Enhancing Data Linkage to Break the Chain of COVID-19 Spread: The Taiwan Experience

Setting up a three‐stage pre‐endoscopy triage during the coronavirus disease 2019 pandemic: A multicenter observational study

Objectives

Between May and July 2021, the coronavirus disease 2019 (COVID‐19) pandemic led to a sharp surge in community transmission in Taiwan. We present a three‐stage restructuring process of pre‐endoscopy triage at the beginning of the pandemic, which can support urgent endoscopic procedures while protecting endoscopy staff.

Methods

The pre‐endoscopy triage framework was set up with three checkpoints at the hospital entrance, outpatient department, and endoscopy unit, with a specific target patient population and screening methods. Relevant data included the number of endoscopic procedures performed, outpatient department visits, and performing screening methods such as temperature measurement, travel, occupation, contact, and clustering history checking, polymerase chain reaction assay, and rapid antigen test.

Results

Forehead temperature measurement and verification of travel, occupation, contact, and clustering history provided rapid, easy, and early mass screening of symptomatic patients at the hospital entrance. During the pandemic, outpatient department visits and endoscopic procedures decreased by 37% and 64%, respectively. The pre‐endoscopy screening methods used displayed regional variations in COVID‐19 prevalence. Among 16 endoscopy units with a community prevalence of ≥ 31.04 cases per 100,000 residents, 12 (75%) used polymerase chain reaction assay and four (25%) used rapid antigen test to identify asymptomatic patients before endoscopy. Of 6540 pre‐endoscopy screening patients, 15 (0.23%) tested positive by laboratory testing. No endoscopy‐related nosocomial COVID‐19 infections were reported during the pandemic.

Conclusions

We present a three‐stage pre‐endoscopy triage based on the local laboratory capacity, medical resources, and community prevalence. These measures could be useful during the COVID‐19 pandemic.

Rapid Control of a SARS-CoV-2 B.1.617.2 (Delta) Variant COVID-19 Community Outbreak: The Successful Experience in Pingtung County of Taiwan

The Severe Acute Respiratory Syndrome-associated Coronavirus 2 (SARS-CoV-2) was an outbreak in December, 2019 and rapidly spread to the world. All variants of SARS-CoV-2, including the globally and currently dominant Delta variant (Delta-SARS-CoV-2), caused severe disease and mortality. Among all variants, Delta-SARS-CoV-2 had the highest transmissibility, growth rate, and secondary attack rate than other variants except for the new variant of Omicron that still exists with many unknown effects. In Taiwan, the pandemic Delta-SARS-CoV-2 began in Pingtung from 14 June 2021 and ceased at 11 July 2021. Seventeen patients were infected by Delta-SARS-CoV-2 and 1 person died during the Pingtung outbreak. The Public Health Bureau of Pingtung County Government stopped the Delta-SARS-CoV-2 outbreak within 1 month through measures such as epidemic investigation, rapid gene sequencing, rapidly expanding isolation, expanded screening of the Delta-SARS-CoV-2 antigen for people who lived in regional villages, and indirect intervention, including rapid vaccination, short lockdown period, and travel restrictions. Indirect environmental factors, such as low levels of air pollution, tropic weather in the summer season, and rural areas might have accelerated the ability to control the Delta-SARS-CoV-2 spread. This successful experience might be recommended as a successful formula for the unvaccinated or insufficiently vaccinated regions.