A Taiwanese University’s Initiatives for COVID-19 Prevention: Implications for Teachers and Students

virus prevention infographics). Most impressively, to date, no lockdown measures have been required, and no local transmission of the virus has been since Additionally, local, county- and city-level initiatives were also enforced, often depending on the number of cases in that particular jurisdiction. Of particular interest to this paper is the role of universities in autonomously adopting standards and practices related to COVID-19 prevention, and the potential impacts on teaching and learning. The case highlighted in this article is from a large public university in Southern Taiwan. Frequent communications by the school to faculty, staff, and students set guidelines for health self-evaluation and monitoring, infection prevention measures and safeguards, classroom arrangement and conduct, and preparations for online teaching in the case of potential lockdown. While lockdown has been avoided, disruptions to teaching schedules have been unavoidable, and the flexibility of teachers and students has been instrumental overcoming the potential obstacles of an uncertain semester.

conditions, such as the requirement for travelers from South Korea to quarantine on February 24 and those from Italy on February 27 [4].
Due to the increasing number of suspected and confirmed cases in February and March, hospitals implemented mandatory wearing of masks, hand sanitization, infrared temperature detection, and the use of buffer zones to separate patients with different risk levels of having COVID-19 [5,6]. Clinical and epidemic criteria changed according to evolving knowledge of the disease, particularly during February and March 2020 [7], which, in conjunction with public announcements , guided residents to call a toll-free number, 1922, in order to first report symptoms, rather than immediately visit a clinic or hospital. Other measures related to hospital care of potential infections include the government's oversight and distribution of personal protective equipment (PPE), limitation on hospital visitors [8], regular disinfection of equipment and facilities, and triaging of cases, all based on Taiwan's experience with the SARS epidemic of 2003 [9,4]. The use of technology in combatting the disease ranged from cellphone short message service (SMS) messages for keeping track of persons under self-quarantine and QRCode scanning for completion of a mobile declaration pass to the use of applications for finding masks during temporary shortages and social media for receiving updated official information on the virus [10]. Furthermore, visitors and citizens were asked to turn on location-tracking functions, such as those provided through Google Maps, in order to trace movements that may later be used by healthcare professionals for contact tracing in the case of infection [11], in addition to the use of travel and health history data available from Taiwanese residents' integrated circuit (IC) chip health cards [12].
Extensive use of technology illustrates the potential application of Big Data analytics in effective contact tracing and tracking [13] with some evidence even suggesting that Google searches can be used as an index for predicting a rise in cases (according to location) following a lag of a few days [14]. In order to further researchers' understanding of the situation in Taiwan, press releases by Taiwan's Centers for Disease Control [15] are available online and contain detailed information regarding COVID-19 cases, including demographic data, travel history, disease onset date, symptoms, and date of confirmation using reverse transcription polymerase chain reaction (RT-PCR) tests [2], a test that is believed to be essential to accurate diagnosis based on inconsistent results from chest radiology [16]. This has further informed researchers and practitioners in the ongoing battle to test, confirm, and treat cases. This paper emphasizes the role of universities, due to the degree of autonomy provided to them in terms of how schools enforce pandemic prevention guidelines, and how teaching and learning would be conducted. The following case will highlight the precautionary measures administered by one university in Taiwan and some preliminary outcomes.

Case Report
The case covered by this paper is of a large public university in Southern Taiwan. Consisting of three campuses, seven colleges, and 36 departments, with over 500 full-time faculty members, the university attracts students from around Taiwan, as well as other countries. As such, students frequently travel to their hometowns during weekends and holidays, by rail or bus, while international students often return to their home countries for winter and summer breaks. Taiwanese students also enjoy travelling during longer breaks. As a result, several returning international students and local students were isolated for the first two weeks of the semester due to the recently enacted self-quarantine measures.
For these students, instructors were responsible for providing opportunities for make-up classes or assignments, which, in cases, included the use of online teaching. As early as February 2 concerns arouse regarding the potential of a delay in the semester start date and the process for taking leave if necessary due to the virus. On February 6, the university disseminated information regarding COVID-19, including guidelines for enforced quarantine, self-quarantine, and health self-management. On February 13, the meeting memos from a meeting of the school administration week semester were felt by all teachers, as an 18 week syllabus had already been approved and uploaded to the university website, and students had already registered for classes. Modifications to the schedule resulted in some missed content and the lack of time for students to adequately prepare for assignments, as compared to the regular 18 week semester. However, due to Ministry of Education guidelines, students were required to complete sufficient hours to qualify for credits. At this time, the beginning of the delayed semester (March 4), the university president sent a letter to faculty and students entitled "Hoping We are Safe and Healthy," which addressed the delayed school semester, the quarantine of student arriving from abroad, the schools efforts to disinfect every area of the campus, and an encouragement for everyone to wear masks, although they were not mandatory island-wide at the time. At the same time, a PDF file was sent with instructions for faculty and students to fill in information on their travel history, current symptoms (fever, cough, throat pain, shortness of breath, runny nose, muscle or joint pain, and others), potential contact with infected individuals, or current self-isolation status. This form was offered on the school's online administration website and is available to be filled out each week. Further weekly information on student seating and online attendance was required by the school.
Teachers were asked to assign students to specific seats and then submit the seating arrangement every week. The rationale was that student seating information could be used for contact tracing if required at any point. If these cannot be avoided, which includes large classes of students, masks must be worn at all times.
2) Indoors, a distance of 1.5 meters is to be maintained at all times, while outdoors the required distance is 1 meter. However, in the case of close proximity within classrooms, everyone must wear a mask.
3) Body temperature is regulated at the entrance to each campus. Those with a fever (defined in other documentation as a forehead temperature ≥ 37.5°C or tympanic temperature ≥ 38.0°C) are not allowed on campus.

4) Hands must be sanitized whenever entering an office or
classroom with 75% alcohol.

5) No food or drink is allowed in classrooms, and all
beverages must have lids.
6) It is recommended to bring your own pen to use for signatures and avoid handshakes. 7) When eating on or off campus, 1.5 meters of separation should be maintained and talking should be prohibited when a mask is not being worn.
While the discomfort with wearing masks was a common complaint from both teachers and students, including the added difficulty in understanding one another and breathing well, compliance was nearly 100%. Frequent hand washing was encouraged and was not considered a burden. Students who were accustomed to eating breakfast or drinks in class were encouraged to use break times to go outdoors to do so. As such, the aforementioned requirements were deemed necessary to prevent transmission from potentially presymptomatic or asymptomatic cases. In compliance with government regulations, information was passed to teachers and students, advising the use of location-tracking functions when travelling off-campus.
This was particularly important for the Tomb-Sweeping Festival mid-term break (which was a total of nine days from March 28 to April 5, 2020). Before the holiday, on March 26, the university president wrote a letter to students, entitled "A Different Spring Break," advising students to observe social distancing, wear masks, frequently wash their hands, avoid touching their face, and avoid getting together with friends during this dangerous time. At the same time, the Taiwanese government was under some criticism for not enacting travel restrictions, since tomb-sweeping involves close proximity to non-family members and the accompanying holiday often involves travel to different parts of the island. Nevertheless, before the break, the CECC did warn travels to take precautions and observe social distancing as much as possible. Thankfully, only a few students required quarantine due to exposure to an individual who was a potential contact of a COVID-19 confirmed case. No cases for the university were reported, so no lockdown and cancellation of face-to-face classes was required.
The week prior to the spring break, instructors were also required to complete a form indicating their plans to implement online teaching in the case of a shutdown, which was being discussed on social media and by some media outlets as a possibility at the time. During March, the Computer Center distributed information on how to use synchronous and asynchronous technologies for teaching, and offered in-person counselling and professional development courses for the use of these platforms. The March 20 email indicated that instructors were to fill in an Excel document with the following information for each course they were teaching: 1) Online teaching method (synchronous, asynchronous, or other); 2) Evaluation method (Online tasks, discussions, tests, or other); and 3) Practicum-related coursework.
In terms of synchronous computer mediated instructional platforms, the university recommended Zoom, CyberLink U

Meeting, Microsoft Teams, Cisco WebEx, Adobe Connect, and Google
Hangouts Meet. Later, on April 7, the school and the Ministry of Education announced that due to privacy and security issues, Zoom should no longer be used. In terms of asynchronous platforms, the university recommended using video or screen recording software. All instructors were required to upload these plans, and to discuss the possibility of implementing online teaching with their students in the case of a lockdown. Students and teachers generally demonstrated distaste for the use of online teaching for several reasons: the lack of immediacy, difficulties in completing group work, assessment and attendance issues, and technical and time limitations, to name a few. As public university employees, protections were in place in case of infection, allowing instructors to take leave without penalty and, when appropriate, receive disease prevention compensation [18]. Students were also protected from unfair penalization in the case of required quarantine or illness.
Their absences would not be registered in the online attendance record, and professors were required to provide them with makeup options.

Results
As of the date of this paper's submission, no cases have been reported at the university. In fact, some measures regarding the wearing of masks have been technically loosened (largely in the case of outdoor activities, in accordance with municipal policies), while student are still required to wear masks indoors and in class.
The percentage of students and teachers who do not wear masks (indoors or outdoors) has increased. Temperature checks, while very common throughout the day earlier in the semester, are now only required at the gate upon arrival. A sticker (color coded for the day of the week) is stuck to the individual's clothing to indicate that they have passed the temperature check for that day. Alcohol sanitizer spray bottle are still commonly available and used, and handwashing is practiced. Thus far, online teaching has not been required, to the relief of many teachers and students. Disruptions in terms of classes, in the form of required make-up assignments or lectures, are still in progress, but are being managed with patience from teachers and students. This positive result is based on the joint regulations and support of Taiwan's government and the university in maintaining prevention of COVID-19 infection. Simple guidelines were followed, such as wearing masks, washing hands, reporting symptoms, self-isolation in the case of fever, and effective social distancing. Some guidelines, such as the university's requirement that students have assigned seats, were deemed impractical by some teachers, as students were required to change seats in order to engage in group work, or students would sit according to convenience rather than an assigned seat, which was often difficult for them to find. Furthermore, due to the fact that students do not have fixed classrooms, and chairs or desks may be moved to meet the needs of individual teachers who use the classrooms, thus rendering assigned seating difficult, if not impossible. Nevertheless, overall adherence to national, local, and university guidelines resulted in a smooth semester with few cases of quarantine, no need for online teaching, and only slight disruptions in the semester schedule.

Discussion
Taiwan's efforts, as highlighted in the introduction section, could serve as a model for other countries to follow. However, it should be noted that Taiwanese society, population distribution, infrastructure, technology, social norms, openness to online tracking, and other unique factors [19,20]