The "Societalization" of pandemic unpreparedness: lessons from Taiwan's COVID response.

Adopting a Civil Sphere Theory framework, we argue that Taiwan's efforts at containing COVID-19 resulted from its "societalization" of pandemic unpreparedness, which was triggered by the 2003 SARS outbreak and resumed during the COVID-19 pandemic. Societalization refers to the process through which institutional failures are transformed into societal crises, with the civil sphere mobilized to discuss institutional dysfunctions, push for reforms, and attempt to democratize or otherwise transform institutional cultures. The societalization of pandemic unpreparedness in Taiwan led to reforms of the public health administration and the medical profession, thereby establishing state mechanisms for encouraging early responses and coordinating centralized command during outbreaks, and healthcare infrastructures for coordinating patient transfer and ensuring supplies of personal protective equipment. Reflections upon past uncivil acts among citizens motivated the civil sphere to foster a discourse of interdependence, redefining the boundaries between individual choices and civic virtues. Meanwhile, unaddressed challenges remained, including threats related to Taiwan's political polarization. Our paper challenges the thesis of "authoritarian advantage," highlighting how democratic societies can foster social preparedness to respond to crises. By illustrating how societalization can reach temporary closures but become reactivated subsequently, our study extends the theory of societalization by explicating its historical dimension.