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Taiwan marks 200 days without local coronavirus case

Taiwan stands out as one of few countries in world able to prevent second outbreak

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Rooms in Grand Hotel Taipei lit up to read "ZERO." 

Rooms in Grand Hotel Taipei lit up to read "ZERO."  (CNA photo)

TAIPEI (Taiwan News) — Taiwan on Thursday (Oct. 29) marked 200 days without a local confirmed case of the Wuhan coronavirus (COVID-19).

The passage of 200 days in Taiwan without a local coronavirus infection has now nearly doubled the record set by other countries lauded by the Western media for their handling of the disease. Vietnam, Thailand, and New Zealand also had long local case-free streaks of 100, 101, and 102 days, respectively, but all three were broken by new outbreaks.

Taiwan's last domestic case (Case No. 386), which was reported on April 12, had contracted the virus while staying at the same residence as another imported case (Case No. 195). Although China declared "zero" local infections on March 19, it has since officially acknowledged subsequent "small" outbreaks in Guangdong, Beijing, Yunnan, Wuhan, Heilongjiang, Liaoning, Jilin, Qingdao, and Xinjiang.

Taiwan has managed to eliminate local infections since April 12 without ever forcing a single city or nationwide lockdown. While China was welding shut the homes of Wuhan residents during the alleged peak of its outbreak, Taiwan was implementing travel restrictions, mask-related measures, mandatory quarantines, targeted testing, and contact tracing.

Having learned a hard lesson from SARS 17 years ago, when Taiwan suffered the highest mortality rate in the world, the country established a permanent National Health Command Center, which includes the Central Epidemic Command Center (CECC). When reports of atypical pneumonia cases in Wuhan started to stream in, Taiwan on Dec. 31 contacted the Chinese Center for Disease Control and Prevention and the World Health Organization (WHO) IHR focal point to clarify whether human-to-human transmission was occurring in Wuhan.

However, the WHO only responded with a short message stating that Taiwan's information would be "forwarded to expert colleagues," and China only issued a press release. As a result, Taiwan was unable to receive confirmation through WHO or Chinese channels that human-to-human transmission was taking place.

Therefore, the government that same day went ahead and launched enhanced border control and quarantine measures "based on the assumption that human-to-human transmission was in fact occurring," according to the CDC. On Jan. 20, the CECC was activated, with Minister of Health and Welfare Chen Shih-chung (陳時中) at the helm.

On Jan. 22, entry permits were canceled for 459 tourists from Wuhan, and by the next day, all Wuhan residents were banned, while the rest of the travelers from China were required to make a health declaration before entering. Taiwan then began issuing travel bans and mandatory quarantines for arrivals from a growing list of countries, before ultimately culminating in a total ban on foreign travelers on March 18.

As fears of local infections increased, the CECC implemented a name-based rationing system for face masks by early February. At the same time, it began enlisting local factories to ramp up mask production and activated Army Reserve troops to help operate the machines, eventually boosting daily mask production to 20 million per day by May.

Starting in February, Taiwan required visitors who were arriving from areas affected by the pandemic undergo quarantine, and by the time the March 18 travel ban went into effect, quarantine became mandatory for all arrivals. This quarantine requirement is still in place, with the exception of business travelers from select countries which are listed as low- or moderate-risk, in which case the quarantines are five and seven days, respectively.

The quarantines are enforced through the use of smartphone apps, which enable authorities to check in on those undergoing quarantine and monitor the user's movements. Another major deterrent for those considering breaking their quarantine is an onerous fine of up to NT$1 million (US$35,000).

Rather than the mass testing seen in China, Taiwan takes a targeted approach in which it only tests those who show symptoms, have come in contact with confirmed cases, or come from high-risk countries. Foreign nationals from most countries are also required to provide a negative COVID-19 test result within three days before boarding their flight to Taiwan.

Taiwan also employs an exhaustive contract tracing system with every confirmed case. A combination of personnel on the ground and cellphone tracking data enables the CECC to acquire a comprehensive list of persons who recently came in contact with an infected patient.

Once a contact is identified, they each undergo both polymerase chain reaction (PCR) and serum antibody tests. They are also told to go into 14 days of home isolation, much like a visitor from abroad.

The CECC on Thursday did not announce any new reports of people with suspected symptoms. Since the outbreak began, Taiwan has carried out 101,218 COVID-19 tests, with 99,950 coming back negative.

Out of Taiwan's 553 officially confirmed cases, 461 were imported, 55 were local, 36 came from the Navy's "Goodwill Fleet," and one is an unresolved case. Up until now, seven individuals have succumbed to the disease, while 513 have been released from hospital isolation, leaving 33 patients still undergoing treatment in Taiwan.