CORONAVIRUS/Cruise ship outbreak decisive in Taiwan COVID-19 policy: health minister

10/03/2020 09:33 PM
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Health Minister Chen Shih-chung (at podium) speaking at a public health forum in Taipei. CNA photo Oct. 3, 2020
Health Minister Chen Shih-chung (at podium) speaking at a public health forum in Taipei. CNA photo Oct. 3, 2020

Taipei, Oct. 3 (CNA) Health Minister Chen Shih-chung (陳時中) on Saturday said the mass outbreak of COVID-19 aboard the Diamond Princess cruise ship in February was pivotal in shaping Taiwan's approach to the disease, by showing that strict quarantine can be even more effective than testing as a means of containment.

Speaking at a public health forum hosted by the conservative, pro-independence Formosa Republican Association, Chen recalled the lessons he learned from the contagion aboard the packed cruise ship as it sat docked in the Port of Yokohama outside Tokyo.

At the time, Japanese authorities adopted the "seemingly sensible" policy of first evacuating passengers who tested positive, while having those who tested negative remain on board, Chen said.

However, a number of those who tested negative were either in the incubation period or were infected with low levels of the virus, and eventually spread it to more than 700 of the ship's 3,000 passengers, Chen said.

This incident alerted Taiwanese authorities to the fact that without a stricter quarantine than the one imposed on the cruise ship, testing can be a wasted effort, Chen said, opining that strict on-board quarantine, even without testing, would have been more effective in containing the outbreak.

The experience of the Diamond Princess, he said, "laid the foundation of Taiwan's quarantine-based" approach to fighting COVID-19.

In the speech, Chen also rebutted criticism that Taiwan had imposed tough restrictions against China, while acting with less vigilance in response to the outbreaks in Europe and North America.

To be honest, he said, the restrictions against Europe and the U.S. were imposed a day or two too late, because the speed of the outbreak in those places was "unimaginably fast."

In the past, those were countries with strong health care systems, which Taiwan has sought to emulate and which, from a public health perspective, should have excellent epidemic prevention capabilities, he said.

However, the culture in many western countries of not seeing a doctor for minor illnesses, may have allowed the virus to spread widely at a community level without being detected, ultimately leading to severe outbreaks, Chen said.

Elsewhere in the speech, Chen compared COVID-19 with the severe acute respiratory syndrome (SARS) outbreak Taiwan experienced in 2003, which sickened 346 people and killed 73.

SARS was a relatively small outbreak with a high fatality rate, Chen said.

Those infected always exhibited fever symptoms, and the virus could only be transmitted after the onset of symptoms, Chen said, explaining the factors that had made it easier to contain.

In contrast, COVID-19 can present a range of symptoms or none at all, making it very difficult to identify people for testing, he said.

In any case where you can't clearly identify potential infections based on symptoms, the effects of testing will be limited, and you have to rely on other approaches, such as universal mask-wearing and hand-washing, he said, adding that this applies not only to COVID-19 but to enterovirus, influenza and other pathogens.

As of Saturday, Taiwan has reported 517 cases of COVID-19 and seven fatalities, while globally some 34 million people have been infected and over 1 million have died, according to statistics from the Central Epidemic Command Center.

(By Chang Ming-hsuan and Matthew Mazzetta)

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