222 days without COVID in Taiwan: what are the reasons for this success? Free

Worldwide, as of 24 November 2020, there have been 58 712 326 confirmed cases of COVID-19, including 1 388 528 deaths in this outbreak globally, reported to the World Health Organization. Vietnam is one of the countries that have achieved great success in combating COVID-19.¹ However, after 99 days without any further local transmission since the first wave, Vuong et al.² reported a second wave that started in July 2020 in a tourist city of Vietnam and led to 551 cases. Vietnam used a multipronged approach with community engagement and liberal use of testing, contact tracing, isolation of all cases and quarantining of contacts.³

Here we report on the success story of Taiwan. Taiwan has a population of ~23.57 million. Of the 248 625 tested individuals in Taiwan, 618 (0.25%) were laboratory-confirmed patients, with 7 (1.13%) deaths reported.⁴ As soon as the first laboratory-confirmed case was reported in Taiwan on 21 January 2020, Taiwan launched international travel restriction for all passengers from Wuhan, China and implemented quarantine measures for all returning travellers to Taiwan for a 14-day period of self-health management since 25 January 2020. With the last reported locally transmitted case on 12 April by 21 November 2020, Taiwan has marked its 222nd consecutive day without a locally transmitted case. During these past 7 months, 148 new confirmed imported cases but no indigenous case was reported in Taiwan. Taiwan has shown that COVID-19 can be kept at bay if the following measures are taken: (i) stringent quarantine of all travellers and returning residents to Taiwan, (ii) rigorous contact tracing and enforced quarantine of all close contacts and (iii) in addition, community-based enforcement of social distancing, hand washing and mandatory use of face masks.⁵ For all inbound travellers who are required to undergo home quarantine according to the laws and regulations, Taiwan has successfully conducted home quarantine among inbound travellers instead of quarantine in dedicated accommodation facilities compared with what China does.⁶ For travellers who have no homes in Taiwan, centralized quarantine is being implemented. Furthermore, more recently, centralized quarantine facilities are being used in case a returning resident shares his or her home with persons older than 65 years of age or persons with co-morbidities.

The rapid response and successful experience of Vietnam and Taiwan have provided exemplary models in sustaining the fight against COVID-19. The biggest challenge is to ensure that imported cases do not lead to onward transmission. Taiwan faces the ongoing challenge with proactive measures including border control, entry quarantine and protection of airport and harbour-related staff.

Authors’ contributions

C.Y.D.: Conceptualization; Supervision; Writing—original draft, review and editing.

T.H.D.: Conceptualization; Writing—original draft review and editing.

W.H.S.: Writing—review and editing.

C.K.H.: Conceptualization; Supervision; Writing—review and editing.

Conflict of interest: None declared.

References