MERS demonstrates need for public health strategies
The Middle East Respiratory Syndrome (MERS) virus is causing alarm in neighboring South Korea and China. As of Sunday, 15 cases of the severe form of SARS have been diagnosed in South Korea, including a man who went to mainland China via Hong Kong, defying health authorities’ border control efforts and subsequently leading to dozens of others needing to be quarantined.
With a fatality rate of 30-40 percent, MERS is indeed a deadly foe. Air travel remains a big problem, as our quarantine procedures need to be reinforced for the inevitable breach in defenses when a patient comes through borders without the disease being noticed — an event that sometimes cannot be helped when symptoms develop afterward.
Fever, coughing, and irritability in the respiratory tract are symptoms of the infection. Because so many contagious diseases share the same traits, it is now contingent on the public to reinforce the protocol for daily hygiene, including washing hands frequently and wearing a mask if coughing.
Health authorities have also identified consumption of uncooked food and camel milk as high-risk factors.
Compulsory quarantine for deadly diseases such as MERS is necessary for the well-being of both the uninfected as well as the carriers. The Korean man who traveled to Guangdong first lied to South Korean health personnel about visiting his father, who was in hospital for MERS, and then lied to Hong Kong border inspectors when he was questioned for displaying a fever, saying that he did not have any contact with MERSrelated patients, according to the United Daily News (UND).
Taiwan has penalties of NT$10,000 to NT$150,000 fines that can be dished out to those who conceal their travel history with respect to MERS contact. Furthermore, denial of travel is legally mandated. While the motivations for contravening safety protocols such as these are varied, they tend to fall into categories of selfish interest in preserving freedom of movement.
MERS and Ebola are both transmitted through contact with body fluids. Once a breakout occurs, it becomes an uphill climb to cap the number of carriers, not to mention the escalating costs of panic and apprehension in society. The best strategy, it would seem, is to build a hardy defense configuration enough to withstand occurrences of disease that are outside Taiwan’s control.
The forerunner in the discovery and fight against the Ebola virus, Dr. Jean-Jacques Myuembe, said in an AFP article published on Saturday that the deadly disease, which shook the world with the 2014 epidemic, “will return.” Taking the threat seriously requires investment in infrastructure, consisting of both a complete anti-disease diagnosisinterception-quarantine-treatment network in place, whose strength is determined by the degree of adherence to effective hygiene standards.
This is turn raises questions about issues like understaffing in hospitals and reported lack of beds as well as proper spacing between hospital beds — 1 meter is necessary, but that standard is not always upheld, said Wang Ren-Hsien, president of the Taiwan Counter Contagious Diseases Society, in a letter to the UND. Wang attributed the central region’s success in Taiwan’s battle against SARS in 2003 to the provision of many empty hospital beds in hospitals where there was an outbreak. According to him, the central region — consisting of six counties and cities — achieved a saturation of empty beds in a high ratio over beds where infected patients were placed. Redundant capacity appears to be an insight here.
Taiwan should redouble its investment in infrastructure innovations, drawing on the ingenuity that has long been one of the country’s strengths, to boost defenses against contagion. While public space always carries with it both the convenience of efficiencies of scale, to the extent possible we should invest in creative technological and ergonomic solutions to mitigate those costs.
As an inspiring antidote to the perils of comfort and hygiene inherent in the confinement of flight cabins, a possible improvement could be to encourage the import of a finshaped airflow direction system designed by high school student Raymond Wang, reported by the Washington Post. The device seeks to address the problem of bodily fluids by creating pockets of fresh air around each person — “personalized ventilation space,” as Wang described. This would cost as little as US$1,000 per seat to install on an airplane, and it could reduce germ-concentration by as much as 55 times by Wang’s own estimates. Looking into innovations like Wang’s could be an effective defense against the transmission of dangerous diseases.