The Foreign Affairs journal recently published an extensive report on the possibility of a flu epidemic breaking out in the near future, prompting Taiwan's media and the public to start paying attention to the issue. In fact, the World Health Organization (WHO) issued a similar warning at the beginning of last year, after reports of human infections by the avian-influenza strain H5N1 surfaced in Vietnam and Thailand. More than a year has passed and the number of human bird-flu infections is on the rise, with people in Cambodia and Indonesia being contaminated by the disease as well.
Recent research suggests that the H5N1 virus has become more flexible in adapting to the environment and limited human-to-human transmissions have taken place. If the virus continues to evolve and becomes easily transmitted from person to person, a pandemic then becomes imminent. Since Taiwan occupies a strategic position in Asia, we cannot disregard this risk.
Throughout history, influenza pandemics have caused massive loss of life and brought adverse social and economic consequences. Therefore, we need to seize all opportunities to prepare for a possible pandemic so that its impact will be restricted as far as possible. The Department of Health (DOH) has been engaging in preparations for a probable pandemic since the beginning of last year. Other than stockpiling antiviral drugs, the DOH declared novel influenza a notifiable communicable disease at the end of last year and set up 460 "sentinels for novel influenza sampling" throughout Taiwan. The purpose of the sentinels is for effective surveillance and prompt provision of antiviral treatment to those suspected of having contracted bird flu. So far all patients who met the sampling criteria have been proven clear of avian influenza through laboratory testing.
In addition, the "National Preparedness Plan for Influenza Pandemic" drawn up by the DOH was passed by the Cabinet in April this year. The core of the plan consists of "three main strategies and four lines of defense."
The three strategies include "flu vaccines, antiviral drugs and public-health intervention."
At the moment, the international community is starting to work on researching and developing an H5N1 vaccine. If mass production for the market becomes a reality, the vaccine will be administered first and foremost on high-risk groups and those responsible for maintaining law and order in society.
In terms of antiviral drugs, the goal is to stock up on enough drugs to innoculate 10 percent of the population and we will attempt R&D in manufacturing technologies for antiviral drugs. In addition, we have stockpiled a substantial quantity of safety equipment and protective gear. We have also planned for isolated treatment facilities and possible measures to restrict school, work and mass activities during a pandemic.
The four lines of defense include "battles abroad, broader quarantine, health management in community and a sound health-care system."
The DOH is working vigorously with other countries to block any infection from spreading to Taiwan. We will continue with quarantine measures that have been put in place at airports and seaports after the SARS outbreak, such as thermal monitoring. Furthermore, we are building up consensus and marshaling manpower in the community for better health management. At the same time, we are constructing a health-care network for epidemic control.
In order to enhance cross-departmental collaboration and understanding of the standard procedures, the DOH has adopted the concept of military drills for disease-control mobilization. The DOH has devised a possible course of development for the flu epidemic and conducted a drill for a Level A2 pandemic situation (ie, suspected human infections of avian flu in Taiwan) on July 7 this year. The highly successful drill included devising operational strategies, quarantine of travelers from epidemic areas, investigation into the magnitude of the crisis and hospitalization of suspected cases.
I traveled to Washington recently where a flu pandemic was the focus of my discussions -- even the US did not have the confidence to declare that it was fully prepared for a pandemic. The US is willing to work with our government in preventing novel influenza.
After the dreadful experience of dealing with the SARS outbreak in Taiwan in 2003, the DOH is wary of a new pandemic and is determined to be a global leader in preparing for the crisis. We urge the public to trust the authorities, to pay attention to information released by the government and to follow the prescribed preventive measures.
On the whole, a pandemic caused by the novel influenza bacteria is likely to occur, even though we are unable to predict the exact time of its occurrence.
However, through analysis of data that are currently available, the number of novel influenza infections in both humans and animals are on the rise. Researchers have also discovered incidents of mass outbreak and suspected human-to-human transmission. As a result, most experts believe that the novel-influenza strain H5N1 is undergoing continuous changes and is becoming more flexible in adapting to the human body. Consequently, they believe the next pandemic is just around the corner.
Such a pandemic will bring unprecedented disruption to the economic and social security systems as well as health care services, even causing them to shut down or disintegrate. We are at a critical point in history to respond to a pandemic. We are running against time in our preparation for the looming crisis. The health authorities alone cannot accomplish the mission, and even cross-departmental collaboration cannot reverse the tide. Only with public consensus and support for government regulations and guidelines can we can minimize losses in what threatens to be the pandemic of the century.
Hou Sheng-mou is the minister of the Department of Health.
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