After being menaced by COVID-19 for more than a year, Taiwan has experienced its first incident of an intensive-care physician being infected, which has led to a cluster of local cases.
Taiwan’s disease control, which had been brimming with confidence, is suddenly threatened with a possible breach. As part of the emergency response, patients at the hospital can be discharged, but no new ones are to be admitted.
People connected with the cluster have been checked and screened, and their movements made public, with local authorities working with the central government to investigate the outbreak.
Some local businesses have closed down temporarily to disinfect their premises. These measures might be a taste of worse things to come.
Nonetheless, healthcare operations are continuing as normal, and healthcare workers are free to move around. The hospital has not been completely locked down — as happened at Taipei Municipal Hoping Hospital during the 2003 SARS crisis — neither has the whole population had to undergo nucleic acid tests, as has happened in Wuhan, China.
More importantly, the Centers for Disease Control has remained firmly in control and has not been thrown into confusion.
The only disturbance came from former department of health minister Yaung Chih-liang (楊志良), who angered many doctors and nurses by saying that the infected physician should be punished for not following standard operating procedures.
Many healthcare professionals have called on Yaung to apologize.
If medical negligence did occur, creating a breach in the wall of disease control that might lead to community infection, should someone not be held responsible?
Yaung, who said: “I was just stating the facts,” is probably not willing to concede.
However, does blaming and punishing individuals contribute anything to fighting an epidemic?
Medical and flight safety can mean the difference between life and death. If a medical safety incident involves large-scale infections that could cause healthcare services to collapse and the mortality rate to soar, it would be comparable to a plane crash that kills or injures hundreds of people.
However, an important principle of flight safety reviews is not to blame personnel. The emphasis of research and discussion is not on the errors themselves or the people who made them, but on the factors that influenced them and led to the mistakes, and on how to prevent human or systemic errors from recurring, possibly with even more serious consequences.
Many years of experience show that, rather than blaming a flight crew for errors, it is better to encourage those involved to boldly desist from concealing the truth and open every curtain. This is the only way to discover the root causes of an accident and prevent it from happening again.
As the Taiwan Aviation Education Development Association says, safety management in aviation has progressed from conducting reviews and making improvements in the wake of accidents, to anticipatory prevention and damage control.
One good thing is that Yaung and his outdated attitude is not one of those in charge of fighting COVID-19. Better still, people in the public eye, including academics who support the opposition, are clear-headed enough to understand the importance of root-cause analysis.
Hopefully, Taiwan’s healthcare sector can remember this lesson, and build a leaner and tougher front-line medical force to fight epidemics.
Lee Hung-sheng is a physician in charge of a clinic in Taichung.
Translated by Julian Clegg
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