Sun, Apr 28, 2013 - Page 8 News List

Plugging gaps in epidemic control

By Yang Yung-nane 楊永年

On Wednesday, the Centers for Disease Control (CDC) confirmed the first case of H7N9 avian influenza in Taiwan when a 53-year-old businessman returning from Suzhou, China, was diagnosed with the virus.

Epidemic prevention experts have said they would not be surprised if instances of human-to-human transmission of the virus begin to emerge.

To avoid an epidemic and the severe consequences that would follow, it is of the utmost urgency that the nation initiate outbreak prevention measures.

Here are three suggestions on how an epidemic prevention system could be devised and made operational:

First, it is necessary to have a comprehensive grasp of all epidemic prevention information.

It is likely that the CDC is the agency which has the quickest access to the best information.

However, the agency may be hindered by four blind spots:

It will not know immediately when a Taiwanese in China infected with H7N9 leaves for Taiwan; it will not know when and where in Taiwan it will be confirmed that that person carries the virus; there is uncertainty as to whether medical institutions have the ability to report epidemic-relevant information in the quickest way possible; and it is uncertain if the CDC will be able to inform the whole bureaucratic apparatus — in particular the epidemic prevention system and its top bureaucrats — about the status of an outbreak, its seriousness and its consequences in the most time-efficient way.

Given these blind spots, it is uncertain whether it will be possible to gain a comprehensive grasp of all epidemic prevention information.

Second, it is necessary to fully mobilize all epidemic prevention resources.

Having a complete grasp of epidemic information is a prerequisite for the effective and correct mobilization of preventative resources.

There are four issues regarding whether the full mobilization of those resources will result in the authorities gaining complete control over the situation: The CDC may not have complete resource information, or it may have failed to conduct a detailed inventory of resources, and even if the centers have a resource inventory it will not necessarily be able to mobilize those resources.

For example, the Bureau of Health Promotion is on an equal footing to the CDC, so it is not an absolute certainty that the centers will be able to effectively mobilize the bureau.

Also, not all epidemic prevention resources are under CDC control, there are also government and privately run medical institutions, and a public health system divided between national and local governments which means that for political reasons, cooperation may not be entirely without problems.

Finally, since the current outbreak originated in China, there are questions as to whether the cross-strait political situation will affect the effectiveness of the mobilization of epidemic prevention resources between the two sides.

The third factor necessary for the implementation of an epidemic prevention system is the full mobilization of the administrative system.

The general administrative system is bigger than the medical or public healthcare systems. If an epidemic spreads and becomes very serious, it will become necessary to mobilize the entire administrative system to contain an outbreak in the same way that it is mobilized when a natural disaster occurs.

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