tealit.com Sars Report

F.A.Q.

12/18/2003

Q.  Has SARS returned?

A.  A 44-year-old lieutenant colonel who works at the medical research center at the National Defense University has tested positive for the SARS virus.

Officials suspect the scientist was exposed to the virus Dec. 5 when cleaning up contaminated liquid in his lab at the state-funded Institute of Preventive Medicine in Taipei. According to government officials he was not wearing the necessary protective equipment at the time. 2 days after this event the researcher left for a medical conference in Singapore, flying on  China Airlines flight CI661 on Dec. 7th.  At the time of his flight to Singapore he was not experiencing any SARS symptoms.  Within hours of his return to Taiwan on Dec. 10 he developed a fever. The return flight number was China Airlines CI 662.

In Taiwan a total of 22 people who came in contact with the researcher during his return flight and after his landing have been ordered quarantined. 70 people in Singapore have been ordered quarantined. 2 people who contacted the researcher and then left for the United States are returning to Taiwan. Of these individuals quarantined none are reported to be currently showing signs of the disease.

Taiwanese authorities are additionally trying to locate 5 foreign nationals who were on the Dec. 10th flight back to Taiwan to warn them to monitor themselves for possible SARS symptoms.  The flight was Dec. 10th, China Airlines CI 662 from Singapore to Taiwan.  The people in question are 3 Americans, one Japanese and one Singaporean.  Why the authorities don't just look up their names from the airline's computers or passport control and then make an announcement is curious.

As of 11pm 12/18/2003 the number of people quarantined was 34.

Q.  So, is Taiwan still considered SARS-free?

A.  Yes.  According to the WHO there is no spreading of SARS in Taiwan now, nor are there any travel advisories.  The current consensus is that this was a laboratory mistake, not an instance of the disease itself making an appearance.

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7/5/2003

Q.  What is the WHO saying about Taiwan?

A.  As of 3pm local time the WHO declared that SARS was no longer spreading in Taiwan.  After 20 straight days with no reported cases, the WHO no longer classifies Taiwan as an area with Local Transmission.

Reuters
CNN
WHO

Q. Has the WHO removed Taiwan from it's Travel Advisory list?

A. Yes.  As of 6/17/2003.
CNN
Reuters

Q. Are people arriving from certain regions being quarantined?

A. No.  Taiwan currently is not quarantining anyone arriving from other countries. 

Q. What is the WHO saying about Beijing?

A. The travel advisory for the city of Beijing was lifted on 6/24/2003. 

Q. What is the WHO saying about Hong Kong?

A. (6/23/2003) With no new cases reported in the last 20 days, Hong Kong was declared "SARS-free."

Local officials are saying that they believe Taiwan will meet the Sars-free standard by late this week.

Q. Do riders on the MRT and busses  still have to wear masks?

A.  As of 6/26/2003 masks were made non-mandatory.

Q.  Have mask requirements on air-passengers been relaxed?

A. Yes.  As of 6pm 5/30/2003 passengers will no longer be required to wear masks.  This applies to both domestic and international flights.

Q. Have businesses tried to exploit the SARS?

A. In response to reports of KTV chains alleging that their rivals’ employees have SARS, the government is proposing amendments to the SARS Emergency Relief Act that will impose penalties of up to three years imprisonment for attempting to falsely spread SARS information for commercial advantage.

Q.  Have new policies been announced regarding Insurance Cards.

A.  Yes.  When replacing your health insurance card, normally your old card is collected when you get the new one.  From 5/23/2003 hospitals and clinics issuing cards will staple the old card to the new one in an effort to allow health care workers to see what hospitals you have previously visited.

Q. Have health officials announced the mortality rate of Taiwan’s SARS outbreak?

A. Yes, as of 5/25/2003:

Age                             Mortality

0-9                               no deaths recorded               

10-19                           4.0%

20-29                           6.3%

30-39                           6.0%

40-49                           14.7%

50-59                           20.3%

60-69                           23.3%

70-79                           15.9%

80 +                             17.1

Q. What is the Taiwan Consumers Association saying about the quality of respiratory masks currently available in Taiwan?

A. According to their report, 25% of masks are ineffective.  They assert that they fail to block water.  To demonstrate this, they used eye-droppers to place liquid on masks.  In one out of 4 cases, water was absorbed into the masks, instead of beading up on the surface.  Additionally, the group recommends that masks not be worn for more than 8 hours.

Q. What is the link to Taipei city's online classrooms?

A. http://home.elearn.hinet.net/index.jsp 

Q. Have the restrictions on people flying in from Philippines changed?

A. Yes.  From May 21st arrivals from the Philippines are not required to be quarantined.

Q. Have restrictions been placed on the sales of fever-reducing medications?

A. Yes.  The government has advised pharmacies selling a class of drugs known as antipyretics, found in many over-the-counter pain relievers, to examine the medical history and determine the temperature of potential purchasers before going ahead with the sale.  This in an effort to prevent people from masking signs of SARS. 

Q. Is the country establishing regional SARS hospitals?

A. Yes.  The DOH's SARS Contingency Committee is finalizing a plan that will see 10 facilities serving as regional SARS treatment centers.  It is hoped that the development of stricter intake procedures at local hospitals and the management of SARS cases at regional centers will help to alleviate the cluster outbreaks and exposures that have occurred at general-use hospitals around Taiwan. 

Q. Has the Ho Ping hospital re-opened?

A. Yes.  It re-opened for employees on 5/19/2003.  21 members of the nursing staff quit.  It began taking patients again today.

Q. What is happening at the Kaohsiung Chang Gung hospital?

A. 124 staff members resigned, citing pressure from spouses and extended family.  

Q.  SARS quarantines that occurred after what date are at full pay?

A.  From March 1st.

Q.  What fines will employers face if they refuse to pay salaries for quarantined workdays?

A. NT$60,000-120,000.

Q. Has the Taipei city government started televising classes for public school students?

A. Yes.  Cable channel 77, owned by the government, will televise junior high school classes weekdays from 9am to 445 pm.  3 classes will be broadcast in the morning, 3 classes in the afternoon.

Additionally, the Taipei city education department  announced a plan to have classes conducted online.  300 teachers have volunteered for the effort, and Chung Hwa Telecom is donating blocks of services, as is Seednet.

http://home.elearn.hinet.net/index.jsp

Further, from May 26th, Microsoft, Acer and Run Jeng corporation are expected to unveil an online tool to help junior high school students prepare for the high school entrance exam.

Q.  Did the Minister of Health resign?

A.  Yes.  In a televised address on 5/15/2003 Health Minister Twu Shiing-Jer resigned.  He has been replaced by 51 year-old epidemiologist Chen Chien-Jen. Twu has been blamed for mis- management of the crisis and its expansion as clusters of cases affecting major hospitals.

Q. Why were Japanese reporters shouting angry questions at local health officials.

A. A 26 year-old doctor from Mackay hospital traveled to Japan for vacation from May 5th-13th.  He had been experiencing a fever, but had not treated any known SARS patients.   Before leaving, he took medication to lower his body temperature, enabling him to get past airport temperature checks.  Soon after returning from Japan, his conditioned worsened.  He is now considered a probable case and is in quarantine at Mackay.  As a result of his trip, Japan has quarantined more than 1000 people.  An employee at one of the hospitals where the doctor stayed is running a fever.  The Japanese press has reacted with outrage.

Q. What is happening at the Tien Mu Taka Shimiya department store?

A. Effective 5/16/2003, with an employee showing possible signs of SARS, the Tien Mu Taka Shimiya made the decision to close for 4 days for disinfection.  The store reopened 5/21/2003.

Q. Have price controls been placed on respiratory masks?

A. Yes.  On 5/14/2003 the government placed a cap of NT$100 for N95 masks, and NT$18 for carbon based and surgical masks (2), while 15 pharmacies were fined for seeking to exploit the demand for face masks by charging usurious prices.  A penalty for exceeding the government set price limits has been  set at NT$100,00-150,00 for retailers.  For any manufacturers, distributors or retailers found guilty of hoarding masks the fine has been set at NT$25 million. 

Additionally, a shipment 10 million masks was found on 5/13/2003 at the CKS airport.  The masks have been ordered held, and will now be sold to local retailers.  Speculation is rampant around why the masks were at the airport, with local commentators accusing companies of intentionally keeping the masks at bay until demand drove prices up.  The new price caps and penalties are meant to address this.  No fines were levied in relation to the masks found at the CKS airport.

In further developments, fines have been levied on numerous corporations for speculative purchases made before the price caps were implemented. 

Q. What is happening at the National Taiwan University Hospital in Taipei?

A. The hospital emergency room re-opened on 5/26/2003.  A strict temperature measurement regime will now be implemented.  Patients with fevers will be put in individual rooms until it can be determined if the fever is being caused by SARS.  Only after feverish patients are determined to be SARS-free will they be put into the general patient population.

Q. What is happening at the Mackay hospital in Taipei?

A. Mackay hospital reported that 7 staff members were suffering from SARS like symptoms.  The hospital has not been closed, nor have services been cut back.  The affected staff members are being treated in quarantine at the hospital.  Hospital staff are now in protective clothing and all visitors and incoming patients are being screened for SARS symptoms. 

Q. Who can extend their visa because of SARS?

A. The longest term a foreign worker can stay in Taiwan is 2 years, plus a single year extension.  A measure to allow foreign workers more time than the current three year total will likely be passed to day.  In what the legislation terms "extraordinary circumstances" workers may have their visas extended 6 months beyond the 3 year maximum.

Q. Has the MRT announced new rules regarding face masks?

A. Yes.  As of Sunday 5/11/2003, people found riding the MRT without face masks will be fined between NT$1,500 - NT$7,500.  As of 5/13/2003 the order was also extended to train travelers.

Also, masks will now be available for purchase in the MRT for NT$10.

Further, it was announced by city officials that MRT riders found to have temperatures of 38 or higher will be taken by ambulance to hospital.

Q. People in which professions are now required to wear a masks?

A. Bus drivers, taxi drivers and restaurant workers are now all required by law to wear masks.

Q.  Was the chief executive of Taipei's Ho Ping hospital fired?

A.  Yes.  Wu Kang-Wen, president of the Ho Ping hospital, was fired on 5/12/2003 amid allegations of mis-diagnoses and attempts at covering up the actual number of SARS cases.

Additionally, the hospital itself has been closed for disinfection.  Patients have been moved to other hospitals.  Also, a special SARS ward is being built at the hospital.

Q. Has the government announced any new policies to ensure at-home quarantined individuals remain at home?

A. Yes.  On Sunday, 5/11/2003, the national announced the purchase of 2000 video monitors to installed in the homes of the most medically at-risk home-quarantined SARS patients.

Q.  What is the US government saying about State Department employees in Taiwan?

A. On 5/10/2003, locally, the US State Department authorized the voluntary departure of family members and non-essential staff.

The AIT itself remains open and will continue normal operating hours and procedures.

Q. What is happening in the When Wha district of Taipei?

A. On 5/9/2003, suspecting that a specific housing block may be harboring the SARS virus after the death of an elderly, single man, whose decomposing body was discovered within his apartment 2 weeks after his death, and with residents showing SARS-like symptoms, authorities closed the structure, began disinfection efforts and quarantined the residents in an effort to stop the disease from spreading beyond the quarantine hospitals and into communities.

The housing block was re-opened and residents began returning on Tuesday 5/13/2003.

Q.  What is the length of the quarantine period?

A. The government has announced a national standard of 10 days for quarantine.

Q.  What is happening at the Taipei American School?

A.  The Taipei American School in Tien Mu has made a decision to close for the remainder of the school year.  It was announced Wednesday evening (5/7/2003) that one of their KA teachers had pneumonia.  Yesterday, with  x-rays showing lung improvement and with test results for the Presence of Corona Virus tests returning negative, the teacher was released from hospital.  The teacher will now be on a 10 day home quarantine.  She appeared on many of Tuesday 5/13/2003's evening news broadcasts in footage showing her smiling and waving from the balcony of an apartment.

The rest of the faculty and staff will return to the school on the 15th.  Students will be returning in August.

 When the SARS episode at the school occurred, a two-day closure of the school was initially announced.  However, there was also a student showing symptoms, bringing the total, with the teacher, to two - requiring a 14 day closure.  There would have been just 14 days left of the school year once the quarantine was over, so the decision was made to finalize the year rather than bring all the students back for 14 days.  Since that time the country standardized all quarantines to be 10 days.

Q.  Is the government considering closing bushibans?

A.  On the heels of a bushiban-wide SARS exposure that occurred when a sick student attended class at a Chinese-curriculum bushiban in the Jung Jen district of Taipei, the Ministry of Education held a  a meeting on Tuesday (5/6/2003) with representatives of the bushiban industry to consider measures to limit the risk of further such exposures, including the possibility of a 10 day nationwide closure of all bushibans.  The closure measure was rejected, mainly because of the jurisdictional an enforcement complications in the face of the variety of licenses and business types.  The proposal that was adopted was that bushibans will be required to adopt the same standards as public schools:  should one person in a class exhibit symptoms of being a probable SARS patient, that class would be closed for 14 days.  Should a second person within the same school become a probable case, the entire school is to be closed for 14 days.

Additionally, if one case is found within a building, any other bushibans within the same building must close for two days for cleaning.  If another bushiban within the same building should find a probable case, all bushibans within that building would be closed for 14 days.

Q. What is happening with the MRT system in Taipei?

A. On 5/6/2003 the MRT opened voluntary temperature checks counters at 4 stations:

Taipei Main Station: 3 Counters

Chung Hsaio-Fushing Station: 1 Counter

Hsi Men Station: 1 Counter

Long Shan Temple Station: 1 Counter

The tests are not required, only voluntary.  If one's temperature is 37.5 to 37.9 the passenger will be provided with a surgical mask free of charge.  If one's temperature is 38 the person will be taken by ambulance to hospital.

Q. Who can I call about SARS and my job?

A. The Labor Affairs Council has set up a hotline for foreign workers in Taiwan who have questions about how they should proceed in regard to their work permits, compensation for SARS quarantines and other issues.  The number is 0800-885-885.  The government has announced that all SARS leaves will be at full pay.  Part of the 50 billion budget passed will be to compensate employers for the paid leave.

It is possible that your school has not enrolled you in the Labor Insurance program.  That would be in violation of the Labor Law.  Regardless of if your school has properly accounted for your enrollment in the Labor Insurance program, foreign teachers are entitled to full compensation for SARS leaves.

Q. Have bushibans been required to take any special measures?

A. It was announced Saturday 5/3/2003 that all bushibans in Taipei city are now required to check the temperature of people entering the school.  Many schools in other regions have begun doing this as well.

A further measure has been discussed by the Taipei city government which would require that any person going into any place of business or government office be checked.

Q. Have new laws been announced regarding SARS?

A. Yes.  A 50 billion NT$ SARS Emergency Relief Act was passed  to deal with the outbreak.  Penalties for non-compliance with quarantine or treatment arising from possible exposure have been introduced, from NT$60,000 to 300,000.  Further, being diagnosed as having SARS and violating quarantine can lead to imprisonment for up to 3 years.  Additionally, the legislation causes quarantine time to be considered a paid leave.  If you have to leave your job due to quarantine, you will receive your full pay, including bonuses. 

As a side-bar to the new rules, the legislation was passed in under 6 days.

Q. Have any schools been closed?

A. According to the Campus Security Report Center of the Ministry of Education:

Schools closed: none

Schools with individual classes closed -  0 schools, 0 classes closed

Q. Of the deaths that have occurred, how many have been officially attributed to SARS.

A. The CDC is saying that 84 deaths can be considered directly related to SARS.

Q. What is the situation with Ho Ping hospital in Taipei city which was quarantined?

A. On 4/24/2003, in response to as many as 25 hospital staff exhibiting SARS like symptoms, authorities ordered the entire hospital sealed.  The staff, patients and even visitors in the hospital were put under quarantine within the building and being told they could not leave for 14 days. 

The hospital itself has now been re-opened. 

When the hospital was first closed on 4/24/2003 even those visitors who had only just arrived at the time of the order were included in the quarantine.  Early on the morning of the 25th, people meeting specific criteria were released to home quarantine.  The quarantined were made up of largely staff and patients.

Staff were being housed in a nearby army barracks, and transported in groups to the hospital for their shifts.  The hospital itself was divided into three levels, with the lower floors for non-sars patients, and the upper two-thirds of the hospital being for SARS cases.

Q. What are the schools doing?

A. If two students are judged to be probable SARS cases the entire school can be closed for as long as 14 days.

Q. How dangerous is the disease?

A. Between 80 percent and 90 percent of patients get better on their own in about a week. The other 10 percent to 20 percent get worse, with many ending up in intensive care and requiring mechanical ventilators to help them breathe. About half of those people die.

Q. Who is most at risk for getting SARS?

A. People over age 40 and those who have other medical problems, such as heart or liver disease, seem to do the worst.

Q. Can SARS be treated?

A. Antibiotics don't seem to work, which is usually the case with virus-caused diseases. One antiviral drug known as ribavirin may help, but doctors aren't sure yet.

Q. What causes SARS?

A. Scientists are not sure, but they have found two previously unknown viruses in patients. One is from the coronavirus family of viruses, the other from a different family called paramyxoviruses. Paramyxoviruses cause many different diseases, including mumps, measles and respiratory illnesses. Coronaviruses usually just cause the common cold.

Q. What is the incubation period?

A. Between two and seven days after exposure, with most people getting symptoms in three to five days.

Q. What are the symptoms of SARS?

A. They are a lot like pneumonia or the flu. People get a very high fever -- at least 104 degrees. They also usually have shortness of breath or other problems breathing and a dry cough. Some people get other symptoms, including a headache, stiff or achy muscles, a loss of appetite, fatigue, a rash and diarrhea.

Q. How do you get SARS?

A. It seems that you have to have very close contact with someone who has it. Almost all the people who have gotten SARS have either been hospital workers who cared for sick people or members of a victim's family. Doctors believe that it is spread by tiny droplets that get airborne when someone sneezes or coughs, or by contact with other bodily fluids such as blood. The people who have gotten SARS outside of Asia have all either recently traveled to Asian countries where it is spreading or had close contact with someone who recently returned from there. 

Experts don't think it's easy to catch SARS from sitting next to a sick person on a plane, but they are investigating one incident in which Chinese tourists may have gotten infected by flying on a plane with an infected man.