key: cord-1029239-fmnle8iy
authors: Cheng, Hao-Yuan; Li, Shu-Ying; Yang, Chin-Hui
title: Safety practices and appropriate infection prevention mitigate potential staffing shortage
date: 2020-06-20
journal: J Formos Med Assoc
DOI: 10.1016/j.jfma.2020.06.015
sha: 79d2163ed5a04ba1acf4024fc6c40c3184f941b2
doc_id: 1029239
cord_uid: fmnle8iy

nan

Letter to the Editor Safety practices and appropriate infection prevention mitigate potential staffing shortage Dear Editor,

In the letter from Chun-Yu Lin et al., the authors misleadingly linked healthcare worker (HCWs) travel restrictions with the preservation of human resources for the healthcare system. The healthcare system becomes overwhelmed when coronavirus disease 2019 (COVID-19) spreads widely in the community. When that occurs, the highest infection risk will come from community exposure, not international travel. Therefore, for HCWs, universal precaution with appropriate personal protective equipment (PPE) is the most appropriate practice to prevent the transmission between HCWs and their patients. 1 The Central Epidemic Control Center had provided comprehensive guidelines for the use of appropriate PPE and corresponding infection control protocols for COVID-19. Since March 30, Taiwan tested >2000 HCWs for COVID-19; none were infected. Contact tracing study in Taiwan also showed low infection risk among HCWs. These data suggest that compliance with infection prevention and control measures are key to the preservation of precious healthcare workforce.

Because of the COVID-19 pandemic, many countries, including Taiwan, implemented border control and warned their citizens against nonessential international travel. However, travel restrictions could not sustain for long; reopening is inevitable. In time, universal quarantine for all travelers may need to be refined to preserve public health and healthcare workforce. Adjusting quarantine measures by risk for individual countries or professions will be a critical issue for policymakers as we begin life under a "new normal".

Currently, no consensus has been reached in the use of serological tests for case investigation and contact tracing because of their poor sensitivity and specificity. Most COVID-19 patients in Taiwan had been detected within one week after their symptom onset and contact tracing conducted within 72 h. Considering such good timeliness, PCR test might be sufficient for identifying patients. Investigations into exposure condition had often been limited by poor patient recall. However, studies have shown that the exposure with the highest risk occurred in household contacts and the common transmission route, 2,3 providing evidence in policy-making to control outbreaks. Additional behavior studies may have only marginal effects. More comprehensive behavior studies may have only marginal effects.

In Taiwan, we took early aggressive approaches in containing the first wave of the pandemic because so much was unknown of COVID-19. The more we learn from the current pandemic, the more accurate we could be in preparing for the second wave of disease. Scientific-evidence-based policy development would be of great importance to minimize collateral health, societal, and economic damages.

Escalating infection control response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong

Contact tracing assessment of COVID-19 transmission dynamics in Taiwan and risk at different exposure periods before and after symptom onset

Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study

The authors have no conflicts of interest relevant to this article.