Learning from the past: Taiwan's responses to COVID-19 versus SARS

Muh-Yong Yen; Yung-Feng Yen; Shey-Ying Chen; Ting-I Lee; Kuan-Han Huang; Ta-Chien Chan; Tsung-Hua Tung; Le-Yin Hsu; Tai-Yuan Chiu; Po-Ren Hsueh; Chwan-Chuen King

doi:10.1016/j.ijid.2021.06.002

Learning from the past: Taiwan's responses to COVID-19 versus SARS

Int J Infect Dis. 2021 Sep:110:469-478. doi: 10.1016/j.ijid.2021.06.002. Epub 2021 Jun 5.

Authors

Muh-Yong Yen¹, Yung-Feng Yen², Shey-Ying Chen³, Ting-I Lee⁴, Kuan-Han Huang⁵, Ta-Chien Chan⁶, Tsung-Hua Tung⁷, Le-Yin Hsu⁴, Tai-Yuan Chiu⁸, Po-Ren Hsueh⁹, Chwan-Chuen King¹⁰

Affiliations

¹ Division of Infectious Diseases, Taipei City Hospital, Taipei, Taiwan; Division of Infectious Diseases, Cheng Hsin General Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: myyen1121@gmail.com.
² Division of Infectious Diseases, Taipei City Hospital, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
³ Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁴ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
⁵ Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan.
⁶ Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan.
⁷ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Health, Taipei City Government, Taipei, Taiwan.
⁸ Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁹ Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
¹⁰ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. Electronic address: chwanchuen@gmail.com.

Abstract

Objectives: To evaluate the prevalence of infection prevention behaviors in Taiwan-wearing facemasks and alcohol-based hand hygiene (AHH)-and compare their practice rates during SARS and COVID-19.

Methods: We surveyed 2328 Taiwanese from July 29 to August 6, 2020, assessing demographics, information sources, and preventive behaviors during the 2003 SARS outbreaks, 2009 pandemic influenza H1N1, COVID-19, and with post-survey intentions. Characteristics associated with the practice of preventive behaviors in 2020 were identified through logistic regression.

Results: Preventive behaviors were conscientiously practiced by 70.2% of participants. Compared with 2003 SARS/2009 H1N1, the percentages of facemask use (66.6% vs 99.2% [indoors], P < 0.001) and on-person AHH (44.2% vs 65.4% [hand sanitizers], P < 0.001) significantly increasedduring 2020 COVID-19. Highest adherence to preventive behaviors in 2020 was among females (adjusted odds ratio [aOR], 1.72), those receiving government COVID-19 information (aOR, 1.52), participants recruited from primary-care clinics (aOR, 1.43), and those who practiced AHH during 2003 SARS/2009 H1N1 (aOR, 1.37).

Conclusions: Government leadership, healthcare providers risk communication, and public cooperation rapidly mitigated the spread of COVID-19 in Taiwan even before vaccination. Future global efforts must implement such population-based preventive behaviors at a level above the viral-transmission-threshold, particularly in areas with fast-spreading SARS-CoV-2 variants.

Keywords: Alcohol-based hand hygiene; COVID-19; Face mask; Public health policies; SARS-CoV-2; Taiwan; Threshold-based bundle strategy.

MeSH terms

COVID-19*
Cross-Sectional Studies
Female
Humans
Influenza A Virus, H1N1 Subtype*
SARS-CoV-2
Taiwan / epidemiology