Covid-19: Lessons from elsewhere

If, after the pandemic, we need to send a medical emergency-preparedness team anywhere to gather first-hand information, we know Taiwan should be among the few prime destinations, irrespective of potential ruffled feathers from friends

By S. Callikan

Covid-19 has undeniably had an unprecedented impact, both sanitary and economic, across the world, and most countries had struggled with no agreed roadmap to find the correct health response strategy. Mauritius, as an island, could only be exposed to such an epidemic outbreak through imported sources, either through its important tourist and travel industry, or from Mauritians returning from exposed areas, including cruise ships, or even uncontrolled migrant movements.

In other words, our airport and, to a lesser extent, the port are the two nerve centres of any potential infectious spread for a disease that, as we know, bows down neither to VVIPs, nor to the political or economic status of its victims. The latter, particularly with the long incubation period of two weeks and with a proportion of asymptomatic infections, can create havoc as involuntary spreaders in society, unless fast and efficient detection, isolation and containment measures are taken.

But we have had a remarkable frontline medical and para-medical team that walked the extra mile that sees us, despite ten unfortunate deaths, in the enviable position of three successive weeks without any new reported case. While we recognise this, there is no doubt that lessons have to be drawn on all fronts: lack of clear sanitary authority on port or airport management, failures at most of our overseas embassies, initial falterings in properly managed quarantine facilities, non-availability of daily life essentials including pharmaceutical supplies and bottled gas, unacceptable price hikes in unscrupulous supermarkets and other outlets, reported hoarding and racketeering on some consumables, to the fate of vegetable growers and fishermen, have all been frayed and disruptive.

These are not failings of laymen and ordinary citizens but of an administration assailed on all fronts, clearly without a preparedness plan prior to the sanitary curfew and pretty much on trial and error mode once it was announced.

It is a worrying state of mind in governing circles when the Quarantine Act makes no headway on the coordination and preparedness fronts as raised previously here and elsewhere. In its sledgehammer approach, the Act gives no leeway to the Health Minister to treat differently any part of our Republic, nor the nature of the communicable disease and its likely morbidity or spreadability. For instance, conditions specific to Rodrigues or Agalega or to a specific eruption zone (say, a Port-Louis suburb) would have warranted a far more refined quarantine control and management tool.

The Act develops no clear graded and coordinated response plan akin to cyclonic conditions that would clearly spell out not just the responsibilities of the general public, but equally important, those of the authorities, who, using the exceptional circumstances of an international pandemic, are granting themselves exceptional powers for any local epidemic; powers that, en passant, may even fail the test of constitutionality according to many independent minds.

While still on the topic of pandemic control and handling, as an island our lessons are worth comparing with other island nations and states. Two in particular stand out for the quite different outcomes as reported in the international press: the UK, one of the worst European cases, and Taiwan – one of the most successful pandemic handlers around the world.

Many of us will have been aware that the UK has become Europe’s prime exemplar of boisterous unpreparedness and desultory Trumpian-style mismanagement and missteps that have outstretched resources and hospital personnel, taking the tragic tally of infections and deaths well beyond Italy and Spain. The Financial Times, not a left-wing alarmist outlet, has even estimated that total deaths are double the official figure. The new Leader of the Labour party, Keir Starmer, was clinically sober, taking pains to factually probe and grill government, in an almost virtual Westminster, on how “We were slow into lockdown, slow on testing, slow on protective equipment.”

Mainland China’s intense pressures have consistently denied Taiwan an independent presence as WHO member or even an observer status, a fact that adds little to the WHO defense from overbearing influence by the global superpower. Its unfortunate and unjustified political exclusion from the WHO health-sharing forums has made Taiwan’s remarkable results in controlling and preventing the spread of the Covid-19 pandemic less available to other nations and less publicized. Yet, as an island nation, these should be of interest to us.

On 10 May 2020, it had already recorded the outstanding feat of 28 consecutive days free from new reported coronavirus cases, that is, twice the normal incubation period. With a recorded 440 infected cases, today nearly all recovered, and only 7 deaths from Covid-19 for a population of 24 million and despite only 70,000 tests having been conducted, is a remarkable feat by all known world standards and achievements, one that has been praised in the Journal of the American Medical Association (JAMA).

Key to its success has been preparedness and planned response levels, maybe resulting from various previous epidemics in the South East Asian region and a likelihood of future outbreaks. It is perhaps fortunate that Luo Yi-jun, deputy director for Taiwan’s Centers for Disease Control, had been scanning the press in the early hours of New Year’s Eve when a thread about an unknown disease causing pneumonia in Wuhan caught his attention. But he immediately emailed colleagues and put the country on alert.

On 31 December 2019, the Taiwanese CDC had the authority to implement inspection measures for all inbound flights from Wuhan, China. On 20 January, in its graded response mechanism, the Taiwan government deemed the risk posed by the outbreak sufficient to activate its Central Epidemic Command Centre (CECC) to level 3 and later to level 1 on 28 February. On 26 January, Taiwan had suspended all air travel to and from China, and put in place quarantine measures for passengers. The JAMA lists more than 120 sanitary confinement measures that were locked in successively by the CECC as alert levels moved upscale.

If, after the pandemic, we need to send a medical emergency-preparedness team anywhere to gather first-hand information, we know Taiwan should be among the few prime destinations, irrespective of potential ruffled feathers from friends. Being far earlier on the curve than most countries and having similar insular conditions with its ports, airports, tourism and airline industries, it could even provide our leaders invaluable lessons in progressive deconfinement and on steps to a planned economic recovery.

* Published in print edition on 22 May 2020