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Taiwan has been widely praised for its handling of the pandemic, with one of the world’s lowest per capita covid-19 rates and life on the island has largely returned to normal.
Only 11 people have died from covid-19 in Taiwan since the start of the pandemic, an impressive feat for one country. where a foreclosure has never been imposed.
At the start of the pandemic, Taiwan was considered a high-risk country for COVID-19 due to its proximity to China and frequent travel between the two countries.
With a history of SARS in 2003, which was not seen as particularly well-handled, the Taiwanese government this time moved quickly to close its borders.
On January 20, 2020, he created a central command center for epidemics coordinate cooperation between different government departments and agencies, and between government and business.
A new study published in the Journal of the American Medical Association (JAMA) looked in more detail at why Taiwan has been so successful in conquering COVID-19.
The study authors, from various health institutes and hospitals in Taiwan and the United States, compared the estimated effectiveness of two types of policies for COVID-19 during the first months of the pandemic: measures case-based and case-based measures. Population .
Case-based measures include detection of infected persons through tests, isolation of positive cases, Contact tracing and close contact quarantine for 14 days.
The population-based measures included policies for the use of masks, personal hygiene and social distancing.
The effects of these policies have been quantified estimate of the effective number of reproductions (R number).
The R number is one way to assess the ability to spread an infectious disease; represents the average number of people to whom an infected person transmits a virus.
An R number greater than 1 means the virus will continue to spread and epidemics will continue.
An R number less than 1 means that the numbers of cases will start to decrease.
PHOTO: DAVID CHANG
While previous studies in other countries have simulated what-if scenarios, this paper combines transmission models with real data detailed to estimate efficiency.
The authors collected data on 158 cases, between January 10 and June 1, 2020, from the Taiwan Centers for Disease Control, and all cases were confirmed by PCR testing.
Data was linked to locally acquired cases, confirmed clusters, and imported cases from people entering Taiwan before March 21 2020.
They then compared the results they found in Taiwan with an estimated R number of 2.5, based on the estimated equivalent number in neighboring China at the start of their covid-19 outbreak.
The winning combination
The study found that policies that were only case-based, like contact tracing and quarantining those infected, could reduce the R-number from 2.5 to 1.53.
The quarantine was the one that contributed the most to reducing the R number.
Case-based interventions have not been able to significantly prevent person-to-person transmission, but have reduced transmission of these secondary cases to a third or fourth person, provided close contacts are quarantined.
Meanwhile, demographic policies such as social distancing and the use of masks have reduced the R-number from 2.5 to 1.3.
The authors concluded that this was the combination of policies case-based and population-based policies, coupled with widespread resident buy-in, leading to Taiwan’s success in containing COVID.
The combination of the two approaches resulted in an estimated R number, using two different methods, of 0.82 and up to 0.62.
They also found that considerable population policies were needed to achieve containment, even though the number of circulating infections was low.
Neither approach would have been sufficient on its own, even in a country with an efficient public health system and sophisticated contact tracing.
PHOTO: EPA
What does this mean for other countries?
Recognizing that all models make assumptions and that this analysis is no different, this paper confirms that the full set of public health measures that we use quite consistently around the world, to varying and rigorous degrees, was necessary.
Although it is interesting that the study results reflect a time when newer variants with higher transmissibility were not a problem.
The authors speculated that the screening and isolation of those infected took place simultaneously.
This was the case in Taiwan but not in other countries, such as England, where delays between tests, results and isolation diminished the effectiveness of case-based measures.
FOTO: GET IMAGES
Taiwan is an island nation capable of controlling the introduction of new cases through border control, and the authors acknowledge that the results of this study they may not be fully applicable to other countries.
This is why the authors focused on the effectiveness of case-based and population-based interventions on local transmission, rather than border controls on the number of COVID-19 introductions.
The authors conclude that intensive contact tracing is not possible when public health systems are overwhelmed.
This never happened in Taiwan due to the success of their strategies, but it did, for example, in Ireland in January 2021, which experienced a third wave of harmful covid-19.
This study also found similar results for the seven and 14 day quarantine and suggests that the quarantine period for those infected could be shortened.
Some countries, including the United States, are considering this possibility, but to date it has not been widely introduced.
We already knew there was a lot to be learned from Taiwan’s success in preventing COVID-19 from taking hold.
Now that vaccines are being administered and new variants emerge, we have more information on the comparative and combined contributions of public health measures.
* Patricia Fitzpatrick is Professor of Epidemiology and Biomedical Statistics at the University of Dublin, Ireland. This article originally appeared on The Conversation. You can read the original version here.
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