Taiwan, an island state in East Asia is located at less than 150 km sea route away from China, the epicentre of COVID-19 outbreak. Among the 23 million population of the island 850 000 reside-in and 404 000 work in China. Though the world’s corona death tool is steeping with elevated graph, Taiwan has recorded only 429 cases and 6 reported deaths as of April 30, 2020.
Taiwan has always been provident from its earlier lessons learnt during SARS outbreak in 2003. Thus, the country became hyper-vigilant once the first case of mysterious pneumonia reported in Wuhan, China. Taiwan developed its proficient and self-established health system to address any upcoming pandemic or epidemic. Taiwan’s advanced hub is combating COVID-19 through science, technology, and democratic proactive governance and most importantly independent of WHO tracking system. Taiwan believes in strategic pre planning prior to the outbreak and constantly reviews immigration policies as and when the situation evolves to monitor any emerging infectious diseases.
Taiwan’ trajectories and execution strategies in assessing COVID-19 and quick actions in preventing a large-scale epidemic may be instructive for other countries as the virus continue to threaten global health and economies.
Rapid response and effective strategies
Ever since the SARS epidemic in 2003, Taiwan has been on constant alert by establishing public health response mechanism which activates emergency public health management structures. Taiwan proficient teams quickly mobilize and institute specific approaches for case identification, containment, and resource allocation.
The arsenal of information also includes the use of advanced analytics, technology, dynamic screening, testing and retesting, communication strategies, accountability, and the presentation of informative and credible daily updates to citizens. Taiwan emphasises on risk and disaster management by establishing robust case tracing mechanisms and defined stringent quarantine protocols.
On January 20, Taiwan established a Central Epidemic Command Center (CECC) spearheaded by Vice President Dr Chen Chien-jen, himself an epidemiologist, and led by Dr Shi-Chung Chen, Minister of Health and Welfare. In April, President Liang Kung-yee announced government investment of NT$2.16 billion (US$71.7 million) in the testing, treatment, prevention and research of COVID-19. A NT$4 billion (US $133 million) 2022-2027 budget has also been approved for the Epidemic Prevention Center Construction project.
In 2004, the year after the SARS outbreak, the Taiwan government established the National Health Command Center (NHCC) as part of disaster management to addresses public health emergencies. The NHCC operates as unified central command system among central, regional, and local authorities composing the CECC, the Biological Pathogen Disaster Command Center, the Counter- Bioterrorism Command Center, and the Central Medical Emergency Operations Center. The dedicated workforce implements optimized surveillance systems, strengthens border controls and quarantine rules, and enhances contagious diseases screening. The CECC also takes an active role in resource allocation, mask rationing, government funds utilization and deploying defence team for mask production.
Taiwan enhanced COVID-19 case detection using National Health Insurance [NHI] database. Additionally, residents use a central hotline toll-free number to report symptomatic cases of themselves and others. As the disease progressed, each major city owned its own hotline to address maximum concerns from the population.
Prudent action and early deployment
As Taiwan is not a member of the World Health Organisation (WHO) it follows its own guidelines deploying in-house capabilities and Information Communication Technology (ICT) strength. When there was a surge of COVID-19 case in neighbouring Asian countries, Taiwan health authorities did a retrospective screening of patients reported as having severe flu. By January, symptomatic travellers returning from the epidemic area were screened by RT-PCR tests when cases were still considerably low.
Government ramped up the production of face masks, personal protective equipment (PPE) and critical medical supplies in January with subsequent quick rationing to its residents. Central medical stores ensures adequate supply with frequent stock validation. Taiwan is sufficiently equipped with critical care assistive devices accounting to 20,000 negativepressure isolation rooms and 14,000 ventilators.
Taiwan streamlined face mask purchase through GPS guided virtual map which helps public to locate nearest pharmacies and the stock available. Citizens are facilitated with an online mask ordering system to collect from convenient store avoiding visit to public spaces. Taiwan Machine Tool & Accessory Builders’ Association (TMBA) encouraged the members to volunteer to build a national team of companies, enterprises and industrial Institutes to produce 92 mask production lines. Taiwan is now the secondlargest surgical mask producer worldwide with daily production capacity of 15 million units.
Border Control, Case Identification, and Containment
Taiwan’s Centres for Disease Control (CDC) claims to have suspected human to human transmission of coronavirus much earlier than WHO based on their immense data on atypical pneumonia from unknown causes.
Around December 31, when WHO alerted world on unknown pneumonia outbreak in Wuhan, Taiwanese officials began to board planes in less than 24 hours to assess passengers on direct flights from Wuhan for fever and pneumonia symptoms before passengers could deplane. By January 5, people with travel history to Wuhan were quarantined and suspected cases were screened for 26 viruses including SARS and MERS with strict board quarantine implementation.
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