by Brian Hioe

Photo Credit: Tsai Ing-wen/Facebook

WITH THE CLUSTER of cases linked to the Taoyuan General Hospital having now expanded to a total of fifteen cases, the Central Epidemic Command Center (CECC) that coordinates Taiwan’s response to COVID-19 has announced that discharged patients that were released from the hospital between January 6 and 19 and their close contacts must undergo a fourteen-day home quarantine. After the fourteen-day home quarantine period, they will be required to monitor their health for seven days and avoid crowded areas in what is referred to as the self-health management period.

The exact number of people that will be quarantined is unknown, but during the press conference in which the decision was announced, Minister of Health Chen Shih-Chung stated that this could be around 5,000 individuals. The Taoyuan General Hospital cluster is Taiwan’s largest COVID-19 cluster to date. A specialized app has been developed to help those linked to the cluster.

Travel information released by the CECC for two of the infected cases

Although it is feared that individuals from the Taoyuan cluster could have transmitted COVID-19 to others while visiting a traditional market, supermarkets, or while working at a MOS Burger, to date, most new cases of domestic transmission are from workers at the hospital or family members of individuals working at the hospital. The CECC is clearly hoping that isolating individuals who have had contact at the hospital will prevent the further spread of COVID-19.

While most cases in the cluster were linked to a hospital ward in the Taoyuan General Hospital, the new measures were rolled out after a new case that was not linked to the same ward, suggesting undetected transmission chains of COVID-19.

The Taoyuan cluster also proves the first case in Taiwan in which domestic transmission of COVID-19 took place because medical personnel treating patients with COVID-19 became infected. Similarly, Taiwan has not had any cases of COVID-19 transmission to date from improperly maintained quarantine regimes, resulting in family members becoming infected with COVID-19.

Quarantining 5,000 individuals would likely overwhelm Taiwan’s existing quarantine facilities, which is why individuals are being made to quarantine at home. Indications are that quarantine facilities in Taiwan have already been taxed by the number of individuals returning from abroad, either for the upcoming Lunar New Year, or to flee COVID-19 conditions elsewhere in the world. As the Lunar New Year approaches, Taiwan will likely see the number of returning individuals grow.

In calling for preemptive home quarantines, the CECC may also be wary of carrying out mass testing for up to 5,000 individuals. As COVID-19 tests are not 100% accurate, this would result in a number of false positives that could cause public panic. False positives would also have to be quarantined, further straining quarantine facilities.

To that extent, while some KMT lawmakers have called for a lockdown of Taoyuan as a whole, the CECC is aiming for more specific measures in quarantining only individuals who have had contact with the Taoyuan General Hospital. One notes that the effectiveness of lockdowns are debated among medical experts, seeing as individuals flee when lockdowns are announced, something that has the potential to further spread a virus. Taoyuan has a population of three million people and has substantial transportation networks with Taipei and New Taipei—locking down Taoyuan effectively would also necessitate locking other cities that are closely connected with Taoyuan, and many residents of Taoyuan would likely travel elsewhere before the imposition of the lockdown.

Indeed, apart from the feasibility challenges facing such a hypothetical lockdown, a lockdown may not help prevent the spread of COVID-19 cases, and would prove disruptive to the lives of many. A cluster of fifteen cases is not yet sufficient size to justify locking down a city, as well.

Photo credit: lienyuan lee/WikiCommons/CC

The CECC is likely hoping to avoid a repeat of the quarantine of the Taipei Municipal Hoping Hospital in 2003, during the SARS pandemic. The response of Taipei authorities to a SARS cluster originating from the Hoping Hospital was to forcibly lock down doctors and patients inside the hospital, arresting individuals that tried to flee, leading to an incident in which a nurse attempted to leap from the eighth floor of the hospital.

It is to be seen whether any of the visitors of the Taoyuan General Hospital attempt to flee quarantines, but the CECC is clearly aiming to avoid such heavy-handed measures. Outside of that it is less heavy-handed, home quarantines for individuals that had contact with the Taoyuan General Hospital proves a more specific way of targeting individuals that may have come in contact with COVID-19, rather than locking down Taoyuan as a whole or even any specific district of Taoyuan.

But how effective such measures are remains to be seen. As observed in calls for a lockdown, it can also be anticipated that the KMT will seek to challenge the authority of the CECC on the matter, even if this may skew toward embracing questionable measures to fight COVID-19.

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