The Outcome and Implications of Public Precautionary Measures in Taiwan-Declining Respiratory Disease Cases in the COVID-19 Pandemic

Abstract

With the rapid development of the COVID-19 pandemic, countries are trying to cope with increasing medical demands, and, at the same time, to reduce the increase of infected numbers by implementing a number of public health measures, namely non-pharmaceutical interventions (NPIs). These public health measures can include social distancing, frequent handwashing, and personal protective equipment (PPE) at the personal level; at the community and the government level, these measures can range from canceling activities, avoiding mass gatherings, closing facilities, and, at the extreme, enacting national or provincial lockdowns. Rather than completely stopping the infectious disease, the major purpose of these NPIs in facing an emerging infectious disease is to reduce the contact rate within the population, and reduce the spread of the virus until the time a vaccine or reliable medications become available. The idea is to avoid a surge of patients with severe symptoms beyond the capacity of the hospitals' medical resources, which would lead to more mortality and morbidity. While many countries have experienced steep curves in new cases, some, including Hong Kong, Vietnam, South Korea, New Zealand, and Taiwan, seem to have controlled or even eliminated the infection locally. From its first case of COVID-19 on the 21 January until the 12 May, Taiwan had 440 cases, including just 55 local infections, and seven deaths in total, representing 1.85 cases per 100,000 population and a 1.5% death rate (based on the Worldometer 2020 statistics of Taiwan's population of 23.8 million). This paper presents evidence that spread prevention involving mass masking and universal hygiene at the early stage of the COVID-19 pandemic resulted in a 50% decline of infectious respiratory diseases, based on historical data during the influenza season in Taiwan. These outcomes provide potential support for the effectiveness of widely implementing public health precaution measures in controlling COVID-19 without a lockdown policy.

Keywords: COVID-19; mass making; public precautionary measures; universal hygiene.

Figure 1

(a) Data extracted from Taiwanese Centers for Disease Control (Taiwan CDC) [6]. (b) Data extracted from American Centers for Disease Control and Prevention (US, CDC) [7]. Note: The figure shows the weekly records of confirmed influenzas A + B cases from 2018 to 2020: a comparison of cases in the US and Taiwan. x-axis: Year-Week interval & y-AXIS: number of cases.

Figure 2

Influenza-like illness cases. Note: National Statistics of influenza-like illness (ILI), data extracted and analyzed from Taiwan CDC systems [6]. x-axis: year-week interval & y-axis: number of cases.

Figure 3

Isolation number of respiratory tract virus. Note: year-week specimen receipt from randomly selected samples of respiratory disease, data extracted from the Taiwan National Infectious Disease Statistics System [6]. It shows the number of isolates representing the distribution of most commonly seen viral infection cases selected from ILI cases. It is the aggregation of two nationwide randomly selected samples from each of the 160 sample taking stations. x axis: year-week interval & y axis: number of cases.