Taipei Times: When did you know you might be able to present Taiwan's SARS situation in the technical briefing? What were you prepared to say in your presentation?
Chen Chien-jen (
Only after I arrived here did I realize that the WHA only allowed its member states to present such reports.
The MOFA then invited Liberia and Chad to request the WHA provide an opportunity to hear my report. Unfortunately, we were not granted the opportunity.
Even so, I was thinking that it might be possible for Taiwanese experts to answer the audience's questions after other countries' presentations. But as other countries' presentations were quite long, we did not have the opportunity to do this either.
It was unfortunate, because the chairman of the technical briefing [World Health Organization (WHO) Secretary-General Gro Harlem Brundtland] treated the issue as a political one. The technical briefing should be of an academic and professional nature. She should not treat it as a political issue.
What I prepared to say in my presentation was the observation of Taiwan's SARS epidemic and hospital infection control measures.
Before April 20, our hospital infection control was very successful, because we had gained considerable experience on this aspect from Singapore, Hong Kong and Canada. Our control of imported cases was quite good too. National Taiwan University Hospital did well in infection control when treating Taiwan's first SARS patient.
However, after the outbreak in Taipei Municipal Hoping Hospital on April 20, we found Taiwan's hospital infection control had failed, which led to further large-scale outbreaks.
We think it is essential that the World Health Organization and other countries learn from Taiwan's experience so as not to repeat our mistakes.
Apart from control of hospital infection and imported cases, I also planned to report on Taiwan's domestic isolation measures, which needed to be reviewed.
When we set up standards for domestic isolation, our knowledge about SARS was inadequate.
These standards might be too strict. Singapore and Hong Kong once suspended schools in order to contain the disease. According to the current understanding of the infection routes of SARS, these measures were too strict and might have caused some unnecessary situations.
Actually, I have prepared slides for my report. I might only have five minutes for my report, but I prepared 10 slides for it. It is really a shame I was not allowed to report.
TT: Last weekend, you had a videoconference with David Heymann, executive director of communicable diseases for the WHO, and other SARS-affected countries. What did you learn from the conference and what information on Taiwan's SARS outbreak did you share with other countries?
Chen: In the conference, all participating countries reported the epidemiological features of their outbreaks, such as infection period, incubation period, fatality rates and preventive measures.
I reported twice on Taiwan's experience, each time for about 10 minutes. I talked about the epidemiological features of Taiwan's outbreak. The videoconference was very pleasant. Perhaps we were too naive. We thought the WHA technical briefing was of the same nature as the videoconference. I did not realize such technical briefings would be politicized in the WHA.
TT: As PFP Legislator Kao Ming-chien (
Chen: The experts shared some information in the conference. However, such information exchange is inadequate. What's more important is that Taiwanese experts went to China out of good will to help. They were not formally invited. They did learn much from the conference and went to China only to understand its situation.
China said it has been communicating with Taiwan on the issue. Saying that the conference represented China's communication with Taiwan on the SARS issue is like saying a deer is a horse.
China used Kao's conference as a key tool for political propaganda. This is beyond my imagination. Obviously, China adopted political skills to handle Taiwan's SARS issue. China is far more sophisticated than Taiwan in coping with the issue. They had been planning this long time ago.
TT: Will you go to the international SARS conference held by the WHO in Kuala Lumpur, Malaysia, in June?
Chen: So far I have not received a formal invitation. Everything can only be said hypothetically. The question is difficult to answer. If the WHO invites us to join the conference in the name of Taiwan, I think we will attend it in order to let people around the world learn from Taiwan's successes and failures in containing the disease. The fact is China is good at taking advantage of certain occasions to play politics.
TT: How do you plan to contain Taiwan's SARS epidemic after your Geneva trip?
Chen: I am fully informed daily about the current outbreak. After analyzing the 39 to 40 probable cases reported every day, I found two-thirds of the caseload were cases reported in the past which had not been verified.
If we look at the onset dates of the cases related to the recent infection in several hospitals, we can find the scale of infection in these hospitals was smaller than that in Hoping Hospital.
Perhaps people have learned from Hoping Hospital about how to contain hospital infections.
I remain circumspect and optimistic about controlling the epidemic. The most important task now is to handle the hospital outbreaks. If people don't touch patients or their fluids and excrements, hospitals should be a clean place to stay. It is unnecessary for health workers to fear they would definitely be infected.
It is important that SARS patients are discovered early. To achieve that, we will set up fever screening points at locations not far from hospitals to check patients with a fever. We plan to set up 138 such points this week.
We call for people nationwide who have a fever to go to these points. If they really have a fever, we will give them special treatment.
If their fever was not genuine, they will be sent into hospitals for treatment as needed. By doing so, we can prevent the major sources of hospital infection. I hope the epidemic will be better controlled next week.
It might take about three weeks to get the outbreak under control. We may see whether these measures are effective by the middle of June.
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