have functions such as providing learning contents/ resources, managing the learning process, answering questions in cyberspace, quizzes and tests, discussions, uploading / downloading learning materials, and video lectures.

Religious activities
There has been support for online religious activities as well. After mass infections in several religious establishments many religious groups have begun emphasizing the need for no-contact religious activities. Hence, the Ministry of Science and ICT (MSIT) temporary implemented support for online activities and “Drive-in worships” in April 2020. Infrastructure and technical assistance were provided to small and medium-sized religious organizations and the government guided technical methods for smartphone-based video recording. Also, necessary data and communication environment have been arranged through providing enough data and building 5G indoor network.
Uzbekistan
The government of Uzbekistan intended to prevent the spread of COVID-19 by implementing a strong national blockade, movement restrictions, epidemiological investigation, and contact tracing. These measures were proposed when confirmed cases were recorded on March 15th, 2020. Uzbekistan citizens actively participated in such actions as mandated by the government.

In the early days of the spread of COVID-19, authorities such as the Sanitary and Epidemiology Agency (SEA) and Uzbekistan's Ministry of Health had difficulties in epidemiological investigation and isolation measures. Specifically, in the process of enacting the COVID-19 Response Guideline and Manual provided by the WHO due to a lack of medical and technical capabilities. As a result, effective contact identification and quarantine measures were not possible, which was an obstacle in preventing the spread of COVID-19.

From March 29th, 2020, the COVID-19 National Advisory Officer from Republic of Korea was dispatched to the Uzbekistan Ministry of Health and worked full-time to resolve the medical and technical problems for responding to COVID-19, which served as an opportunity to effectively manage COVID-19 infection and prevent the spread of infection.

However, such long-term strict epidemiological investigation and mass containment of contacts, national blockade measures and movement restrictions became a heavy economic burden to people, and the infection began to spread in local communities due to the difficulty in testing and tracing. In particular, the incidence of COVID-19 patients has increased rapidly, mainly in border regions, due to the mass return of Uzbekistan citizens returning from Russia, Turkey and Kazakhstan. As the situation deteriorated, the medical system for epidemiological investigation and infection prevention gradually weakened as the national competence level of Uzbekistan to effectively control and manage COVID-19, was exceeded. Since then, instead of focusing on infection prevention, mass testing and tracing, focus has shifted to the COVID-19 policy, which prioritizes the goal of strengthening the treatment capacity of COVID-19 patients and reducing the mortality rate.

Uzbekistan’s current task is capacity enhancement and securing competent manpower that can handle COVID-19 testing, tracing, and treatment. Uzbekistan reorganized the governance for infection control, the newly established the National Reference Lab in Sanitary and Epidemiology Agency(SEA), and the Ministry of Health for reinforcing the capability in the testing field, and developed the domestic testing kits. In fact, 50% of total kits are currently covered by domestically manufactured kits. Uzbekistan is also making continuous efforts to respond to COVID-19 as well as new infectious diseases through various attempts and changes such as the development of various websites and applications to check the moving lines based on GPS and Bluetooth. The country is also establishing temporary facilities for exclusively handling COVID-19 as well as new hospitals with 10,000 beds within a short period of time.

The following are some of the experiences of Uzbekistan's response to COVID-19 and the cautious lessons to be learned from the response. First, the need for very immediate and proactive measures to prevent the early spread of infectious diseases. Second. securing the capacity of the national medical system for diagnosis, epidemiological investigation and preventive measures to implement the proactive measures. Third, meticulous coordination and implementation of medical measures such as infection control, prevention and epidemiological investigation, and social policy measures such as social distancing. Lastly, it is judged that the installation and operation of a high-level decision-making system that can determine and execute infection control policies based on scientific evidence and opinions is important.
2.1 Governance
Prior to the first domestic case in March 2020, Uzbekistan established the governance for responding to and managing COVID-19 by reforming the existing organizations and establishing new organizations in accordance with the Presidential Decree.

On January 29, 2020, the Uzbekistan government established the Special Republican Commission (SRC) under the Cabinet in order to prevent the spread of COVID-19 (Presidential Decree No. PP-5537). The SRC is chaired by the prime minister with key ministers and vice ministers as members to enable efficient cooperation between the ministries, and the Uzbekistan government strengthened the authority of the SRC to allow it to make major decisions regarding the response to COVID-19. In this way, all ministers and citizens could respond to COVID-19 efficiently. In March 2020, strict movement control and the isolation of confirmed cases were implemented according to the decisions made by the SRC by blocking all overseas inflows, prohibiting the use of all facilities including restaurants and cafes, and suspending school attendance and family events.

From April 2020, the Scientific Committee for COVID-19 response was established and operated under the direct control of the Minister of Health along with the COVID-19 national advisory dispatched from the Republic of Korea. With the above committee at the center, it was an organization that effectively led the revision of the 1st, 2nd and 3rd editions of the Uzbekistan National COVID-19 Response Guideline and Manual.

In July 2020, the State Inspectorate for Sanitary and Epidemiological Supervision under the cabinet were abolished according to a Presidential Decree (No.UP-6035). The Sanitary and Epidemiology Agency (SEA) and Research Institute of Virology (RIV) under the Uzbekistan Ministry of Health currently plays an integrated role in epidemiological investigation, infectious diseases research, and control. Fourteen Oblast-level SEA and 221 Rayon-level SEA exist under the SEA, taking the role of regional infection control.

The country received the Oxford-AstraZeneca and the Chinese-Uzbek ZF-UZ-VAC 2001 vaccines through COVAX facility in March 2021, planning to initiate mass vaccination from April 1st starting from medical personnel and vulnerable groups.
2.2 Uzbekistan’s COVID-19 Response
Testing
Currently, both national institutions and private institutions conduct COVID-19 testing in Uzbekistan. National institutions carry out Reverse Transcription Polymerase Chain Reaction (RT-PCR) testing, and private hospitals carry out antigen testing (approximately $15 test price) and antibody testing (approximately $15), including RT-PCR testing (approximately $25).

For the sample collection from a suspected COVID-19 case, the suspected case reports his/her symptoms to an emergency call center (1003, 1105) that is linked with a polyclinic(public primary healthcare clinic). Through a consultation, a staff member from the laboratory and a preventive medicine doctor visit the residence of the suspected case in pairs and collect a sample. Then, the sample is sent to 62 laboratories across the country and RT-PCR testing is conducted. If the sample is tested positive, the information of the confirmed case is sent to the divisions under the Ministry of Health. Furthermore, an epidemiological investigator under the regional SEA visits the residence of the confirmed case again and carries out the epidemiological investigation for 14 days prior to the confirmation.

On average, 40,000 to 50,000 COVID-19 tests are carried out daily in Uzbekistan. COVID-19 test kits from Germany, Russia, China, and Korea are mainly used at first. In July 2020, the Center for Advanced Technologies under the Ministry of Innovative Development developed a test kit that could be manufactured domestically for the first time among the Central Asian countries. Currently, an average of 150,000 test kits are manufactured per week domestically in Uzbekistan, and the country now uses domestically manufactured kits and imported kits at a 50:50 ratio.

In comparison to the early stages of the COVID-19 spread, Uzbekistan has secured a relatively sufficient number of test kits, PCR instruments, and manpower. The National Reference Laboratory, established under the SEA in July 2020, for exclusively handing COVID-19 testing currently carries out an average of 1,000 to 1,100 tests daily for the purpose of epidemiology investigation. However, the system to produce competent manpower that can handle test kits or RT-PCR instruments proficiently must be improved due to a sudden pandemic situation. Accordingly, Uzbekistan needs to use such infrastructure actively and develop competent experts by strengthening the country’s capabilities in order to respond to the COVID-19 pandemic and prepare for new infectious diseases.

Tracing
In the beginning the pandemic, epidemiological investigation was carried out in handwriting via phone call or a visit to the confirmed case. Also, people who came into contact with the confirmed case were traced and COVID-19 testing was carried out regardless of their symptoms or were transported to a medical facility using an ambulance. The daily moving line and contacts were recorded directly to enable prompt and accurate epidemiological investigation in the case of infection with COVID-19. However, the number of increased confirmed cases has exceeded the available capacity of epidemiological investigation and control by written records due to a lack of epidemiological investigators. As a result, epidemiological investigation is not currently conducted well. To overcome this difficulty, an application called “Self-Safety” was developed using ICT technologies, providing the function to confirm the moving line based on GPS and Bluetooth. However, its usage is low due to avoidance of personal information sharing, battery depletion, and the platform based on the voluntary participation of users.

Treatment
For COVID-19 positive cases, a mild case takes a medicine provided by a polyclinic and is isolated at home. In the case of a moderate and a serious case requiring hospitalization, such cases are transferred to a temporarily established triage center using an ambulance, and the critical case is transferred to a designated COVID-19 hospital. There are 7 temporary triage centers (approximately 4,200 beds) in Tashkent, and a wide space for treating mild and serious cases is secured from public sports complex facilities, resorts facilities, and the Olympic stadiums, and the treatment of confirmed cases is carried out 24 hours a day. All temporary quarantine facilities consist of rooms for two people. One doctor is designated for 15 beds of mild cases and one doctor is designated for 6 beds of serious cases, and a nursing station is established for every 80 beds.

Confirmed cases with pneumonia, fever over 38°C, or a 15% or greater lung infiltration are hospitalized unconditionally. Cases with no symptoms or slight symptoms take medicine provided by a nearby polyclinic and are self-isolated at home and their symptoms are observed. In the early stages of COVID-19 spread, there were not enough hospitals available for treatment. In response, Uzbekistan began to establish “Zangiota No. 1” and “Zangiota No. 2” that were special hospitals in the Zangiota District in accordance with the Uzbekistan government's resolution “on measures to improve the efficiency of providing medical care to patients infected with coronavirus infection.” The hospitals with 10,000 beds established in August 2020, currently treat serious and critical cases.
2.3 Economic Recovery and Social Distancing
Economic Recovery
On July 30, 2020, the Ministry for Support of the Mahalla and the Family and the institutions in charge of social and economic development prepared the list of families requiring financial aid and provided such assistance to more than 400,000 families during according to a Presidential Decree (No. 6038). The Uzbekistan increased pensions of socially disadvantaged classes, including disabled people and unemployed elderly people, by 10% from September 2020. The Uzbekistan government also extended the support of child pension to families whose support was terminated between July 2020 and September 2020, by 6 months.

In addition, the Uzbekistan government continued nationwide financial assistance, and the Ministry of Education, Ministry of Health, Ministry of Finance, and the Mahalla and Family Support Ministry provided financial support or supplies such as school supplies and winter clothes to the children of families facing financial difficulty. The central bank reduced its policy rate from 16 to 15% on April 15, and from 15 to 14% on September 8, 2020. The 2021 budget of 165.8 trillion soms (15.9 billion dollars) includes higher expenditures on healthcare systems, vaccine purchases and distribution, social assistance, wage increases and policy lending to support the economy, primarily through the Fund for Reconstruction and Development. The Uzbekistan’s Senate allowed an overall fiscal deficit of up to 5.5% of the country’s GDP. (IMF, 2021)

Social Distancing
The primary goal of social distancing in Uzbekistan is to slow the spread of COVID- to reduce infection among high-risk populations and to reduce the burden on health care systems and workers.

In March 2020, when the first case occurred in Uzbekistan, all schools, kindergartens, and universities closed, and mobile operators had opened free access to information and educational sites and online classes from the national TV project Online-maktab (“Online School”) were launched. Graduation exams at universities were held online. The closure of cinemas, bans on public events, the biggest traditional festivities "Navruz," football matches, and the cease of operation of children's playrooms and disco bars were announced. All government and non-governmental organizations have been instructed to terminate meetings. Air and road communication with other states was suspended. The departure of foreigners from Uzbekistan and the return of compatriots were administered by charter flights. Domestic tourist tours, religious denominations, and public transports in Tashkent were canceled.

A ban and a penalty on walking in public without wearing masks was introduced in March 2020.From April 2020, gatherings of more than three people were prohibited and in public places, the observance of a social distance of 2 meters between people was introduced. A national guideline for COVID-19 by the Ministry of Health was adopted. The guideline introduced instructions on how to wear and use masks as well as a technique of washing hands.

From May 2020, districts and cities were assigned quarantine levels depending on the epidemiological situation. The quarantine level descriptions are as follows. Red Quarantine Level - regions where coronavirus infected cases have been detected in the last 14 days. Yellow Quarantine Level - regions where no new cases of coronavirus have been detected in the last 14 days, but where patients with coronavirus are present. Green Quarantine Level - regions where there are no persons infected with coronavirus, or where previously confirmed cases have fully recovered.

The second blockade through August 14 was implemented in July 2020. The use of public transportation, markets, supermarkets, and parks was restricted, and wedding ceremonies were prohibited. The use of personal vehicles was permitted only for limited hours and only for transport to a hospital/pharmacy and for the purchase of procuring groceries. Persons aged over 65 were prohibited to go out. As of August 15, 2020, the Uzbekistan government began to alleviate the restrictions gradually on the condition of practicing thorough quarantine measures and the observation of social distancing by individuals. The Uzbekistan government removed the restrictions of vehicle operation by time and currently responds to COVID-19 by requiring thorough observation of sanitation recommendations by individuals while allowing economic activities such as the imposition of fines for no mask use, temperature checks, and hand sanitization among the public.

Most nonessential businesses such as restaurants, hotels, and houses of worship have reopened from February 2021 with sanitization and social distancing protocols in place. (G.W., 2021) Private gatherings of maximum 30 people are allowed, but people must wear facemasks in public and comply with social distancing guidelines of 2 meters. As of March 18, 2021, Uzbekistan authorities have amended COVID-19-related international entry restrictions from mandatory PCR testing at arrivals to providing evidence of a negative PCR Covid-19 test taken within 72 hours prior to arrival (G.W. 2021) Authorities appointed countries Green, Yellow, and Red depending on the self-assessment of infectious threat. Arrivals from Green locations are permitted to enter without restriction whereas arrivals from Yellow and Red countries must be quarantined for 14 days.
2.4 ICT
Information and communications technology (ICT) in the health field is managed by IT Med under the Ministry of Health, and IT Med is in charge of the establishment and operation of COVID-19-related systems. Various online platforms have been established in response to COVID-19 in Uzbekistan.

1003 and 1105 emergency call centers have been established, and they play the role of helping a suspected COVID-19 case call the polyclinic, explain his/her symptoms and receive treatment through self-quarantine or hospitalization. Also, the Telegram messenger app is generally used in Uzbekistan and is also actively used for responding to COVID-19 cases. Government agencies and private organizations share recent COVID-19 news or information using a Telegram channel and provide information on the main Q&A board for the response to COVID-19 cases and linked websites through the Telegram Bot. The current COVID-19 status and response manuals are provided through the coronavirus.uz website and applications and statistical data obtained in linkage with the in-company system of the Ministry of Health are provided.

In July 2020, the Ministry of Health and the Ministry for the Development of Information Technologies and Communications of Uzbekistan, together with the Tashkent City administration, had launched the “Self-Safety” mobile application, which warns the user of possible contacts with persons infected with the Coronavirus. The application uses data from the GPS and Bluetooth modules of a mobile device, and if a virus is detected in one of the users, the system will match all crossing points within a radius of five meters within one minute. As a result of determining the intersection points according to the specified conditions, all users who were in the radius will be notified of a possible contact, and recommendations for action will be delivered in the form of PUSH notifications.

In addition to such ICT-based platforms, other platforms developed by private companies also exist. Platforms using ICT, including websites that provide information on pharmacies and pharmacy stock status, as well as websites that provide free medical consulting are actively being developed. However, it is necessary to develop a representative program and a platform with higher utilization in order to prepare for new infectious diseases in Uzbekistan through the integrated management of dispersed data and transparent information sharing.

The most urgent and important task related to ICT is to computerize the epidemiological investigation system based on the national procedures and manuals for the prevention and management of infectious diseases in Uzbekistan. After such epidemiological investigation work can be computerized, effective infectious disease management and infectious disease management capacity can be increased and strengthened. Only when the development and use of such a national epidemiological investigation management system is premised, it will be possible to develop and implement an effective isolation management system and a movement tracing system for confirmed patients using mobile phones and GPS, similar to the Republic of Korea model.
Taipei,China
While the global death toll having surpassed three million, in Taipei,China, the total number of confirmed cases is 1,116 with only 12 deaths (April 29th, 2021). This is particularly notable considering the country’s close geographic proximity and economic ties with the mainland China, the first place of outbreak. Among the countries that showed successful containment of the virus at the initial phase, Taipei,China remains as the only country that has been recording no local transmission for five consecutive months. Furthermore, these successes ultimately resulted in less serious recession of its national economy.
3.1 Governance
Most of analysis on the reason how Taipei,China could have been capable of containing the virus focus on its experience with Severe Acute Respiratory Syndrome (SARS). The disease had hit the country hard and the government experienced serious failures, leaving costly lessons on prevention and containment of infectious disease. This experience led to an overall reformation of the control tower for infectious disease including the Centers for Disease Control and immediate response of the relevant bodies when they recognized an emergence of a new virus in December 2019.

Along with the speediness of its responses, the government also focused on transparency and expertise. Experts were in the front line for information sharing and public communication, with daily press conference which assured further transparent release of information within the nation and internationally as well. Transparency was ensured through the Taipei, China’s CDC online portal providing data about the number of new cases and deaths on daily basis, the protocol for testing and preventive measures.

The centralized command system and its immediate actions had played a critical role from the first phase. During the outbreak’s early stage, “real-time surveillance with rapid risk assessment, border control and quarantine, and laboratory capacity building”(Cheng, Li, & Yang, 2020, p.1) were centered on its strategies, leading to successful initial responses. As soon as the outbreak was detected, monitoring and risk assessment on this new virus had started, accompanied by gradually reinforced travel restriction to certain regions of China and quarantine measures at the border.

The authorities still focuses on controlling imported cases with entry and quarantine measures. Though there had been some changes regarding specific guidelines and available countries, all travelers are mandated to provide COVID-19 RT-PCR test result issued within three days before the departure of flight. They should arrange a residence for quarantine after the entry andpractice 14-day quarantine. The COVID-19 test and strict quarantine are exempted to travelers who are from Palau, as two the countries launched a ‘travel bubble’ from April 1st, 2021. The authorities also require travelers to use the Quarantine System for Entry for online health declaration to screen whether they meet the regulations. The Communicable Disease Control Act provides a legal basis for essential manuals for citizens to comply with in their everyday life, such as the Self-Health Management Compliance Items and Notice. People are also mandated to wear masks in places where risk of transmission and infection is high, and those who violate the regulation can be fined up to NT$15,000 (538 USD).

Furthermore, the central database based on the National Health Insurance (NHI) system, local follow-up on detecting and monitoring infection, and rapid setup of high-tech surveillance system were crucial in the initial and later management of infection. NHI system also played a significant role for rationing masks, as the rationing was based on NHI cards of residents which are linked to pharmacies and local health centers. In a similar vein, allocation of other necessary materials and human resources was effectively conducted via centralized and organized governance. It was further promoted due to central and local governments cooperation, as well as partnership with private sectors especially in terms of case investigation and screening, clinical research and information technology.

Efficient surveillance on citizens’ health is now being monitored via so-called ‘V-Watch System’ after national vaccination was initiated from March 22th, 2021. The system is a result of cooperation between the CDC and DeepQ, a health care unit of HTC Corporation. It aims to monitor vaccinated individuals by enabling health reporting via Disease Control Butler, which is an official LINE chatbot of Taiwan CDC (Taipei, China CDC, 2021).

Social trust and the public remaining concerned should be also noted as other underlying reasons which enabled effective governance . Rapid and efficient implementation of policies, paired with trust between the government and citizens, had a synergy effect. Chen Shih-chung, a Minister of Health and Welfare, recorded 91% approval rate at the end of March while he has been popular for being a speaker of daily conference. The former vice president Chen Chien-jen was mainly responsible for policy control. Both have long careers and expertise in epidemiology. Chen Chien-jen, especially, is known as an epidemiologist who had held post as a Minister of Health and after the SARS pandemic. Even though he now finished serving as a vice president, he still provides his voice on the pandemic, sometimes sharing his experience on managing the model successfully while emphasizing the importance of evidence-based policymaking and scientific thinking in this kind of crisis (Chen Chien-jen, 2020). Hence, the public’s trust did not come out of nowhere – transparent and swift release of information and communication by daily press conference with Q&A session, health promotion messages to the public, 24-hour public epidemic hot line for questions and reporting can be praised as the basis.

The Centers for Disease Control of Taipei,China (Taipei,China CDC) recently established a bilingual chatbot on Google Assistant to serve as another channel for the public to obtain latest information regarding disease prevention. This allows local residents and foreign nationals to ask questions about the COVID-19 coronavirus pandemic in Chinese and English. The chatbot provides various kinds of information, such as introductory information on COVID-19, methods of transmission, symptoms, epidemic status within other countries/regions and face mask stocking information in each pharmacy.

The remarkable success of Taipei,China in its responses to COVID-19 were made possible thanks to the rapid establishment and operation of the command system that were centralized and cooperated with local governments, cross-departmental agencies and task forces, and private sectors, smoothly implemented and maintained with the public’s support.
3.2 Response in the health sector
Health sector management was largely affected from the lessons learned from SARS, as the experience from the previous epidemic demanded instant and organized responses of the authority to minimize the damage. This was also enabled thanks for already existing national system of Taipei,China: the National Health Insurance. Its database has been utilized as a basis for nationwide public health network, reflecting reported real-time information and cases as well. It led to early detection of infection and effective containment and monitoring system.

Part of Taipei,China’s successful strategy rests with its early response and robust case tracing mechanisms. The authorities started collating data from two disparate sources – the immigration and customs database and the national insurance database – to create a unified big data platform for analytics.

NHI(National Health Insurance) big data is used to help front-line workers detect cases. In order to prevent specific individuals from becoming a gap in epidemic prevention, some target’s data would require to be specified such as the travel history of people subjected to home quarantine or naval crews etc. It also linked related information to build smart disease prevention technology for frontline workers. Healthcare workers can use NHI-MediCloud system to check patients' travel history and determine if a patient is potentially infected with COVID-19 based on the patient's symptoms, so that necessary patient diversion measures can be immediately taken. Medical institutions can use the electronic referral platform to upload medical information of people in home isolation or home quarantine to facilitate the judgement of infection condition(Ministry of Health, 2020).

For the isolation measures, Taipei,China represents a successful model of how to combat COVID-19 through banning foreign nationals from entering the country. On March 18, 2020, the country officially restricted the entrance along with the measures distributed by the Central Epidemic Command Center (CECC). The government has accompanied automatic visa extension for foreigners staying in the country to minimize further movements of the population. Now in 2021, the government of Taipei,China is allowing foreigners to enter the country with submission of a negative COVID-19 RT-PCR test result within 3 days before taking the flight to the country. However, people who have traveled or transited through the United Kingdom, the Republic of South Africa, or the Kingdom of Eswatini should undergo the 14-day quarantine at a hotel or at their own residence (MOFA, Republic of China, 2021).

Isolation and quarantine measures were strengthened by technology measures. Anyone who enter Taipei,China must use the Quarantine System for Entry. Travelers’ information is integrated into the disease prevention tracking system for the 14-day quarantine, as well as the Digital Fencing Tracking System to accurately track whereabouts of people in quarantine and issue warnings. The location of people in home isolation and home quarantine can be monitored by detecting electromagnetic signals of their mobile phone to determine whether they leave the range of their home. If anyone violated, the tracking system will send a warning message to them, as well as the civil affairs authorities, health agencies, and local police to get hold of their location(Ministry of Health, 2020).

A technical support platform for COVID-19 was also established in order to accelerate the development of vaccines, drugs and rapid test kits. The platform established the specimen application mechanism through integrating the domestic biosafety three-level laboratories and providing related virus assays. Taipei,China collected specimen and clinical data from COVID-19 patients for value-added analysis and providing to industry, academia, research institutes, and the medical community through the Taipei,China’s COVID-19 Research Network and Database Project and National Biobank Consortium of Taipei,China to accelerate overall research for disease prevention(Ministry of Health, 2020).
3.3 Economic Recovery
Taipei,China’s successful management on the pandemic has allowed it to prevent the more significant economic disruption that its regional peers have seen. The economy expanded by 2.98% in 2020 (Bloomberg, 2021).

The government of Taipei,China responded with a three-pronged plan of disease prevention, industrial relief and economic stimulus toward this uncertain circumstance. Taipei,China also implemented the Special Act for Prevention, Relief and Revitalization Measures for Severe Pneumonia with Novel Pathogens on February 25, 2020, approving an initial special budget of NT$60 billion (US$2 billion). On 21st March, the special act was amended to expand the special budget by NT$150 billion in order to cover wider, more comprehensive range providing supports including individual tax breaks, household expense subsidies, industrial relief and business tax cuts(Executive Yuan, 2020).

The government subsidized 40% of the salaries of difficult enterprises every month to prevent nearly 900,000 people from losing their jobs and help the industry through the hard times. However, as the pandemic continued, the Executive Yuan proposed a second expansion of the special budget on July 23 2020 that called for an additional NT$210 billion to continue financing prevention, relief and stimulus measures, including subsidies for workers' wages and business operations, and money for the research, development and purchase of vaccines. (Executive Yuan, 2020).

Financial aid measures include providing businesses and workers with NT$700 billion in loans, including NT$300 billion in operational and stimulus loans to small and medium-sized enterprises (SMEs). The Central Bank offering generous loan interest subsidies to SMEs, for example, with a loan amount of less than NT$4 million the Credit Insurance Fund will provide a 90% credit guarantee and the loan interest rate is 1%. There is also lenient processing of returned checks; subsidizing banks that reduce or forgive interest on old SME loans. There also have relief loans to workers in order to assist the those affected by the epidemic. Workers who have participated in labor insurance or did not participate in labor insurance, but able to provide proof of work facts, can apply for labor relief loans. The credit insurance fund provides a credit guarantee of 10%, and the maximum loan limit is NT$100,000 per person. Loan period last for three years, interest rate is 1.845%, and the first year's interest is subsidized by the Ministry of Labor(Executive Yuan, 2020).

For employment assistance, subsidies are available to supplement salaries for furloughed or short-time workers and to encourage them to undergo training while on leave. Workers who lose jobs during the outbreak will receive the usual unemployment payments which could receive 60% of average monthly insurance salary (KPMG, 2020), those who had family dependence could receive additional insurance up to 20% last for 6-9 months, and companies hiring these workers will receive compensation. 3 months subsidy is available for self-employed workers and non-employed workers with living allowances that a monthly subsidy of NT$10,000 could be receive one time which total amount is NT$30,000. As for employers, government assistance will go mainly toward stabilizing employment relations. Priority assistance will be given to affected SMEs and high-risk manufacturers for health and safety-focused facility and equipment upgrades during the pandemic. Subsidies have also been expanded to encourage companies to promote a healthier work-life balance for employees(Executive Yuan, 2020).

Business entities facing operational difficulties due to COVID-19 may apply for refunds of overpaid business taxes. Small business entities exempted from reporting their sales amounts will automatically have their assessed tax amounts lowered. Profit-seeking enterprises that lose business income due to COVID-19 may deduct the losses from taxable income. Tax deadlines have been eased to allow taxpayers to postpone payment of taxes or pay in installments. Those who encountered difficulties may apply for deferral for a maximum of 12 months or by monthly installments of up to 36 months, without late payment interest. Tax breaks will be given to employers who pay employees during time off due to the coronavirus. Taxpayers receiving government-provided subsidies and allowances may exclude such assistance from taxable income(Executive Yuan, 2020).

For companies that have significant decline in business revenue, for instance, monthly turnover dropping by 15% or more compared to last year for two consecutive months, could have 5% water fee discount, monthly ceiling is NT$5,000; in terms of electricity costs, low-voltage users (service industries and SEMs) discounted by 10%, and the monthly ceiling is NT$100,000. High-voltage users (medium and large users) benefits from reducing the contract capacity and the basic electricity fee, and the fee will be restored within two years without any service charge(Executive Yuan, 2020).

The government of Taipei,China also have different relief and revitalization plan for key industries. After the epidemic has stabilized, promote various revitalization and counseling measures such as vouchers to revive domestic demand industries, especially for retail, catering, night markets, traditional markets and other industries. The government provides preferential measures to stimulate consumer spending. In addition, by holding large-scale exhibitions and sales activities, and inviting international buyers to come to Taipei,China to visit and purchase, stimulate consumption, assist the recovery, transformation and upgrading (Executive Yuan, 2020).

Legislative Yuan approved Taipei,China’s government budget for 2021 after a cut of NT$25.6 billion (US$892.4 million) in which the cut includes 5 percent less for subsidies to local governments and 3 percent less for expenditures on military equipment and facilities. (CNA, 2021) The government expenditure is set at NT$2.14 trillion while projected government revenue is approximately NT$2.05 trillion. The discount rate, the rate on refinancing of secured loans, and the rate on temporary accommodations is kept unchanged at 1.125%, 1.50%, and 3.375%, respectively since the reduction of 0.25 percentage points on March 19,2020. (ICMA, 2021)
3.4 Social response
Social trust on current government enables Taipei,China successfully manage the pandemic situation. Chen Shih-chung, a Minister of Health and Welfare, recorded 91% approval rate at the end of March and he has been popular for being a speaker of daily conference. The formal vice president Chen Chien-jen who was mainly responsible for policy control has received high level of trust from the people.

Mask provision
The daily production capacity of face mask manufacturers in Taipei,China before the outbreak was 1.88 million face masks with a maximum production capacity of 2.44 million face masks per day. In order to assure there is sufficient domestic resources for the prevention and control of epidemics, The Ministry of Economic Affairs has imposed a ban on the exportation of face masks on 24 January 2020. Exporting face masks is forbidden unless exporters apply for special case approval from the Bureau of Foreign Trade, under the Ministry of Economic Affairs. Followed by the requisition and rationing of all domestically-produced face masks (about 4 million pieces per day) by the National Health Command Center and Central Epidemic Command Center.

Since January 28th 2020, people coudl purchase 3 masks every 3 consecutive days ($8 NTD per piece). Starting from 6 February, each person was allowed to purchase 2 surgical masks (price decreased to NT$ 5 each) every seven days. Starting from 2 March, the purchase limit was increased to 3 masks for adults and 5 masks for children per week.

Name-based rationing system 1.0 for purchases of masks allows the people whose ID card numbers end with an even number to buy masks on Tuesdays, Thursdays and Saturdays, and the people whose ID card numbers end with an odd number to buy masks on Mondays, Wednesdays and Fridays while everyone can buy them on Sundays. Office workers and people with disabilities can ask their family members or friends to buy face masks on their behalf. However, each person is allowed to buy face masks for another person by presenting the person’s NHI card, and the abovementioned rules of purchase apply. Moreover, face masks for children are only allowed to be purchased when NHI cards of children under 12 are presented. Regarding the elderly living alone and physically or mentally challenged people in need of face masks, local social welfare bureaus and public health bureaus will cooperate to provide face masks from the local government’s stockpile of face masks in order to prioritize them for these minority groups. (Taiwan Centers for Disease Control, February 4, 2020)
The procedure involves inserting National Health Insurance (NHI) card in a service machine, keying in a mobile phone number then checking-out at the cashier. This first effort was then updated to distribution system 2.0 where the public could order masks via the Name-Based Mask Distribution System at either the eMask website or the NHI App from a mobile phone, it also support other payment methods besides cash. In this stage, pre-order online is allowed. People can pick up masks within 14 days from the second week. People can also pre-order and pick up masks at the same time. Citizens were allowed to buy the quota of 7 days which 5 masks for children and 3 masks for adults.

The 3.0 system is an extension of the two previous measures which allows people to pick up and pre-order masks at convenience stores, thus enhancing accessibility for the general public. Also mobile payment is available for this stage. Citizens were allowed to buy 10 masks for children and 9 masks for adults per 14 days. (National Health Insurance Administration of Taipei,China, 2020) Starting from December 31, 2020, the NHI-contracted pharmacies were allowed to sell 10 face masks per person regardless of adults and children. The same change came into force from January 4, 2021, for other distribution channels.
Distance learning
Under the pandemic, Taipei,China remained a country where schools are still mostly functioning normally. After the outbreak of the virus, the start of spring semester of 2020 was delayed for two weeks in Taipei,China. As its one semester if 18-week course, the first semester of 2020 was completed from March 2nd to July 10th. The Ministry of Education had established and provided general guidelines which included the following: (a) screening on travel records, contacts, and clusters, (b) following social distancing, (c) ordering 14-day closing when there are two or more confirmed cases – and closing of a class when there is any confirmed case – with a reporting process for suspected cases and school closing policies, requiring to wear masks for sure. Schools also had to maintain their hygiene measures and continuous ventilation of the buildings (Chao, 2020). Health screening on personnel and students centered on temperature and symptoms checks on their arrivals and family members are not allowed for entry. During the class and mealtime, students were to use divided desks with some dividers. Though it did not had limitations on maximum size of classes. Instead, Taipei,China has managed to maintain homeroom classes stable as possible, with making teachers to move between classes instead of students. (Melnick & Darling-Hammond, 2020) Colleges and universities faced more challenges with their international students. As students from mainland China account for more than 20% of international students in Taipei,China, universities also postponed the start of spring semester for two weeks. There are a handful examples of universities where education was ensured by distance learning with online tools and most of events that require gathering of people were cancelled. National University of Taiwan (NTU), for example, has implemented strict rules on campus by (a) making sure that only students, faculty, and alumni can come into the campus, (b) controlling campus access by campus identification cards, (c) checking body temperatures on a daily basis, (d) refraining the people from entering the campus for 14 days who are themselves under home isolation or living with family members that are under home isolation, under quarantine or self-management of health (Cheng et al. 2020).

Though the regular courses and classes have been operated in Taipei,China without serious challenges relatively to other countries, Ministry of Education (MOE) has been very much supportive in assisting and advising education institutions on their COVID-19 responses. It required education institution to create a taskforce team for more efficient and rapid responses and to develop plans for alternative course delivery to prepare in advance (FICHET Taiwan, 2020).

Distance learning has also been given attention under the pandemic. According to the guidelines given by the Ministry of Education (MOE), schools should provide necessary tools and training to assist the faculty under the pandemic situation. Especially when it comes to a situation where distance learning is adopted, schools should provide digital teaching assistants (TA) for online course preparation and management. While the guideline advices to prioritize face-to-face classes when it is possible, it also provides guidance on distance learning. MOE recommends “to utilize methods of synchronous online learning, or adopt blended teaching methods with asynchronous teaching materials and synchronous online interactive discussions.” (Ministry of Education, 2020) Also, when the class is suspended due to confirmed cases within the class, “schools should not only conduct distance learning with synchronous and asynchronous online courses, but also undertake weekday makeup classes after the classes resume under the principle of 1 credit for 18 hours to maintain both teaching quality and flexibility.” (Ministry of Education, 2020)

University students could use the online courses though it mostly depended on the universities’ rules, such as NTU permitting those who cannot attend face-to-face classes to apply for online courses (Cheng et al. 2020). It was required for classes with more than 100 students to be conducted virtually from early April and during the first three months of the outbreak the total number of online courses nearly tripled (Chiu, 2020). NTU also provides 68 open access online courses on Coursera.

Religious activities
It is worth noticing that religious leaders also played crucial roles when it came to a bottom-up approach and civic commitments to responses to the COVID-19. During the initial phase of the spread of the virus, some local governments like Taoyuan City banned large-scale religious events that can gather massive people. However, legal restriction on religious events has not been placed in the country and this was made possible through continuous communication between political and religious groups.

Religious leaders were not reluctant to have open dialogues with the government and did not oppose holding back their religious events, understanding the risk of spread of the virus. While the legal ban on massive religious events was proposed by the opposite party, the government pushed ahead with focusing more on communication and voluntary commitments of the religious communities and their leaders, resulting in the actual participation of them. For instance, Dajia Matsu Pilgrimage, which is the largest annual religious event of the country, was postponed to June of that year on the basis of agreed understanding between the government and the religion. The organizers recognized the risk that can follow, considering the advice from health experts and their commitments were recognized by the government as well (Lee, 2020). The event was held from April 9th of 2021 under similar preventive measures that were conducted during the last year’s pilgrimage, while the entire event was live-streamed.
Singapore
Singapore’s government reacted with a swift and transparent response to the outbreak of COVID-19. The government pursued a policy of comprehensive testing, quarantining, and tracing of suspected cases. Measures were quickly taken to limit both imported cases as well as community infections and response measures were strengthened according to the severity of the situation. Consistent transparency and regular communication from the government-built trust in the administration’s ability to handle the crisis, and the general public engaged in social distancing and followed government guidelines. Large scale testing as well as the increased health sector capacity developed in preparation for a virus outbreak also played vital roles in Singapore’s success in containing the spread of COVID-19. The government took strong measures to alleviate the economic impact of COVID-19 by implementing four different fiscal packages worth a total of 93 billion Singapore dollars (S$). Additionally, the effective use of technology enabled contact tracing to be carried out efficiently. Singapore was the first country in the world to develop and deploy a national COVID-19 tracing App, which further limited community infection.

In June 2020, the Singapore government started to ease its Circuit Breaker lockdown measures. By the end of June, most the economy had reopened but there are still limits on the number of people who can gather. Employees working from home can choose to return to working at their company building, as long as they continue to work from home for at least half their working time. From 1 October, event organizers are allowed to apply for approval to host events with up to 250 people. Additionally, from 3 October up to 100 people are allowed at weddings and religious worship services.

Daily new cases of COVID-19 in Singapore from 24 January - 10 October 2020
The overall recent trend of new COVID-19 cases in Singapore is a gradual decrease.As of 29 April 2021, there have been a total of 61,121 confirmed cases of COVID-19 in Singapore, including 30 deaths. At the national level, Singapore remains in Stage 2, localized community transmission with a continued downward trend in daily reported cases (WHO, 2020).
4.1 Governance
After the virus outbreak in China, Singapore’s government did not hesitate to take prompt action. On 31 December 2019, the Municipal Health Commission reported a cluster of cases of pneumonia in Wuhan, Hubei Province in China. From January 3 2020, all travelers arriving from Wuhan at Changi Airport in Singapore had to undergo temperature screening, with the Ministry of Health (MOH) informing doctors to look out for suspected cases of people who returned recently from the Wuhan area, and patients with fever and acute respiratory illness or pneumonia, who had travelled to Wuhan at least 14 days before the onset of their symptoms, being isolated to prevent virus transmission (Goh, 2020).

Temperature screening was expanded to all travelers coming from China on 20 January and those showing symptoms who had travelled to any part of China within the previous two weeks were also subjected to isolation measures from 22 January (Yong, 2020). On 23 January a multi-ministry task force chaired by Health Minister Gan Kim Yong and National Development Minister Lawrence Wong was set up to coordinate a whole-of-government, whole-of society response. As the outbreak worsened the Chinese government issued a lockdown in Wuhan and Singapore had its first confirmed COVID-19 case on 24 January, Singapore’s government issued additional border measures, such as expanding temperature screening to land and sea checkpoints, and preparing Holiday chalets as quarantine centers. Singapore also proactively implemented travel restrictions on passengers of any nationality coming from mainland China on 1 February 2020, even though at that time the World Health Organization (WHO) stated travel bans were not necessary. To make quarantining less difficult, the government provided an $100 daily allowance to self-employed individuals who are quarantining, prohibited employers from detracting quarantine days from staff’s annual leave, and made clear that hospital bills would be paid for by the MOH for all suspected and confirmed cases of the virus. Singapore also began establishing local production capabilities of surgical masks from February to meet the needs of healthcare workers and to make the healthcare system is sustainable. By responding quickly and adapting the severity of containment measures according to the situation, Singapore was able to greatly reduce the number of imported cases in the early stages of the crisis and encourage individuals to receive medical care without being concerned about the economic cost.

A relevant legal framework also came into force from April 7 of 2020, regulations named as “the COVID-19 (Temporary Measures) (Control Order) Regulations 2020”. It includes legal requirements on mask wearing, restriction and requirements on social gatherings, safe management measures for different kinds of situations. The order has been constantly revised depending on the trend, while the most recent version keeps being provided via the government website as well.

From the beginning of the crisis the government of Singapore provided clear and consistent communication to the public. Health authorities released up to date information daily which strengthened the credibility of the administration’s policies. Deputy Prime Minister Heng Swee stated that being transparent and putting out clear, accurate information are important to allay people's fears amid the outbreak. Government advertisements carried on the front page of Singapore’s largest daily newspaper urged readers with even mild symptoms to see a doctor and refrain from going to school or work. After the government raised its outbreak alert on 7 February to orange, one level below the maximum, panic buying started. To address citizens’ concerns the Prime Minister, Lee Hsien Loong, delivered an address to the nation directly in three of the city-state’s four official languages. He also used digital media capabilities, such as Facebook, to assure the population that the administration was in control of the situation. The public was advised to obtain accurate and factual information from reliable sources including government websites, and government issued information on Facebook and Instagram (Lee et al, 2020). The MOH also began providing regular WhatsApp group updates on what extent the virus had spread domestically. Delivery of information on social media channels helped to control panic, and also reinforced the public’s trust in the government’s response to the crisis. By communicating openly and frequently the government-built credibility in their ability to handle the crisis in the eyes of the general public. Furthermore, the MOH also endeavors to direct correction on unidentified or false information regarding vaccines that are circulating online.
4.2 Response in health sector
Testing
To contain the virus the government of Singapore carried out large scale testing for COVID-19 and contact tracing. Early detection of cases was crucial for containing the outbreak of the virus (Sim et al, 2020). In the early stage of the crisis Singapore began producing the materials needed for mass production of testing kits and the health authorities began testing all influenza-like and pneumonia cases for COVID-19. Contact tracing operated 24/7, starting with patient interviews, and has also involved police, flight manifests and a locally developed test for antibodies, which linger even after an infection clears. The fact that testing and hospital treatment was free for residents who have suspected or confirmed case incentivized individuals to receive testing if they suspect infection. br> br> Tracingbr> Singapore utilized technology in combating COVID-19. The TraceTogether Programme is a program to enhance Singapore’s contact tracing efforts in the fight against COVID-19. The TraceTogether Programme comprises of the TraceTogether App and TraceTogether Token. The TraceTogether App was released on 20 March 2020, and TraceTogether Token was introduced on 28 June 2020. The token was launched as an alternative to the smartphone app aimed at people who do not own or prefer not to use a mobile phone. The tokens have unique QR codes and have a battery life of up to nine months. Both the App and Token work by using short-distance Bluetooth signals to detect other participating users within the vicinity (Tracetogether, n.d.). This enables the efficient identification of people who were in close proximity to an infected person by using the proximity data collected. Users will be alerted by a contact tracing officer if they are detected to have been near someone infected with the coronavirus. The information is stored securely on the phone or token and is only shared with the MOH if a user tests positive for COVID-19. The information obtained enables community-driven contact tracing by allowing the health authorities to contact individuals who have been in contact with those who have tested positive for COVID-19 (Government of Singapore, n.d.). To address concerns about long-term civil liberties and privacy violation the government has made clear that the TraceTogether App will cease functionality at the end of the outbreak. The tracking of those who came in close contact with individuals who had tested positive for COVID-19 helped prevent clusters from spreading (Pung et al, 2020).
The government of Singapore also utilized technology to keep records of who had visited certain locations in order to use the information for contact tracing when necessary. On 12 May, the Ministry of Health (MOH) mandated the use of SafeEntry contact-tracing system at all businesses and services. SafeEntry is a national digital check-in system that logs the NRIC/FINs and mobile numbers of individuals visiting hotspots, workplaces of permitted enterprises, as well as selected public venues to prevent and control the transmission of COVID-19 through activities such as contact tracing and identification of COVID-19 clusters (Government of Singapore, n.d.). The SafeEntry program provided additional information for contact tracing and thus helped contain transmission of the virus.

Treating (Health sector capacity)
Singapore had built up its health sector capacity and capability in addressing infectious diseases, such as SARS, MERS, H1N1 (MOH Singapore, 2020b). Due to its experience, Singapore’s health system had excess capacity and systems in place in preparation to respond effectively (Woo, 2020). National stockpiles of personal protective equipment (PPE), critical medications and vaccines for up to 6 months were established in advance in preparation for a virus outbreak (Goh et al, 2006). Prior to the COVID-19 outbreak designated hospitals were prepared to receive and treat infected patients. The National Centre for Infectious Diseases (NCID), which opened in September 2019, is a 330-bed purpose-built facility designed to strengthen Singapore’s capabilities in infectious disease management and prevention (National Centre for Infectious Diseases Singapore, n.d.). Benchmarked to international standards and best practices for treatment and safety, the NCID enhanced Singapore’s ability to respond effectively to the outbreak of COVID-19.

Vaccination of Singapore
The Singaporean government has allocated $4.8 billion for public health, and this has included vaccination which has arisen as additional precautionary measure other than contact tracing, testing and safe distancing. As of April 6th, 2021, approximately 1,130,000 citizens were primarily dosed with the COVID-19 vaccine. The number of people who have received their full vaccination regimen is found to be about 535,864 (Ministry of Health, Singapore, 2021). This is a huge progress compared with the data of people vaccinated by February the same year, which was about 250,000 (Government of Singapore, 2021).
4.3 Economic response
The outbreak of COVID-19 had a significant impact on Singapore’s economy. As the pandemic disrupted the global economy it led to both demand- and supply-side shocks to its economy (Ministry of Trade and Industry, Singapore, 2020b). To counter the economic impact, Singapore has introduced four fiscal packages to assist workers and businesses during the pandemic. On 18 February 2020, the Minister for Finance as part of the Unity Budget, announced a S$4 billion Stabilization and Support Package which included job and cash-flow support to help businesses retain and retrain workers. On 26 March 2020, as the global COVID-19 outbreak continued to worsen, the government announced a second stimulus package of S$48.4 billion called the Resilience Budget. It contained support for households, assistance for workers to remain employed and provided support for businesses. This budget also introduced measures to help specific sectors which were severely impacted by COVID-19 such as the Aviation, Tourism, Food Services, Land Transport and Arts & Culture sectors. On 6 April 2020, the day before the “circuit breaker” measures took effect, the government introduced a third stimulus package called the Solidarity Budget. The package of S$5.1 billion purpose was to mitigate the effect of the “circuit breaker” measures on citizens. As part of the package, the Job Support Scheme to subsidize wages and help companies keep their employees was enhanced and the number of rental waivers was increased. On 26 May 2020, a fourth stimulus package worth S$33 billion titled the Fortitude Budget was announced. The focus of this package was to create jobs and build skills for workers, support transformation of enterprises and strengthen community resilience. In addition to these measures, on 17 August 2020 it was announced by the Minister for Finance that various support schemes and new initiatives to provide continued support for businesses and jobs that have been impacted by the COVID-19 pandemic would be extended. The four budgets introduced by Singapore’s governments in response are estimated to have averted a loss in real GDP of about 5.5 per cent in 2020 (Ministry of Trade and Industry, Singapore, 2020c).

The 2021 budget which entered into force on April 1, 2021 included S$11 billion for the Covid-19 Resilience Package. The Covid-19 Resilience Package is expected to ease the recovery process and focuses on three prongs: public health and safe re-opening; support for workers and businesses; support for specific sectors. (SGA, 2021) S$4.8 billion is allocated for safeguarding public health and safe reopening which includes free vaccination for those who are eligible. S$5 billion will support workers and businesses in which S$ 2.9 billion will be used for the continuation Jobs Support Scheme and the remaining amount for Covid-19 recovery grant, SGUnited Jobs and Skills Package, and Temporary Bridging Loan Programme. The Jobs Support Scheme of S$25 billion have been already used to support more than 150,000 employers for up to 17months. Another S$1.2 billion will support specific sectors under stress due to the pandemic such as the aviation sector (S$870 million) and arts, culture and sports sectors (S$45 million). (SGA, 2021)

Preparing for Post-COVID-19
While working aggressively to contain virus, Singapore has also been preparing for the Post-COVID-19 future. The Emerging Stronger Taskforce (EST), which held its first meeting on 6 May, consults multiple stakeholders, including business leaders, industry experts, and Trade Associations and Chambers to identify systemic shifts arising from COVID-19 and impact of these shifts on the economy, and how these translate into challenges and opportunities, and provides recommendations on how Singapore should reset its economic strategies to stay economically resilient in a post-COVID-19 world (Ministry of Trade and Industry, Singapore, 2020a). Singapore recognizes that it is important to look beyond the immediate challenges and plan for the longer term, so that Singapore’s economy can emerge stronger from this crisis. The taskforce plans to share its preliminary recommendations by early next year.
Economically Singapore is still suffering from the negative impacts of the pandemic. The Ministry of Trade and Industry (MTI) today narrowed Singapore’s GDP growth forecast for 2020 from “-7.0 to -5.0 per cent”, from “-7.0 to -4.0 per cent” on 11 August 2020 (Ministry of Trade and Industry, Singapore, 2020d).
4.4 Social response
Singapore’s government strengthened its social distancing measures as COVID-19 cases increased. A “circuit breaker” ran from Apr 7 to June 1 2020, but was eased from early May. Only essential services could continue to keep their premises open. Restaurants were only allowed to offer take-away, drive-thru and delivery of food. Citizens were instructed that masks should be used when people leave the house for essential needs, but urged to stay at home as much as possible.

All schools closed from 8 April and students switched to home-based learning as part of the “circuit breaker”. After the end of the “circuit breaker” schools opened in phases from 2 June, with most students in school for one week, then switching to home-based learning the next week. Students are required to wear masks, their temperatures are checked on entry, and hand sanitizers are installed for students and staff use. The government also announced by next year all secondary school students will receive a personal laptop or tablet for online learning. Third level institutions continued having lectures and tutorials online, with exceptions for practical and laboratory session classes, and final-year projects. As public education has taken the route to reopen under such circumstances, not only immediate response but also long-term effects of the pandemic is being considered. Singapore is planning to invest more on teachers and key education staff’s career development since profession developments had negative impacts due to the pandemic. Furthermore, more career tracks will be introduced to them as an additional support for promotion to senior roles (The World Bank, 2020).

Generally, citizens followed distancing guidelines issued by the government, so the rate of community infections was lowered. Drawing from the public engagement efforts in SARS, public education efforts in Singapore emphasized social responsibility and appropriate behavior. At workplaces, employers were encouraged to conduct regular temperature and health monitoring for employees, as well as to implement business continuity plans in preparation for a possible lockdown, such as having employee working from home or working in segregated groups (Lin, Lee & Lye, 2020). The government recognized the shortage of masks among the general populace and the government distributed four surgical masks to each household in February as well as took action to increase the general supply of face masks. Singapore’s leaders originally urged citizens to wear masks only when already ill until the beginning of April, but from June, Singapore’s ministry of health recommended ‘masks will now be required as the default’ (MOH Singapore, 2020a). Wide scale use of masks by general populace likely contributed to reducing new infections. Strict measures were enacted by the government to reduce the spread of COVID-19, such as new laws governing social distancing that could see rule violators serve up to six months in prison thousands of dollars in fines were broadly supported by citizens. Temasek Foundation has committed to a nationwide distribution of one new reusable mask alcohol-free hand sanitizer for each Singapore residents in March and April 2021. Using government-issued IDs, free masks in different sizes can be collected from vending machines island-wide. (Temasek Foundation, 2021)

Migrant dormitories
After the initial government response and weeks of a partial national lockdown, it seemed that the COVID-19 situation among the general public was largely under control. Unfortunately, the government had overlooked the possibility of large-scale outbreaks in migrant communities. An estimated 200,000 migrant workers live in 43 dormitories in Singapore. With usually between 12 and 20 workers living per room with the sharing of common facilities such as bathrooms and kitchens, it was impossible to perform effective social distancing. Local officials underestimated the vulnerability of these locations, and COVID-19 clusters emerged (Leung, 2020). In April 2020, Singapore appeared to have the spread of COVID-19 under control yet when testing was expanded to migrant dormitories it became clear that the clusters had developed, reaching a high of 1,426 confirmed new cases on 20 April, with most of these cases being migrant workers. As testing was expanded to migrant worker communities, the number of new cases gradually fell. On 11 August, the Singapore Ministry of Manpower said in a press release that all workers living in dormitories have either recovered or have been tested to be free from the virus, except for those currently in quarantine.

In mid-December 2021, 152,000 migrant workers have been infected even with the restriction of movement while fewer than 4,000 people have been infected in Singapore. (BBC, 2020) The Ministry of Manpower expected that recovered and vaccinated workers living in dormitories would significantly reduce the risk of transmission of COVID-19. As a result, 9,000 eligible workers from five of the biggest dormitories received their vaccination on March 26, 2021. (Wei, T., 2021) An additional 30,000 foreign workers across 30 dorms have been scheduled to receive Covid-19 vaccination. (Yufeng, K., 2021)