Central Epidemic Command Center

The Central Epidemic Command Center (CECC; Chinese: 國家衛生指揮中心中央流行疫情指揮中心) is an agency of the National Health Command Center (NHCC). It has been activated by the government of Taiwan for several disease outbreaks, such as the 2009 swine flu pandemic and the COVID-19 pandemic. The head of the agency is Chen Shih-chung, the minister of health and welfare.[1] The CECC is associated with the Taiwan Centers for Disease Control (Taiwan CDC).

A temporary command center was first established in 2003 during the SARS epidemic, which caused 71 deaths in Taiwan.[2][3] Then, as a result of lessons learned from this epidemic, a permanent National Health Command Center was approved as a project on 16 August 2004; NHCC offices opened in the CDC building on 18 January 2005. The CECC is one of the command centers that are part of the NHCC.[2][4]

2009 swine flu pandemic

On 28 April 2009, the CECC held its first meeting hosted by the Minister of Health, Yeh Ching-chuan. Participating agencies included the Department of Health, the Ministry of Interior, the Ministry of Foreign Affairs and the Ministry of Economic Affairs.[5] On 20 May 2009, the CECC confirmed Taiwan's first imported case of H1N1 influenza. The CDC immediately reported to the WHO and other countries through International Health Regulations Focal Points. On 24 May, the first indigenous case was confirmed. These precautionary measures triggered many different policy responses in Taiwan.[6]

2013 bird flu epidemic (virus subtype H7N9)

On 3 April 2013, the Executive Yuan activated the CECC in response to the H7N9 influenza (avian influenza or bird flu virus) epidemic in mainland China.[7][8] The Executive Yuan deactivated the CECC for H7N9 influenza on 11 April 2014.[7]

The CECC convened 24 meetings with government agencies including the Council of Agriculture, the Ministry of Transportation and Communications, and the Ministry of Education. It also convened meetings with 22 city and local governments. In addition, regional and deputy commanding officers of the Communicable Disease Control Network attended these meetings.[7]

On 17 May 2013, the slaughtering of live poultry was banned at traditional wet markets, eliminating risk of avian influenza being transmitted from animals to humans.[7]

2015 dengue fever outbreak
Premier Chang San-cheng attending a CECC conference on 16 September 2015

Dengue fever is caused by the dengue virus, and is common in tropical and sub-tropical climates.[9] Outbreaks occur from time to time in Taiwan, and the CECC was activated on 14 September 2015.[10][11] There were 43,784 cases reported in total, most of these being in the tropical climate of the southern cities of Tainan and Kaohsiung with 52% and 45% respectively.[12] Taiwan experienced consecutive outbreaks of dengue fever in both 2014 and 2015.[13]

2016 Zika virus epidemic
Chang San-cheng attending a CECC conference on 2 February 2016
Main article: 2015–2016 Zika virus epidemic

CECC was activated on 2 February 2016.[14]

COVID-19 pandemic
CECC press conference on 16 February 2020
Main article: COVID-19 pandemic in Taiwan

In response to the coronavirus pandemic, the CECC was activated on 20 January 2020.[15][16]

Coordinating the response to COVID-19

The CECC has the authority to coordinate work across government departments and enlist additional personnel during an emergency.[17] The CECC has coordinated government response measures across areas including logistics for citizens on the Diamond Princess, disinfection of public spaces around schools, and daily briefings from Minister of Health Chen Shih-chung, which are regularly aired on large news channels in Taiwan. Originally established as a level 3 government entity, the CECC was promoted to level 1 on 28 February 2020.[18]

In January, Taiwan closed its borders to all residents of Wuhan amid concerns that the country was not receiving timely updates, because it was excluded from the World Health Organization (WHO).[19]

Activities of the CECC

The agency has sent warning text messages target to mobile phones in specific areas, urging people to practice social distancing, especially by avoiding crowded scenic areas.[20]

On 18 March, the CECC raised its travel notice for the United States, Canada, Australia, and New Zealand and advised against all nonessential travel to these countries. It also announced that certain exempted foreign nationals must observe a 14-day home quarantine upon arrival from overseas.[21]

On 25 March, even as Taiwan saw zero new confirmed cases on that day, the CECC announced recommendations that indoor events which would be attended by more than 100 people should be suspended, while outdoor gatherings of more than 500 people should also do so.[22]

Taiwan's response

Taiwan's response has been praised in JAMA, the journal of the American Medical Association. According to JAMA, Taiwan should have seen the second-largest outbreak of COVID-19 in the world, but has instead effectively eliminated community transmission.[23] Taiwan has done this without ordering people to stay home or shutting down schools, restaurants, shops and other businesses.[23] As a result, Taiwan's economy is not suffering the same economic damage as countries under lockdown.[23]

References
  1. China (Taiwan), Ministry of Foreign Affairs, Republic of (2020-04-01). "New coronavirus-combating measures unveiled by CECC, MOTC". Taiwan Today. Retrieved 2020-04-17.
  2. Shapiro, Don (2020-03-19). "Taiwan shows its mettle in coronavirus crisis, while the WHO is MIA". Brookings. Retrieved 2020-04-19.
  3. "整合指揮、捍衛健康-「國家衛生指揮中心」正式啟用". cdc.gov.tw (in Chinese). 2005-01-18. Retrieved 2020-04-19.
  4. "NHCC". cdc.gov.tw. 2018-01-31. Retrieved 2020-04-19.
  5. "WHO raises influenza pandemic alert level, Taiwan establishes Central Epidemic Command Center in response". 2009-04-28. Archived from the original on 2012-02-29. Retrieved 2020-04-11.
  6. Lai, Allen Yu-Hung (2018-10-02). "Agility amid uncertainties: evidence from 2009 A/H1N1 pandemics in Singapore and Taiwan". Policy and Society. 37 (4): 459–472. doi:10.1080/14494035.2018.1519979. ISSN 1449-4035.
  7. "As Central Epidemic Command Center for H7N9 influenza is deactivated per Executive Yuan's consent, Taiwan CDC continues to closely monitor H7N9 influenza activity". www.cdc.gov.tw. Retrieved 2020-04-19.
  8. "新聞發布". 15 October 2016. Retrieved 2020-04-11.
  9. Hsu, Jason C.; Hsieh, Chin-Lin; Lu, Christine Y. (2017-01-01). "Trend and geographic analysis of the prevalence of dengue in Taiwan, 2010–2015". International Journal of Infectious Diseases. 54: 43–49. doi:10.1016/j.ijid.2016.11.008. ISSN 1201-9712. PMID 27865829.
  10. Wang, Sheng-Fan; Wang, Wen-Hung; Chang, Ko; Chen, Yen-Hsu; Tseng, Sung-Pin; Yen, Chia-Hung; Wu, Deng-Chyang; Chen, Yi-Ming Arthur (2016-01-06). "Severe Dengue Fever Outbreak in Taiwan". The American Journal of Tropical Medicine and Hygiene. 94 (1): 193–197. doi:10.4269/ajtmh.15-0422. ISSN 0002-9637. PMC 4710429. PMID 26572871.
  11. "登革熱疫情將破萬！政院才宣布成立「中央疫情中心」" (in Chinese). The News Lens 關鍵評論網. 2015-09-15.
  12. Wang, Sheng-Fan; Chang, Ko; Loh, El-Wui; Wang, Wen-Hung; Tseng, Sung-Pin; Lu, Po-Liang; Chen, Yen-Hsu; Chen, Yi-Ming Arthur (December 2016). "Consecutive large dengue outbreaks in Taiwan in 2014–2015". Emerging Microbes & Infections. 5 (12): e123. doi:10.1038/emi.2016.124. ISSN 2222-1751. PMC 5180368. PMID 27924810.
  13. Wang, Sheng-Fan; Chang, Ko; Loh, El-Wui; Wang, Wen-Hung; Tseng, Sung-Pin; Lu, Po-Liang; Chen, Yen-Hsu; Chen, Yi-Ming Arthur (2016-01-01). "Consecutive large dengue outbreaks in Taiwan in 2014–2015". Emerging Microbes & Infections. 5 (1): e123. doi:10.1038/emi.2016.124. PMC 5180368. PMID 27924810.
  14. "WHO確認茲卡病毒為「國際公衛緊急事件」 疾管署：和伊波拉威脅同等級" (in Chinese (Taiwan)). The News Lens 關鍵評論網. 2016-02-02.
  15. Chiang, Yi-ching; Wen, Kuei-hsiang; Wang, Cheng-chung (16 March 2020). "CORONAVIRUS / How Taiwan has been able to keep COVID-19 at bay". Archived from the original on 17 March 2020. Retrieved 16 March 2020.
  16. Lee, I-chia; Shan, Shelley (21 January 2020). "Epidemic response command center set up". Taipei Times. Archived from the original on 1 April 2020. Retrieved 5 March 2020.
  17. Lin, Cheryl; Braund, Wendy E.; Auerbach, John; Chou, Jih-Haw; Teng, Ju-Hsiu; Tu, Pikuei; Mullen, Jewel (2020). "Policy Decisions and Use of Information Technology to Fight Coronavirus Disease, Taiwan". Emerging Infectious Diseases. 26 (7): 1506–1512. doi:10.3201/eid2607.200574. PMC 7323533. PMID 32228808.
  18. Lin, Sean (28 February 2020). "Virus Outbreak: Su, eyeing 'good offense,' promotes CECC". Archived from the original on 3 March 2020. Retrieved 6 March 2020.
  19. Aspinwall, Nick. "Taiwan, Shut Out From WHO, Confronts Deadly Wuhan Coronavirus". The Diplomat. Retrieved 2020-04-17.
  20. "Virus Outbreak: CECC messages warn against crowding - Taipei Times". www.taipeitimes.com. 2020-04-05. Retrieved 2020-04-17.
  21. "Bureau of Consular Affairs, Ministry of Foreign Affairs, Republic of China(Taiwan)". 31 July 2017.
  22. "Taiwan Is Flattening the Curve. Singapore Is Locked Down. Inside Their 'Second Wave' Coronavirus Responses". Ketagalan Media. 2020-04-10. Retrieved 2020-04-17.
  23. Thiessen, Marc A. (16 April 2020). "As Taiwan shows, the antidote to the virus is freedom". The Washington Post (Opinion).
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