by Bonny Ling
Photo Credit: Solomon203/WikiCommons/CC
ON JUNE 4TH, two COVID-related news items dominated the press briefing by the Central Epidemic Command Center (CECC) in Taiwan. First was the planned arrival of 1.24 million doses of the AstraZeneca vaccine provided by the Japanese government. And second was the report of a cluster of infections in an electronics factory in Miaoli County, affecting mostly migrant workers. A total of 67 individuals, including eight Taiwanese nationals and 59 Filipino nationals were confirmed to have COVID at the electronics factory. In response, the CECC established an incident command post at the site, staffed with emergency disease prevention and epidemiological investigation specialists.
On June 5th, the CECC announced that Miaoli was indeed facing a severe local infection cluster. It ordered immediate measures to bar the movement of all migrant workers between factories, including the unnecessary transfer of migrant workers to new employers and the transport of workers to different factories owned by the same employer. Employers and labor brokers were further instructed to carry out disease prevention and control measures as prescribed by the Ministry of Labor.
On June 6th, the CECC announced that the number of migrant workers testing positive for COVID in the first factory has increased to 182 individuals, with 24 additional cases reported in two other electronic factories in Miaoli. On June 8th, 16 more cases connected to the Miaoli migrant factory worker cluster were reported, and a second round of COVID testing for the workers linked to this cluster will begin on June 11. Figures indicate that there are currently 960 migrant workers in quarantine facilities, 1,027 quarantined in dormitories, and another 1,100 living in a large dormitory complex who were rapid tested and awaiting results.
In the past month of COVID-19 case spikes across the island, the Taiwanese government has taken some positive steps to address COVID infection amidst migrant workers. These include facilities to test undocumented migrant workers with the commitment of no penalty or law enforcement action. In addition, on June 6th, the government announced that all foreign workers will receive full pay while under quarantine, which goes a long way towards alleviating livelihood concerns of migrant workers that they will not lose earnings while complying with quarantine measures. Yet the Miaoli County government later announced that all migrant workers would not be allowed to go out except to travel to work or to buy supplies under the supervision of their dormitory managers and that there will be increased law enforcement presence on the streets for monitor and control. This has raised questions whether this is an illegal infringement of their freedoms at a time during which Taiwan is not under a full lockdown.
Early Days of Migrant Cluster Outbreak
IT IS CLEAR that Taiwan is at the very early beginning of what Singapore saw in April 2020, when a spike in COVID-19 infections amongst its migrant worker population led the government to order a lockdown of all migrant dormitories. These residences are often cramped and badly ventilated, a hotbed for viral transmission. The current COVID situation in Taiwan is fast evolving. One hopes for the cases associated with the Miaoli factory clusters to soon show a consistent downward trend. Nevertheless, it is prudent to plan for more challenging developments and look to Singapore’s experience with controlling the COVID-19 outbreak amongst its migrant worker population. There are lessons that Taiwan can learn from and avoid in order to prevent the escalation of COVID-19 cases, as well as how to do this in a way that does not stigmatize the migrant worker population in Taiwan.
In Singapore, nearly 300,000 migrant workers living in dormitories came under strict movement restriction in 2020. As reported, these facilities can be very large and purpose-built or they can be smaller factory-converted and makeshift living quarters. The rooms typically accommodate between 12 to 20 inhabitants, thus making social distancing virtually impossible. By August 2020, more than 50,000 dormitory residents (a staggering one-sixth of the migrant population living in such facilities in Singapore) had tested positive for COVID-19, which at that time made up more than 90 percent of all COVID-19 cases in Singapore.
Lesson #1: No discrimination in the enjoyment of the right to health between migrant and local population; any differential treatment must meet the test of necessity
In April 2020, Singapore came under heavy criticism for designating two migrant dormitories as “isolation areas,” effectively placing over 20,000 migrant workers in quarantine. Amnesty International criticized the move as potentially discriminatory and risks exposing healthy individuals to a higher chance of infection in the crowded living conditions.
It is worth pointing out that the CECC press release on June 6th, 2021 (Bullet 3) points to a difference in treatment by nationality without clarifying why this was necessary: “Epidemiological investigations are launched among Taiwanese nationals who have been confirmed to have COVID-19 to identify contacts.” The same press release in Chinese has the added line that “其餘員工，加強健康監控。[For the remaining employees, health monitoring shall be strengthened.]”
It is unclear why contact tracing was not conducted for those who tested positive for COVID but not of Taiwanese nationality. The assumption for the differential treatment is that this disparity arose because the migrant workers at this factory are already housed in dormitories separate from the general population. However, in many ways, contact tracing for the migrant workers confirmed to have COVID-19 could be less complicated, owing to their regimented workdays. That Taiwan has been under near-lockdown conditions in recent weeks also potentially simplifies contact tracing by eliminating the possibility of social transmissions outside the dormitory and work settings.
Looking to the experience of Singapore, Taiwan needs to avoid exposing healthy individuals to COVID-19 infection as a matter of priority. The movement ban for migrant workers in the affected areas can have the discriminatory effect of exposing healthy individuals to greater risks of COVID-19, while confining them to an atmosphere of anxiety, fear and stress.
The question here is whether the movement ban meets the threshold of necessity.
Why did the CECC decide not to replicate contact tracing for the migrant workers in the Miaoli electronic factory but chose to trace the contacts for the affected Taiwanese nationals? Has the infection rate amongst migrant workers in the dormitories become prevalent enough to deem such blanket bans necessary?
Or was this decision borne out of operational capacity; for instance, if contact tracing was thought to be too difficult to carry out in other languages as cases increased. If so, then the clear answer is not a “bubble containment” strategy to address migrant outbreak clusters. Instead, additional efforts should be directed to strengthen testing and tracing capacity in the main migrant languages for the manufacturing sector in Taiwan, predominately Vietnamese and Filipino, but also Thai and Bahasa Indonesian.
On June 7th, updated Ministry of Labor instructions supplemented the CECC press release and appears to adopt a more nuanced approach towards controlling the surge of COVID-19 cases in migrant dormitories. It calls for COVID-infected workers to list close contacts and then be quarantined in a room with its own sanitation facilities. Quarantine costs, if necessary, will be partially subsidized by the Ministry of Labor.
This is a welcoming development, for the reason that the longer a containment strategy is deployed for migrant COVID-19 clusters in dormitories, without sufficient rapid testing, separation of those testing positive, and medical treatment, infection rate will spread. In such a scenario, containment becomes a self-fulfilling outcome, as epidemiological contact tracing reduces in utility. The updated Ministry of Labor instructions thus offer an alternative, where quarantine is based on necessity and the results of contact tracing and not imposed on the grounds of nationality.
Lesson #2: Urgently improve dormitory and workplace conditions, including additional cleaning regimes that follow COVID prevention guidance, reducing the density of migrant dormitory residents
In April 2020, the Singaporean government implemented certain World Health Organization (WHO) recommendations on the preparedness, prevention and control of COVID-19 for refugees and migrants in non-camp settings. In particular, the recommendations call for employers to provide functional basic utilities such as water, sanitation and hand washing facility, for all workers, with separate dormitory buildings reserved for those quarantined with suspected infection and for workers with COVID. Furthermore, quarantined areas should have sufficient health, sanitation and logistics personnel and that testing should be made available for all workers.
It is an understatement to state that migrant workers must be safely accommodated and have access to adequate water and sanitation facilities at all times, especially crucial during a pandemic. Although Taiwan is not a member of the WHO, the government must nimbly implement those recommendations most relevant in its emergency response to this COVID cluster outbreak. This means increasing the surge capacity of the Ministry of Labor to inspect migrant dormitory to ensure that they meet the basic water and sanitation requirements and that all accommodations are safe and not overcrowded. Quarantine hotels that currently sit largely empty due to the present ban on foreign arrivals can be used as secondary housing to reduce density in the most high-risk and crowded living quarters.
Corporate social responsibility auditors who conduct inspections of Taiwanese suppliers for international brands frequently flag the health and safety conditions of worker dormitories. In Singapore, concerns on worker dormitories similarly were flagged as early as 2013, regarding overcrowding and outbreaks of typhus, dengue and pneumonia. Individuals in crowded dormitories are not only at a high risk of contracting respiratory infections, but their mandated quarantine in such environments can increase anxiety of being far from home and dealing with the uncertainties of a prolonged lockdown. Initial reports have emerged in Taiwan that paint a pressure-cooker environment, where COVID testing for migrant workers has not speedily taken place and where infection will likely spread.
Looking to the migrant testimonies from the lockdown in Singapore last year, we know that these sentiments of anxiety, fear and stress will heighten the longer the quarantine is in place. Migrant workers spoke of feeling imprisoned and worried not only for their families back home but also of themselves becoming ill with COVID-19. One report by the Singaporean civil society organization, Transient Workers Count Too, described a migrant worker who was locked inside his room with 19 others by management of the dormitory after one of the roommates was diagnosed with COVID-19. Looking forward, Taiwanese authorities need to forewarn employers, labor brokers and dormitory facility operators that such actions are not acceptable as part of COVID-19 management and will be heavily penalized.
Lesson #3: Measures must be proportional and regularly assessed, with accurate information promptly communicated in languages migrant workers understand; in parallel, misinformation and stigma of migrant workers must be actively countered
Another criticism of the Singaporean experience with COVID outbreak in the territory’s migrant dormitories is that the quarantine for migrant workers was exceptionally long. By June 2020, a large degree of normality had returned to most of the city-state residents when the government lifted the most restrictive COVID-19 measures. Nevertheless, even when the infection rate amongst the migrant workers in Singapore dropped to zero by October 2020, movement restrictions remained for them and lasted well into 2021.
Local advocacy organizations called the prolonged lockdown imposed on migrant workers unjustified and prison-like, given that most restrictions had been lifted for the general population. In April 2021, hope for the lifting of movement restrictions for migrant workers in Singapore was dashed when another COVID-19 cluster was found amongst 1,200 migrant workers. Shortly after, stricter COVID control measures also came in for the general population in May 2021. The Singaporean experience clearly underscores the need for measures to be proportional to their intended effects, based on regular assessment of the public health situation.
In addition, measures to combat the spread of COVID are ineffective without buy-in. This means that information must be promptly and accurately communicated to migrant workers in their own languages. Guna Subramaniam, from the Migrant Workers Programme of the international think-tank Institute for Human Rights and Business, who is based in Singapore, commented: “Employers should exercise their duty of care to respect human rights and meet the basic social protection needs of all employees. This includes migrant workers having access to accurate information in a language they can understand. This may also include translators who can provide information and support for them to access healthcare and communicate with and understand medical professionals.”
Foremost, measures cannot be indefinite and imposed on a population that is already at increased risk of COVID infection due to their living conditions. Migrant workers in Taiwan are already a marginalized population. For example, migrant workers in the domestic care sector fall outside Taiwan’s Labor Standards Act and do not receive the protection of statutory minimum wage. In reality, the complexity of the transnational migrant labor system means that many of the challenges in addressing the health needs of migrants during COVID-19 are symptoms of deep-seated inequalities that cannot be easily plastered over during a public emergency. It will take sustained commitments from all stakeholders, beyond governments, to address the complicated jigsaw puzzle that is our current system of international labor migration.
COVID Shines a Harsh Light on Inequalities
LIKE IN SINGAPORE, the COVID-19 outbreaks amongst migrant workers in Taiwan only highlight their existing vulnerabilities. Those of us who have worked on migrant rights in Taiwan and broadly in the region know the migrant recruitment system is one with structural faults, enabled by an asymmetry of power between employers and employees. Prejudice against migrant workers exist, yet the local economy depends on migrant workers to meet crucial domestic labor shortfalls.
In this context, Taiwan’s CECC notably was quick to dispel the notion that migrant workers somehow brought COVID-19 on themselves through their socialization. The Minster of Health and Welfare, Chen Shih-chung, unequivocally stated that the migrant COVID clusters were due to their living conditions, when he was directly asked about what contributed to the outbreaks in migrant dormitories at the COVID-19 daily briefing on June 5th. This was significant and exemplified public health at its best to counter misinformation and, worse, scapegoating at a time of tension and uncertainty.
Nevertheless, important questions remain on why COVID-19 outbreaks in migrant dormitories seemed to have caught authorities by surprise, given that Taiwan had an envious long stretch of no COVID cases when much of normal life reigned, and it could look to other countries to prepare for likely scenarios.
Inclusive Vaccination Schedule
IN THE SHORT term, vaccination is the way out of the pandemic. Migrant workers’ access to vaccinations needs to be guaranteed and provided on a non-discriminatory basis. Here, the question is not whether migrant workers in Taiwan should be vaccinated; they clearly should have access to COVID-19 vaccinations. Migrant workers in Taiwan pay for the National Health Insurance from their monthly wages, like their local counterparts. This entitles them, as a matter of right — not of charity — to the range of medical services, inclusive of vaccines, offered by Taiwan’s nationalized health scheme.
Furthermore, it is important to emphasize that international law on the rights of migrant workers states that all migrant workers have the right to receive emergency medical care that is “urgently required for the preservation of their life or the avoidance of irreparable harm to their health on the basis of equality of treatment with nationals of the State concerned” and that such emergency medical care cannot not be refused even if the workers have irregular residency or employment status (International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families, Article 28).
The key question is whether and how different groups of migrant workers will be prioritized for COVID-19 vaccinations. In Singapore, the government had to balance the need to vaccinate migrant workers to control COVID-19 infection in their dormitories with the need to protect the general population, based on an assessment of exposure risks that begin with medical frontline workers and then moving to other factors of vulnerability. Looking to what Taiwan can learn from Singapore, one of the factors for priority vaccination can be the size and density of the migrant dormitories as a risk factor, with large migrant dormitories in Singapore getting preference for COVID-19 vaccines, as a balance between the various considerations.
Moreover, for Taiwan, in a scenario that is uniquely Taiwan: another reason for the priority for the vaccination of migrant workers can be their role as key workers in industries deemed as especially crucial, such as the semiconductor industry or the overall high-tech sector, given their importance in the domestic economy and security implications for Taiwan and the global electronic supply chain. For instance, if workers who toil in the vast web of factories supplying parts to the Taiwan Semiconductor Manufacturing Company (TSMC) are designated as key workers, then necessity and logic dictate that the government must prioritize all workers in this sector for vaccination, regardless of their nationality. Fundamentally, more than an economic calculus, this would be only scenario in line with Taiwan’s commitment of non-discrimination and as a nation based on an ethos of human rights, if the vaccination schedule is inherently inclusive of migrant workers and drawn on the basis of equality of treatment with Taiwan nationals.
Given the very limited supplies of vaccines sent to Taiwan thus far, the percentage vaccination rates reported by all local governments still remain very low, firmly in the single-digit territory. With the majority of local governments reporting below 3 percent of the population vaccinated against COVID-19, any discussion of prioritizing migrant workers for vaccination, whether based on the established factors of health vulnerability or strategic contributions to the domestic economy, ahead of segments of the general population will face opposition. It will not be popular. Ethnic nationalism will rear its nastiness, already seen in public online forums like the PTT where participants can comment anonymously.
What is needed now and more than ever is the courage for all to follow through on the central human rights tenet of non-discrimination. For the past year, Taiwan has embarked on a public relations campaign of it helping the world during the pandemic with deliveries of medical supplies. The COVID outbreak in migrant dormitories in Taiwan timely underscores the people component in Taiwan’s New Southbound Policy. At this crucial moment, the world watches to see how Taiwan helps the global citizens residing in its midst, for now is still not too late to imagine a different outcome from all that has come before, for our collective dignity during a time of COVID.