Home News COVID ‘may have been contained’: Taiwan’s ex-health minister

COVID ‘may have been contained’: Taiwan’s ex-health minister

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The coronavirus pandemic may have been contained if the authorities in Wuhan had notified the World Well being Group earlier and allowed an professional workforce to analyze in December 2019, based on Dr Chen Chien-jen, Taiwan’s former vice-president and well being minister who made his identify in the course of the SARS [Severe Acute Respiratory Syndrome] outbreak almost 20 years in the past.

“Transparency and openness is essential for the containment of infectious ailments,” Dr Chen informed Al Jazeera in an interview. “If the state of affairs in Wuhan was very nicely reported to the World Well being Organisation and the WHO organised a workforce and went to Wuhan in mid-December 2019, I feel the illness may have been contained and no different international locations would have suffered.”

This week marks a 12 months because the central Chinese language metropolis was sealed off and positioned in a strict lockdown. A WHO workforce is now in Wuhan and is anticipated to start on-the-ground investigations after finishing a 14-day quarantine.

Greater than 97 million folks around the globe have now been recognized with COVID-19 and greater than two million have died, based on Johns Hopkins College.

Dr Chen was Taiwan’s well being minister in the course of the SARS disaster and performed a crucial position in overhauling the island’s epidemic response system, which is credited with its relative success in conserving the coronavirus at bay.

Taiwan has thus far seen simply seven deaths and skilled an eight-month streak with out a native an infection for a lot of 2020, which led to late December.

Dr Chen Chien-jen was the vice chairman of Taiwan till 2020 and a former well being minister who’s credited with the coverage adjustments which have helped maintain COVID in verify [File: Tyrone Siu/Reuters]

Al Jazeera sat down with Dr Chen at his workplace in Academia Sinica, Taiwan’s most famous analysis establishment, the place he works as a analysis fellow after retiring from politics. The interview has been edited for size and readability.

When will we see issues return to regular?

Because the first spherical of vaccine has already been distributed in a number of international locations – particularly in North America and Europe – I feel that it actually will depend on how briskly the availability of the vaccine might be distributed around the globe.

In Europe, I can see that if the vaccination programme is adopted, perhaps by June the state of affairs in Europe will turn out to be so-called “regular”. However I all the time say we shouldn’t return to previous regular, we must always set up a brand new regular – which suggests even though now we have managed the pandemic we must always nonetheless maintain vigilance on any rising infectious ailments sooner or later.

What are you able to inform us in regards to the new virus pressure within the UK?

It’s not sudden.

SARS Coronavirus-2 [COVID-19] is an RNA [ribonucleic acid] virus and an RNA virus is sort of prone to have a mutation. The rationale COVID-19 virus has mutated so quickly is [because] it unfold very broadly and handed by means of a variety of people, so it was extra prone to evolve right into a extremely infectious pressure.

From a virus viewpoint, one of the best virus is very infectious however much less virulent. It received’t trigger too many individuals to have a extreme illness after which die. The SARS virus was very virulent. The case fatality was as excessive as 10 %, and lots of people contaminated with the SARS virus obtained very sick and needed to go to the hospital to be remoted and handled there. As soon as they have been remoted within the hospital, there was no method for [virus] to unfold.

And that’s the rationale why the SARS virus was contained.

I feel for the UK pressure, now we have to be very cautious as a result of it’s extremely contagious so we’re competing for time between the vaccination and the speed of transmission. If the transmission goes a lot sooner than the immunisation programme, then immunisation principally fails.

 

There are a lot of totally different vaccines within the works however there was a variety of scepticism about China’s vaccine. Are you able to clarify why?

Normally, it will take 10 to fifteen years for a corporation to develop a vaccine and get approval. This time you possibly can see that in solely 9 to 10 months, we have already got a vaccine and the rationale for that’s a variety of international locations governments have an enormous funding in vaccine growth.

We will use RNA vaccines:  Moderna, BioNTech, and Pfizer they’re “messenger RNA vaccines.” Some corporations are creating a DNA vaccine, after which there’s the protein subunit vaccine, like Medigen in Taiwan. There’s an adenovirus vaccine, that’s AstraZeneca and Oxford College after which there’s an inactivated vaccine and that is principally the Chinese language vaccine. The Chinese language vaccine corporations manufacture a variety of inactivated vaccines.

A very powerful factor that regardless of which platform you utilize, regulatory businesses are going to do a evaluate. One necessary factor is transparency and openness. All corporations should publish all their medical trial knowledge to realize the general public belief of the vaccine and that’s the rationale why WHO has thus far solely authorized Moderna and Pfizer-BioNTech. Even AstraZeneca has not but obtained approval from WHO as a result of they should obtain all of their analysis knowledge and medical trial knowledge.

That is the rationale why folks may need some doubts on the Chinese language vaccine, as a result of we haven’t seen clear info for the evaluate. It can make folks fear about efficacy and security of the vaccine.

Taiwan has had probably the most profitable methods in coping with COVID. Do you suppose a few of this needed to do along with your pace and the very fact you addressed it early?

We all the time maintain a really vigilant surveillance of any pandemic on this area, as a result of we had SARS, H5N1 from mainland China, and likewise African swine flu.

On December 31, 2019, one among our CDC officers went to the PTT [Bulletin Board System] and so they noticed messages about [an] atypical pneumonia in Wuhan. At the moment there have been solely seven circumstances, however seven circumstances of atypical pneumonia is an enormous factor to us as a result of atypical pneumonia equals SARS.

On the identical day, we began on-board quarantine of passengers from Wuhan. By mid-February, we already had border management for passengers from China, Hong Kong and Macau.

In early January, we [also] began to call COVID-19 as a reportable illness. We mobilised greater than 20,000 isolation rooms for sufferers and 12,000 ventilators for the doable demand of the rising infectious illness.

After SARS, we additionally requested all of the hospitals to have one month’s inventory of PPE – private safety gear. After I was the well being minister, I arrange a nationwide well being command centre. As soon as there’s an epidemic or pandemic, it’s reactivated, so this had all been completed within the first two weeks of January final 12 months.

A nurse checks chest x-rays for indicators of Extreme Acute Respiratory Syndrome (SARS) at Nationwide Taiwan College Hospital’s out of doors fever remedy centre in Taipei in Might 2003. Taiwan overhauled its epidemic response and preparation after SARS – a much less infectious however extra lethal illness than COVID [File: Richard Chung/Reuters]

And on January 22, President Tsai Ing-wen referred to as a nationwide safety council assembly she requested what had been completed and whether or not there’s something now we have so as to add. I stated we don’t have sufficient face masks and she or he requested the Minister of Financial Affairs to requisition 73 face masks factories and set up 92 manufacturing traces. So, the third factor that’s necessary is early deployment.

(It) can be essential is to realize the general public belief and public help. We upgraded our command centre to cupboard stage after which we held each day press conferences and we have been fairly open and we had clear details about [our] operations.

So, prudent motion, fast response, early deployment, transparency and solidarity they’re all essential, not solely early detection.

Are you able to describe what SARS was like 20 years in the past and what Taiwan discovered from that have?

On the very starting, we had the primary few circumstances of SARS, and at the moment we felt fairly assured as a result of all of the circumstances have been taken care of within the medical centre and so they had excellent gear and good data and expertise to deal with sufferers with rising infectious ailments.

So, we thought-about, “Oh, we’re fairly good, now we have no downside.” However while you face rising infectious ailments, viruses respect no borders. In case you are fairly smug and also you ignore them, then it’s fairly seemingly you’ll fail.

What now we have been doing for COVID-19 is to observe our expertise and the data we discovered from SARS.

Taiwan was not well-prepared for any pandemic problem, so we began our transformation of the Taiwan CDC [Taiwan Centers for Disease Control], the Taiwan well being Ministry, our Communicable Illness Management Act, our medical care system for infectious ailments, and arrange our Nationwide Epidemic Well being Command Centre.

After that we additionally had a problem from mainland China from H5N1 avian flu and the H1N1 pandemic in 2009-2010. The Taiwan folks and the Taiwan authorities discovered rather a lot from earlier challenges.

Chemical warfare troops from Taiwan’s military disinfect the emergency room of Taipei’s Municipal Ho Ping Hospital in Might 2003. Dr Chen says SARS confirmed that Taiwan discovered viruses respect no borders and conceitedness results in failure [File: Simon Kwong/Reuters]

How does China’s response to COVID-19 examine with SARS?

I used to be shocked by Wuhan.

Initially, we thought Wuhan’s observe [must be] fairly good as a result of China was essentially the most severely affected nation by SARS. Individuals there ought to have discovered rather a lot. However once we despatched two specialists to Wuhan – we requested to go on January 6 and so they allowed our specialists to go there on January 11 – and so they requested questions: “These are the sufferers hospitalised, and the way about their shut contacts? How about their members of the family, their colleagues at work or their college students in class?” They usually stated, “No, they [the contacts] don’t have any pneumonia so they aren’t taken care of.”

After they got here again, we stated, “Oh my god. It’s actually unhealthy.”

The rationale for that’s for any form of pandemic, remedy is sweet for the affected person however remedy will not be ok for the containment of an outbreak. If you wish to comprise an outbreak, you undoubtedly should pay extra consideration to shut contacts, as a result of shut contacts are those who’re most probably to unfold the virus locally. They’re within the incubation interval. They don’t have any form of symptom, nonetheless, they’re able to transmitting the virus.

That is the rationale why in Taiwan we paid a variety of consideration to get the names of all of the shut contacts of confirmed circumstances. Then we ask them to remain at dwelling for 14 days and we use an digital fencing system to watch them.

The place do you suppose the virus got here from? The primary SARS virus was reportedly traced to a single bat collapse Yunnan province.

From an infectious illness epidemiologist viewpoint, the illness ought to come from the primary outbreak space. It might by no means be in a single space after which transmitted to a different space to trigger an outbreak there. That is fairly, fairly unlikely.

At the least the person-to-person transmission ought to have occurred in Wuhan, regardless of if the primary affected person zero is contaminated from a bat in Yunnan or someplace. It’s a lot simpler accountable a wild animal, however how can a bat from Yunnan infect folks in Wuhan? So perhaps in Huanan Seafood Market, proper? In the event that they did eat a variety of bats, it’s seemingly, however folks additionally suspect the virus is from the P4 lab [Wuhan National Biosafety Lab.] In the event that they used a bat to attempt to get the virus, that’s one other risk. It wants investigation and it wants transparency with the intention to uncover the origin of COVID-19.

Wuhan’s Huanan Wholesale Seafood Market, the place the primary COVID-linked circumstances emerged in December 2019. It was closed, cleared and disinfected quickly after the town was sealed off [File: Dake Kang/AP Photo]

Do you consider within the concept COVID-19 was made in a lab?

Type of. It’s one of many prospects. If persons are not doing their analysis rigorously, they’re prone to get the an infection. There was a state of affairs in Taiwan. In December [2003], at our Institute of Preventive Medication that belongs to the Nationwide Defence Medical Faculty, a P4 lab, a colonel was carrying on a examine however he was dashing to Singapore to attend a gathering. So he took care of every thing, however he noticed within the rubbish tank there was one piece of rubbish, and he simply used his naked fingers to take it out and put within the disinfection tank. Then he went to Singapore to attend a SARS worldwide convention however he was contaminated after he got here again. He didn’t transmit it to anybody but it surely created [political] turbulence as a result of 100 folks have been on the convention.

He was a really cautious individual and an excellent scientist and nonetheless solely a small mistake and he was contaminated. It’s common for lab staff to get an an infection. It’s one risk, so it wants investigation.