key: cord-292513-7mhd4wzk
authors: Yi-Fong Su, Vincent; Yen, Yung-Feng; Yang, Kuang-Yao; Su, Wei-Juin; Chou, Kun-Ta; Chen, Yuh-Min; Perng, Diahn-Warng
title: Masks and medical care: Two keys to Taiwan's success in preventing COVID-19 spread
date: 2020-06-04
journal: Travel Med Infect Dis
DOI: 10.1016/j.tmaid.2020.101780
sha: 
doc_id: 292513
cord_uid: 7mhd4wzk

nan

Despite being close to China, Taiwan has stopped the COVID-19 with general screening strategy and encouraging people in Taiwan to wear a mask. Taiwan reported the first COVID-19 case on 21 January 2020. About 850 000 and 400,000 of Taiwan's 23 million citizens live and work in mainland China, respectively. There were 2.71 million visitors from Mainland China in Taiwan in 2019 [1] . The narrowest point between Taiwan and mainland China is just 130 kilometres. Taiwan is one of the areas with the highest risk of the COVID-19 pandemic, but it did not happen. Taiwan has recorded just 438 cases and 6 deaths on May 05, 2020, including 55 local cases and 383 imported cases, respectively.

In European and American countries, it is generally believed that only infected patients need to wear a mask and that wearing a mask implies an admission of disease. In Asian countries, on the other hand, it is common for people to wear masks to prevent COVID-19. The daily production capacity of face mask manufacturers in Taiwan before the outbreak was 1.88 million face masks with a maximum production capacity of 2.44 million face masks per day. To ensure sufficient domestic resources for the prevention and control of epidemics, the Government of Taiwan has imposed a ban on exports of face masks on 24 January, followed by the requisition and rationing of all domestically-produced face masks (about 4 million pieces per day) by the National Health Command Center and Central Epidemic Command Center (https://www.cdc.gov.tw/En). Starting from 6 February, each person was allowed to purchase two surgical masks (priced at NT$ 5 each, equivalent to USD 0.17 each) every seven days. Starting from 5 March, the purchase limit was increased to three masks for adults and five masks for children every seven days. To ensure an adequate supply of face masks, Thailand, South Korea, and France announced the implementation of export controls on face masks starting from 4 February, 26 February and 3 March, respectively. Germany and Russia also announced a ban on exports of face masks on 4 April. Besides, the World Health Organization (WHO) also called for all countries to boost their production of face masks on 4 April.

Taiwanese people who suspect they may have been infected with COVID-19 can go to the emergency department of the nearest hospital for relevant medical examinations (including sampling and testing for COVID-19, blood tests, and X-ray imaging test) with out-of-pocket medical expenses of less than NT$ 600 (USD 20).

People with high suspicion of COVID-19 infection will be admitted to isolation wards, and those who have tested positive for COVID-19 can only be discharged home after three consecutive respiratory specimens test negative for the virus. In that case, patients will have to pay less than NT$ 3,000 (USD 100) out-of-pocket for medical services. Most of the medical expenses incurred by Taiwanese people are covered by the National Health Insurance program. As of 05 May, there were a total of 438 confirmed COVID-19 cases out of 65,589 screening tests under surveillance with a positive rate of 0.67%. Of the confirmed cases, 6 patients died from the disease and 334 patients (76.3 %) have been released from quarantine, while the remaining patients are still hospitalised in isolation wards.

On 1 April, Taiwan President Tsai Ing-wen announced plans to donate 10 million face masks to countries that have been severely affected by the epidemic. Taiwan is donating 2 million masks to the United States, 7 million masks to European countries, and 1 million masks to countries that have diplomatic relations with Taiwan. Taiwan is currently deliberating on epidemic prevention and control strategies, and is sharing its research outcomes with the United States, European Union (EU), and the Czech Republic. Besides, Taiwan also collaborates with Australia and the United States on the exchange of materials for the prevention and control of epidemics. President Tsai pointed out that Taiwan will definitely not stand idly by based on humanitarian considerations and will actively enhance collaborations with various countries for the prevention and control of COVID-19. Taiwan is willing to assist the international community in terms of face masks, medicines, and technologies. Currently, Taiwan is capable of producing 18 million face masks per day and will boost its production capacity to 20 million face masks per day. The purchase limit has also been revised to nine masks for adults or 10 masks for children every 14 days starting April. At present, the number of confirmed COVID-19 cases has exceeded 3 million worldwide with countless medical personnel risking their lives to treat patients [2] . The United States and EU countries are greatly affected by the COVID-19 epidemic.

On the basis of Taiwan's invaluable experience in the prevention and control of epidemics: 1. We encourage the public to wear face masks during the epidemic while keeping the price of face masks low by controlling the manufacture and sale of face masks; 2. We ensure public access to affordable comprehensive screening tests and medical care for COVID-19. We believe that these two approaches are among the main factors contributing to the success of Taiwan in limiting the spread of COVID-19.

Taiwan's experience may help European countries and the United States to contain the COVID-19 epidemic.

JAMA 2020. 2. World Health Organization: Coronavirus disease 2019 (COVID-19): situation report

The authors declare that they have no conflict of interest.
