As the coronavirus pandemic continues to paralyze the world, it is crucial to understand which measure is effective in stopping the spread. There are success stories from Germany & South Korea, showing that the spread can be contained by extensive testing and contact tracing. Here, I would like to share the story from my home country, Taiwan, on how Taiwan copes with this pandemic. Disclaimer: I don’t have any formal medical background, and this post is simply providing a different perspective of the effectiveness of washing hands frequently & wearing surgical masks on stopping the spread.
COVID-19 in Taiwan
As a country just 180 kilometer (110 miles) away from China, lots of media and press predicted that Taiwan would be heavily impacted due to its proximity to China. Surprisingly, the result is the opposite. So far, the spread in Taiwan is well contained by the the government’s timely actions to suspend incoming flights, enforce home quarantine of potential cases, precise contact tracing of confirmed cases, and sufficient supply of protective gears - masks etc. These measures are also proven effective in containing the spread in other countries, such as Germany & South Korea.
In particular, there is one major effort made by every one in Taiwan - wearing surgical masks and washing hands frequently. In Taiwan, people are used to wearing surgical masks for different reasons, such as sun protection, allergy prevention and so on. It is common to see people with surgical masks walking on the streets, and nobody would judge or question the motivation.
As of May 9, the number of confirmed cases in Taiwan is around 440. As the figure shown below, most of the cases are imported overseas, while the indigenous cases (community spread) are relatively low. Around March 15, lots of Taiwanese people returned from countries where the COVID-19 situation deteriorated. Consequently, the indigenous cases in Taiwan increased slightly after Mar 15, but it didn’t turn into a severe outbreak. This is mainly a result of good personal hygiene and surgical mask-wearing practices. Taiwanese people’s awareness of the virus and willingless to follow government orders keeps everyone safe. This not only shows in the low number of COVID-19 cases in Taiwan but also shows in the low number of other infectious diseases, which would be covered in the following paragraph.
Note: Dummu fleet is a cluster of cases from a navy ship that returned to Taiwan after missions overseas
Other infectious diseases in Taiwan
Besides the ongoing novel coronavirus, this time of the year is also when the public get hit hard by influenza. See the flu season, normally winter & spring, highlighted in pink in below figure. The following figures show a decrease in the number of outpatients of influenza & the cases of severe complications after the COVID-19 outbreak. It aligns with the time when the large portion of Taiwanese public started wearing mask to combat COVID-19, and also shows that wearing masks is critical in stoping the spread of infectious diseases.
Influenza
The first figure below shows the monthly number of influenza with severe complications. The next figure shows the monthly number of outpatients of influenza. Both figures show that the outbreak of influenza around January 2020 is severe compared to recent 10 years, which is around 300K outpatients. This year would have become a huge outbreak of influenza based on historical trend. The COVID-19 happened at the end of January 2020 and changed the story. As the situation worsened globally, the Taiwanese public started wearing masks and washing hands more frequently than ever to maintain good personal hygiene. It reflects on the number of influenza cases in February 2020 when the cases dropped significantly. Since the way how influenza spread is similar to COVID-19, it is not surprising to see the drop in influenza cases as almost every Taiwanese wears a surgical mask. The third figure below shows a decrease in the monthly cases of other Pneumonia since February 2020.
Influenza with severe complications
Outpatient of influenza
Outpatient of other Pneumonia
Enterovirus
Enterovirus is a common infectious disease in Taiwan. The cases usually start ramping up around March and reach peak around May and June. Let’s look the figures below. The first figure shows the the monthly cases of Enterovirus with severe complications. The next one is the monthly cases of outpatient and emergency of Enterovirus. It is currently May, when the cases of Enterovirus are expected to increase. However, the number of cases in March and April 2020 stayed relatively low, compared to other years. The way Enterovirus spread is similar to COVID-19 and influenza - by airborne respiratory droplets or touching a contaminated surface. Thus, it shows again that the measures used to contain the COVID-19 also help to decrease the number of cases of other infectious diseases. It is not at the peak season of Enterovirus yet, but I hope this trend of little increase in cases can be maintained for the coming months.
Enterovirus infection with severe complications
Outpatient and emergency of Enterovirus infection
Summary
From the number of cases of several common infectious diseases in Taiwan, it clearly shows that the spread of these diseases is contained because people in Taiwan are following the preventative steps from Taiwan government to stop the spread of COVID-19 - mask wearing and frequent hand-washing. Thanks to its government & citizens, Taiwan is one of the few countries where daily lives haven’t changed that much under the COVID-19 situation.
Here is the guideline from CDC of United States. It also suggests to cover mouth and nose when around others.
I really believe that the pandemic would end soon, but it requires all of us to take it more seriously and act on it. There is no shortcut to preventing infectious diseases from spreading. By doing simple steps like wearing masks and maintaining good personal hygiene, you’re truly saving lives, yours, your loved one’s, and much more.
Reference
- All data are downloaded as of May 9, 2020. The data of May 2020 is not included in the plots since the data of May is not yet complete.
- All the data processing & plot details are here.
Please reference my post when used.