Effects of #COVID19 #Prevention #Measures on Other Common #Infections, #Taiwan (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 26, Number 10—October 2020 | Research Letter

Effects of COVID-19 Prevention Measures on Other Common Infections, Taiwan

Hong-Hsi Lee and Sheng-Hsuan Lin

Author affiliations: New York University School of Medicine, New York, New York, USA (H.H. Lee); National Chiao Tung University, Hsinchu, Taiwan (S.H. Lin)

 

Abstract

To determine whether policies to limit transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) hinder spread of other infectious diseases, we analyzed the National Health Insurance database in Taiwan. Rates of other infections were significantly lower after SARS-CoV-2 prevention measures were announced. This finding can be applied to cost-effectiveness of SARS-CoV-2 prevention.

Keywords: SARS-CoV-2; COVID-19; Taiwan.

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How to Safely Reopen #Colleges and #Universities During #COVID19: Experiences From #Taiwan (Ann Intern Med., abstract)

[Source: Annals of Internal Medicine, full page: (LINK). Abstract, edited.]

How to Safely Reopen Colleges and Universities During COVID-19: Experiences From Taiwan

Shao-Yi Cheng, MD, MSc, DrPH, C. Jason Wang, MD, PhD, April Chiung-Tao Shen, PhD, Shan-Chwen Chang, MD, PhD

DOI: https://doi.org/10.7326/M20-2927

 

Abstract

Reopening colleges and universities during the coronavirus disease 2019 (COVID-19) pandemic poses a special challenge worldwide. Taiwan is one of the few countries where schools are functioning normally. To secure the safety of students and staff, the Ministry of Education in Taiwan established general guidelines for college campuses. The guidelines delineated creation of a task force at each university; school-based risk screening based on travel history, occupation, contacts, and clusters; measures on self-management of health and quarantine; general hygiene measures (including wearing masks indoors); principles on ventilation and sanitization; regulations on school assemblies; a process for reporting suspected cases; and policies on school closing and make-up classes. It also announced that a class should be suspended if 1 student or staff member in it tested positive and that a school should be closed for 14 days if it had 2 or more confirmed cases. As of 18 June 2020, there have been 7 confirmed cases in 6 Taiwanese universities since the start of the pandemic. One university was temporarily closed, adopted virtual classes, and quickly reopened after 14 days of contact tracing and quarantine of possible contacts. Taiwan’s experience suggests that, under certain circumstances, safely reopening colleges and universities this fall may be feasible with a combination of strategies that include containment (access control with contact tracing and quarantine) and mitigation (hygiene, sanitation, ventilation, and social distancing) practices.

Keywords: SARS-CoV-2; COVID-19; Taiwan.

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#Contact #Tracing #Assessment of #COVID19 #Transmission #Dynamics in #Taiwan and Risk at Different Exposure Periods Before and After Symptom Onset (JAMA Intern Med., abstract)

[Source: JAMA Internal Medicine, full page: (LINK). Abstract, edited.]

Contact Tracing Assessment of COVID-19 Transmission Dynamics in Taiwan and Risk at Different Exposure Periods Before and After Symptom Onset

Hao-Yuan Cheng, MD, MSc1; Shu-Wan Jian, DVM, MPH1; Ding-Ping Liu, PhD1; et al. Ta-Chou Ng, BSc2; Wan-Ting Huang, MD3; Hsien-Ho Lin, MD, ScD2,4; for the Taiwan COVID-19 Outbreak Investigation Team

Author Affiliations: 1 Epidemic Intelligence Center, Taiwan Centers for Disease Control, Taipei, Taiwan; 2 Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan; 3 Office of Preventive Medicine, Taiwan Centers for Disease Control, Taipei, Taiwan; 4 Global Health Program, National Taiwan University College of Public Health, Taipei, Taiwan

JAMA Intern Med. Published online May 1, 2020. doi:10.1001/jamainternmed.2020.2020

 

Key Points

  • Question  – What is the transmissibility of coronavirus disease 2019 (COVID-19) to close contacts?
  • Findings  – In this case-ascertained study of 100 cases of confirmed COVID-19 and 2761 close contacts, the overall secondary clinical attack rate was 0.7%. The attack rate was higher among contacts whose exposure to the index case started within 5 days of symptom onset than those who were exposed later.
  • Meaning  – High transmissibility of COVID-19 before and immediately after symptom onset suggests that finding and isolating symptomatic patients alone may not suffice to interrupt transmission, and that more generalized measures might be required, such as social distancing.

 

Abstract

Importance  

The dynamics of coronavirus disease 2019 (COVID-19) transmissibility are yet to be fully understood. Better understanding of the transmission dynamics is important for the development and evaluation of effective control policies.

Objective  

To delineate the transmission dynamics of COVID-19 and evaluate the transmission risk at different exposure window periods before and after symptom onset.

Design, Setting, and Participants  

This prospective case-ascertained study in Taiwan included laboratory-confirmed cases of COVID-19 and their contacts. The study period was from January 15 to March 18, 2020. All close contacts were quarantined at home for 14 days after their last exposure to the index case. During the quarantine period, any relevant symptoms (fever, cough, or other respiratory symptoms) of contacts triggered a COVID-19 test. The final follow-up date was April 2, 2020.

Main Outcomes and Measures  

Secondary clinical attack rate (considering symptomatic cases only) for different exposure time windows of the index cases and for different exposure settings (such as household, family, and health care).

Results  

We enrolled 100 confirmed patients, with a median age of 44 years (range, 11-88 years), including 56 men and 44 women. Among their 2761 close contacts, there were 22 paired index-secondary cases. The overall secondary clinical attack rate was 0.7% (95% CI, 0.4%-1.0%). The attack rate was higher among the 1818 contacts whose exposure to index cases started within 5 days of symptom onset (1.0% [95% CI, 0.6%-1.6%]) compared with those who were exposed later (0 cases from 852 contacts; 95% CI, 0%-0.4%). The 299 contacts with exclusive presymptomatic exposures were also at risk (attack rate, 0.7% [95% CI, 0.2%-2.4%]). The attack rate was higher among household (4.6% [95% CI, 2.3%-9.3%]) and nonhousehold (5.3% [95% CI, 2.1%-12.8%]) family contacts than that in health care or other settings. The attack rates were higher among those aged 40 to 59 years (1.1% [95% CI, 0.6%-2.1%]) and those aged 60 years and older (0.9% [95% CI, 0.3%-2.6%]).

Conclusions and Relevance  

In this study, high transmissibility of COVID-19 before and immediately after symptom onset suggests that finding and isolating symptomatic patients alone may not suffice to contain the epidemic, and more generalized measures may be required, such as social distancing.

Keywords: SARS-CoV-2; COVID-19; Incubation period; Quarantine; Taiwan.

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Three #Taiwan’s domestic #family #cluster infections of #coronavirus disease 2019 (J Med Virol., abstract)

[Source: Journal of Medical Virology, full page: (LINK). Abstract, edited.]

Three Taiwan’s domestic family cluster infections of coronavirus disease 2019

Shih‐Feng Liu MD,  Nai‐Ying Kuo RRT,  Ho‐Chang Kuo PhD, MD

First published: 28 April 2020 | DOI: https://doi.org/10.1002/jmv.25949

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/jmv.25949

 

Abstract

Background

Since the first case of coronavirus disease 2019 (COVID‐19) was identified in Taiwan 2020.01.21. Several family cluster infections of were found later. This study aimed to report family cluster infections and observe subsequent development.

Material and methods

We collected cases of domestic family cluster infection among COVID‐19 confirmed cases from January 21, 2020 to March 16, 2020. Data sources were collected from a series of official messages reported by the Taiwan Central Epidemic Command Center (CECC) press conference.

Results

There were three domestic family clusters infections in this period. The first cluster was cases 19 to 23. The index patient was confirmed a Taiwanese passenger from Zhejiang. Of the 257 close contacts, 4 (case 20‐23) were confirmed positive and the others were negative. The second cluster is cases 24‐26. The index patient was currently uncertain. There were 853 contacts, 242 of whom have been in close contact, 2 of whom have confirmed positive (case 25‐26) and 240 had negative reactions. The third cluster was cases 27‐32. The index patient was currently uncertain. There were 828 contacts, 183 of whom have been in close contact, 5 of whom have confirmed positive (case 28‐32) and 179 had negative reactions. All contacts of three clusters have been isolated and no new confirmed cases have been identified to date

Conclusion

Taiwan CECC made some measures which may not completely stop the spread of SARS‐CoV‐2, but they are being implemented to slow the spread of the disease and are currently not widespread in Taiwan.

This article is protected by copyright. All rights reserved.

Keywords: SARS-CoV-2; COVID-19; Taiwan; Cluster of cases.

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#Collateral #Benefit of #COVID19 #Control Measures on #Influenza Activity, #Taiwan (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 26, Number 8—August 2020 | Research Letter

Collateral Benefit of COVID-19 Control Measures on Influenza Activity, Taiwan

Shu-Chen Kuo  , Shu-Man Shih, Li-Hsin Chien, and Chao A. Hsiung

Author affiliations: National Health Research Institutes, Zhunan, Taiwan

 

Abstract

Taiwan has strictly followed infection control measures to prevent spread of coronavirus disease. Meanwhile, nationwide surveillance data revealed drastic decreases in influenza diagnoses in outpatient departments, positivity rates of clinical specimens, and confirmed severe cases during the first 12 weeks of 2020 compared with the same period of 2019.

Keywords: SARS-CoV-2; COVID-19; Seasonal Influenza; Taiwan; Quarantine.

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Decreased #Influenza #Incidence under #COVID19 #Control Measures, #Singapore (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 26, Number 8—August 2020 | Research Letter

Decreased Influenza Incidence under COVID-19 Control Measures, Singapore

Roy Jiunn Jye Soo, Calvin J. Chiew, Stefan Ma, Rachael Pung, and Vernon Lee
Author affiliations: Ministry of Health, Singapore (R.J.J. Soo, C.J. Chiew, S. Ma, R. Pung, V. Lee); Saw Swee Hock School of Public Health, Singapore (V. Lee)

 

Abstract

We compared indicators of influenza activity in 2020 before and after public health measures were taken to reduce coronavirus disease (COVID-19) with the corresponding indicators from 3 preceding years. Influenza activity declined substantially, suggesting that the measures taken for COVID-19 were effective in reducing spread of other viral respiratory diseases.

Keywords: SARS-CoV-2; COVID-19; Seasonal Influenza; Taiwan; Quarantine.

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The #Practice of Wearing #Surgical #Masks during the #COVID19 #Pandemic (Emerg Infect Dis., summary)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Summary, edited.]

Volume 26, Number 8—August 2020 | Letter

The Practice of Wearing Surgical Masks during the COVID-19 Pandemic

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To the Editor: We read with interest the meta-analysis conducted by Xiao et al. (1) that found no significant reduction in influenza transmission with the use of surgical masks in the community, based on 10 randomized controlled trials. Nevertheless, mechanistic studies found that surgical masks could prevent transmission of human coronavirus and influenza virus infections if worn by infected persons (2). The authors pointed out the limitations of their study: small sample size and suboptimal adherence in the mask-wearer group (1). Recommendations on masks in the community vary across countries during the coronavirus disease (COVID-19) pandemic (3); studies have reported mixed results (2,4,5).

(…)

Keywords: SARS-CoV-2; COVID-19; Taiwan; Face masks.

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#Policy #Decisions and Use of #IT to #Fight 2019 Novel #Coronavirus Disease, #Taiwan (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 26, Number 7—July 2020 | Policy Review

Policy Decisions and Use of Information Technology to Fight 2019 Novel Coronavirus Disease, Taiwan

Cheryl Lin, Wendy E. Braund, John Auerbach, Jih-Haw Chou, Ju-Hsiu Teng, Pikuei Tu  , and Jewel Mullen

Author affiliations: Duke University, Durham, North Carolina, USA (C. Lin, P. Tu); University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.E. Braund); Trust for America’s Health, Washington, DC, USA (J. Auerbach); Taiwan Centers for Disease Control, Taipei, Taiwan (J.-H. Chou, J.-H. Teng); University of Texas, Austin, Texas, USA (J. Mullen)

 

Abstract

Because of its proximity to and frequent travelers to and from China, Taiwan faces complex challenges in preventing 2019 novel coronavirus disease (COVID-19). As soon as China reported the unidentified outbreak to the World Health Organization on December 31, 2019, Taiwan assembled a taskforce and began health checks onboard flights from Wuhan. Taiwan’s rapid implementation of disease prevention measures helped detect and isolate the country’s first COVID-19 case on January 20, 2020. Laboratories in Taiwan developed 4-hour test kits and isolated 2 strains of the coronavirus before February. Taiwan effectively delayed and contained community transmission by leveraging experience from the 2003 severe acute respiratory syndrome outbreak, prevalent public awareness, a robust public health network, support from healthcare industries, cross-departmental collaborations, and advanced information technology capacity. We analyze use of the National Health Insurance database and critical policy decisions made by Taiwan’s government during the first 50 days of the COVID-19 outbreak.

Keywords: SARS-CoV-2; COVID-19; Taiwan.

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A Case of #COVID19 and #Pneumonia Returning From #Macau in #Taiwan: Clinical Course and anti-SARS-CoV-2 IgG Dynamic (J Microbiol Immunol Infect., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Microbiol Immunol Infect 2020 Mar 10 [Online ahead of print]

A Case of COVID-19 and Pneumonia Returning From Macau in Taiwan: Clinical Course and anti-SARS-CoV-2 IgG Dynamic

Nan-Yao Lee 1, Chia-Wen Li 2, Huey-Pin Tsai 3, Po-Lin Chen 1, Ling-Shan Syue 2, Ming-Chi Li 2, Chin-Shiang Tsai 2, Ching-Lung Lo 2, Po-Ren Hsueh 4, Wen-Chien Ko 5

Affiliations: 1 Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Center for Infection Control and Department of Internal Medicine, National Cheng, Kung University Hospital, Tainan, Taiwan. 2 Center for Infection Control and Department of Internal Medicine, National Cheng, Kung University Hospital, Tainan, Taiwan. 3 Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan; Medical Laboratory Science and Biotechnology, National Cheng Kung University, Tainan, Taiwan. 4 Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. 5 Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Center for Infection Control and Department of Internal Medicine, National Cheng, Kung University Hospital, Tainan, Taiwan. Electronic address: winston3415@gmail.com.

PMID: 32198005 DOI: 10.1016/j.jmii.2020.03.003

 

Abstract

A 46-year-old woman presented to the emergency department with 2-day fever and cough at seven days after returning from Macau. COVID-19 and pneumonia was diagnosed based on the positive real-time RT-PCR tests for oropharyngeal swab samples and the presence of anti-SARS-COV-2 IgG starting from the illness day 11 and post-exposure 18-21 days.

Keywords: COVID-19; IgG; Macau; Novel coronavirus; Pneumonia; SARS-CoV-2; Serology; Taiwan.

Copyright © 2020. Published by Elsevier B.V.

Keywords: SARS-CoV-2; COVID-19; Macau; Taiwan.

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#Response to #COVID19 in #Taiwan – #BigData #Analytics, New #Technology, and Proactive #Testing (JAMA, summary)

[Source: JAMA, full page: (LINK). Summary, edited.]

Response to COVID-19 in Taiwan – Big Data Analytics, New Technology, and Proactive Testing

C. Jason Wang, MD, PhD1,2; Chun Y. Ng, MBA, MPH2; Robert H. Brook, MD, ScD3,4

Author Affiliations: 1 Departments of Pediatrics, Medicine, and Health Research and Policy, Stanford University School of Medicine, Stanford, California; 2 The New School for Leadership in Health Care, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; 3 David Geffen School of Medicine, Department of Medicine, University of California, Los Angeles; 4 The Pardee RAND Graduate School, RAND Corporation, Santa Monica, California

JAMA. Published online March 3, 2020. doi:10.1001/jama.2020.3151

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Taiwan is 81 miles off the coast of mainland China and was expected to have the second highest number of cases of coronavirus disease 2019 (COVID-19) due to its proximity to and number of flights between China.1 The country has 23 million citizens of which 850 000 reside in and 404 000 work in China.2,3 In 2019, 2.71 million visitors from the mainland traveled to Taiwan.4 As such, Taiwan has been on constant alert and ready to act on epidemics arising from China ever since the severe acute respiratory syndrome (SARS) epidemic in 2003. Given the continual spread of COVID-19 around the world, understanding the action items that were implemented quickly in Taiwan and assessing the effectiveness of these actions in preventing a large-scale epidemic may be instructive for other countries.

(…)

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Corresponding Author: C. Jason Wang, MD, PhD, Stanford University, 117 Encina Commons, CHP/PCOR, Stanford, CA 94305 (cjwang1@stanford.edu).

Published Online: March 3, 2020. doi:10.1001/jama.2020.3151

Conflict of Interest Disclosures: None reported.

Keywords: SARS-CoV-2; COVID-19; Taiwan.

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