Over the last 10 days, COVID-19 cases have exploded in Taiwan, which has stood out as the world leader in controlling the disease. Meanwhile, on the other side of the Pacific, cases in the United States, which ranks number one in total cases and deaths, have seen a sharp drop in cases. Social distancing restrictions and mask mandates are being eased as Taiwan locks down.

The sudden change in the two countries is because of one thing: Vaccination rates. After a slow start in the US, 47.6 percent of the population over 18 is now fully vaccinated, and 60 percent is partially vaccinated (as of May 18). Among people over 65, 72.8 percent are now fully vaccinated. In total, 37.5 percent of the entire US population is now fully vaccinated.

In Taiwan, by contrast, only 1 percent has been vaccinated. Until mid-May, the island had few cases, and the spread was thought to be under control, reducing the urgency to implement mass testing and vaccination. The exact route of the current wave is unknown, but the shortening of quarantine period for airline crew from 14 to 3 days most likely allowed the fast-spreading UK variant in.

The case of Taiwan underscores the importance of vaccines in fighting the virus. Public health measures, such as lockdowns, social distancing, masks, testing, and tracing are essential to slow the rapid spread in the initial stages and to keep it at bay until a vaccine is developed. The US failed to implement these measures effectively at the beginning and paid the price in lives and social dislocation.

Fortunately, effective vaccines were developed in less than a year from the first outbreaks. They are the only way to bring the highly contagious virus under control quickly and effectively. All efforts to bring the pandemic under control should focus on vaccination.

At present, vaccination rates are highest in an eclectic group of small nations, the UK, and the US. The situation is changing by the day, and vaccinations are moving along steadily in many wealthy and middle-income countries. In Turkey, for example, vaccinations have reached 18 percent partially vaccinated, and cases have fallen rapidly. The slow pace of vaccination in world’s poorest countries remains a problem that demands attention.

Among wealthy nations, Australia, New Zealand, Japan and Taiwan have the lowest rates of vaccination. Interestingly, all these countries are islands that have combined strict controls on international travel with strong public health measures. In early May, Australia even took the draconian measure of banning Australian citizens in India from returning home and threatened a fine and jail time if they tried to sneak in. Japan continues to ban most foreigners from entering the country.

Geographically, South Korea is a peninsular nation, but politically it is an island. Other than a few passenger ferries to China and Japan, the only way in and out is by airplane. Like the other island nations, South Korea has imposed controls on international travel while implementing strong public health measures.

South Korea differs from the other island countries in its commitment to openness. It developed a system early on that allows Korean citizens and foreign visitors to enter the country if they agree to a 14-day quarantine. The system has worked, and the country has not needed to make take harsh measures like Australia and Japan.

The commitment to openness has given impetus to the vaccination program because, as the case of Taiwan shows, leaving the nation unvaccinated leaves it vulnerable and makes a return to openness impossible. At present, 7.2 percent of the South Korean population has received one dose of vaccine, but only 1.8 percent are fully vaccinated. The pace is about the same as the wealthy island nations.

As vaccinations have increased, health authorities have responded by allowing people vaccinated in South Korea to skip quarantine on their return. They have come under criticism for not waiving quarantine for people vaccinated outside of South Korea. Health authorities rightly worry that proof of vaccination could be faked, allowing a new variant to enter before vaccination rates are high enough to fend it off. The travel industry and frequent visitors have argued that the policy is too strict and hurts the economy.

Both arguments are persuasive. As the case of Taiwan shows, just a few people slipping through the safety net can wreak havoc. On the other hand, South Korea has made an admirable commitment to openness. The best approach is to focus on vaccinations, particularly for vulnerable groups, and adjust entry procedures as confidence levels rise.


Robert J. Fouser
Robert J. Fouser, a former associate professor of Korean language education at Seoul National University, writes on Korea from Pawtucket, Rhode Island. He can be reached at robertjfouser@gmail.com -- Ed.