Taiwan’s Vice President Cheng Cheng Jeng on his national battle with Covid-19

Taiwan’s response to Covid-19 is quick and effective. Despite its proximity to China, there are only 395 cases and 6 deaths. In an exclusive interview, Chen Chien-jen, the country’s vice president and renowned epidemiologist, explains Taiwan’s plan for the coronavirus battle and the lessons it holds for the UK and WHO. Answers are edited for spaces.

What did Taiwan learn from monkeys in 2003?

We have learned a lot about prudent action, quick response and early adoption.

It is important to monitor emerging infectious diseases, especially in this region, as they are closer to China. In addition to SARS, in 2005 there was H1N1 bird flu, H7N9 bird flu, now Covid-19.

Second, it will publish travel warnings as needed, and third, it will optimize border quarantine and identify imported cases. This time, atypical pneumonia-an infectious lung disease with no known cause-was found to be quarantined for patients and possible person-to-person transmission-on-board quarantine of all passengers flying from Wuhan Was carried out.

Then there is a 14-day home quarantine for close contact with passengers from the affected area. During the implementation of SARS, we found that nosocomial infections were extremely dangerous, so we upgraded our healthcare system to provide a nationwide network of isolation systems and infectious disease healthcare centers. This strategy should be planned before it occurs.

Proper supply of PPE is important. In 2002, the lack of face masks for the N95 led to the need for a face mask distribution system and increased production. Currently, we are producing more than 13 million pieces a day, and we anticipate boosting this to 15 million.

Second, there is health education about home quarantine and what children have to do at school. This and risk communication must be transparent.

How many critical care beds are there?

At full capacity, there are 20,000 negative pressure isolation rooms and 14,000 ventilators.

Since the outbreak control is an effort between ministries and coordination is essential, we have established a national epidemic command center. It is very important that everyone in the country, the government and the people, be involved.

Can Taiwan’s pandemic strategy be successfully replicated in larger countries? Can I still learn the lesson?

Yes, it is. It is never too late in any country to control an outbreak of any kind. There are still many possibilities for countries to adopt the good strategies developed here to contain outbreaks. Social distance and good health behavior are definitely important. Wash your hands often, measure your body temperature, and use a face mask if necessary. Close contact at home [of the infected] Do not eat together. of [patient] You can live in a single room. You don’t have to stop all activities. Outbreaks can be controlled as long as 50% or more of the population reduces 50% of their social contacts. They can go to school and work, but need to reduce non-essential recreation and social contact.

Home quarantine is important. Close contacts need to be at home for 14 days to check their health.

Frontline health care workers must have the appropriate PPE. The United Kingdom and the United States are doing their best to do that, and Taiwan is happy to help.

We need to work together to develop rapid diagnostics, antivirals, and even vaccines as soon as possible.

What recommendations do you have for the UK? Is mass testing useful?

In Taiwan, out of 395 cases, only 55 cases were locally infected, and only 10 cases could not be traced to the source, so the mass test was not conducted. In many cases, mass testing should be done if there are no known sources of infection. However, it may not be efficient or cost effective. Need to test [patients’] Keep in close contact as a top priority, then the riskiest groups-healthcare professionals, supermarket cashiers, taxis, public transport drivers. If you are not infected, you will not be infected.

Western pandemic planning documents do not assume the blockades found in Europe and the United States. why?

Asian countries are always at great risk of developing infectious diseases. We are faced with timed bombs of living things, so we are ready. Vietnam, Singapore and Hong Kong were heavily influenced by monkeys. So they still do a very good job. There was Mers in Korea, so I learned from it. We are in a much more dangerous situation than America and Europe, and people always learn from disasters. As our world is shrinking, we need to share information transparently and quickly. This is the mission of the World Health Organization.

After Sars, WHO set up a warning system-a public health emergency of international concern. When the pandemic flu occurred in 2009, only three countries announced PHEIC about a month after the first case affected. Therefore, we have developed a rapid diagnostic method, prepared antiviral agents, and developed a vaccine very quickly. Some say that the first case for Covid-19 was early December or mid-December 2019, but this time the PHEIC was announced at the end of January. Worse, they have not yet considered travel warnings of any kind. So why do you announce that it is PHEIC? It was too late because there were already over 8,000 confirmed cases in 19 countries.

Why is WHO different from Covid-19? What are the implications of Taiwan WHO exclusions?

I don’t understand why WHO didn’t act as quickly as it did for H1N1 or monkeys. WHO did not invite us to the emergency meeting January 22-23. Before that, I asked the CDC in China to send two experts to Wuhan to investigate the situation. based on [their] Observations and personal dialogue revealed that the situation was already very severe in mid-January. They discussed whether to isolate the entire Wuhan. The hospital situation was really bad. We also found something very important-they paid much more attention to serious cases in the hospital. When asked about tracking close contact and caring for patients with mild symptoms, they did not respond very well. If intimate contact can be tracked, the patient will not spread the disease.

What do you think about China’s response to this pandemic?

Wuhan front-line health workers did a very good job of treating severe cases of atypical pneumonia of unknown cause. They also did their best to share information with Wuhan Health Authorities. I don’t know why this information wasn’t taken so seriously. Usually, epidemiologists and infectious disease doctors believe that once a patient comes to a hospital, it’s only the tip of the iceberg, and many people are infected. As a result, some Wuhan doctors gave this warning to their colleagues, but unfortunately did not take it very seriously.

Do you think there was political cover-up?

I don’t really know, but when compared to alerts [from] For healthcare professionals, I don’t think alerts were sent to the public or to the world.

There was a notification from Wuhan on social media on December 31, and it said that the CDC and WHO in China were already seen in the CDC. What did the notification say?

The notice said there are seven cases of atypical pneumonia, but it was not considered to be SARS, and specimens were tested for possible causes. However, all these patients were isolated for treatment.

Do you think this virus occurred in the market?

They say the virus originated from the Southeast seafood market, but looking at the first 42 cases published in academic journals, about 10 have no history of going there. This is a very important tip that the market may not be the cause of this infection. In early December, cases from Thailand, Hong Kong and Japan were reported. All patients who did not go to the market. There may be clusters, but not all are infected. From an epidemiological point of view, once you have a patient or population, you need to find their contacts and keep track of two things: the source and whether the people around you are infected. However, they have never paid attention to mild or asymptomatic cases.

Is there any indication of where the virus came from?

Trying to trace to [index] If very difficult. If the case has a mild illness, it cannot be found. And according to this so-called Infectious Pyramid of Covid-19, there are many cases of mild and asymptomatic cases, although the severity is minimal. Therefore, for Covid-19, identifying index cases is much more difficult than Sars.

What is the proper exit strategy for lockdown?

Covid-19 is similar to the flu. It is very contagious in many mild or asymptomatic cases, and it is not possible to eliminate this virus completely, as it can spread through droplets and contaminated areas. We need to develop rapid diagnostics and antiviral drugs. The milder cases can then be treated by a local private practitioner. In severe cases, it can also be treated at a medical institution, with rapid diagnosis and antiviral medication. This protects and heals the patient and protects close contact from infection. The vaccine may be given in a year or 1.5 years. Before that, we need to maintain a social distance. I live in a self-limiting way, but still normal.

How do you open a trip and trade again?

To coordinate international shipping, all countries need to share data and make incidents transparent. In order to know the infection situation in each country, seroepidemiological studies that examine blood samples are necessary.

What is Taiwan’s contribution to diagnosis and vaccines?

There are three vaccine development teams in collaboration with the EU and the United States: Academia Sinica, National Institutes of Health, and Medigen and US NIH.

There are two prototype fast diagnostics. For testing antigens. Another way to test your blood – for serum markers – for antibodies. We want to get a license soon and we will be happy to share any new developments. For pharmaceuticals, we are participating in a clinical trial of rendecibir. This looks very good in severe cases, but even better in mild cases.

Will life soon return to normal?

I once predicted the end of May, but it is very difficult to predict accurately. Europe has peaked and it is down. It’s still up in America. All countries have been mobilized, with far better results than a month ago. This is an excellent phenomenon of globalization, Covid-19 containment.