title: From SARS in 2003 to H1N1 in 2009: lessons learned from Taiwan in preparation for the next pandemic.
abstract: In anticipation of a future pandemic potentially arising from H5N1, H7N9 avian influenza or Middle East Respiratory Syndrome, and in large part in response to severe acute respiratory syndrome (SARS) in 2003, the city of Taipei, Taiwan, has developed extensive new strategies to manage pandemics. These strategies were tested during the 2009 H1N1 outbreak. This article assesses pandemic preparedness in Taipei in the wake of recent pandemic experiences in order to draw lessons relevant to the broader international public health community. Drawing on Taiwan and Taipei Centers for Disease Control data on pandemic response and control, we evaluated the effectiveness of the changes in pandemic response policies developed by these governments over time, emphasizing hospital and medical interventions with particular attention paid to Traffic Control Bundling. SARS and H1N1 2009 catalysed the Taiwan and Taipei CDCs to continuously improve and adjust their strategies for a future pandemic. These new strategies for pandemic response and control have been largely effective at providing interim pandemic containment and control, while development and implementation of an effective vaccination programme is underway. As Taipei's experiences with these cases illustrate, in mitigating moderate or severe pandemic influenza, a graduated process including Traffic Control Bundles accompanied by hospital and medical interventions, as well as school- and community-focused interventions, provides an effective interim response while awaiting vaccine development. Once a vaccine is developed, to maximize pandemic control effectiveness, it should be allocated with priority given to vulnerable groups, healthcare workers and school children.
authors.affiliation: Section of Infectious Diseases, Taipei City Hospital, Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan. Electronic address: myyen1121@gmail.com.
authors.forename: M-Y
authors.initials: MY
authors.lastname: Yen
authors.affiliation: Department of Surgery, Taipei City Hospital, Department of Health, Taipei City Government and National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: A W-H
authors.initials: AW
authors.lastname: Chiu
authors.affiliation: Department of Political Science, State University of New York, New Paltz, NY, USA.
authors.forename: J
authors.initials: J
authors.lastname: Schwartz
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: C-C
authors.initials: CC
authors.lastname: King
authors.affiliation: Center for Environmental Laboratory Services, National Kaohsiung Normal University, Kaohsiung, Taiwan.
authors.forename: Y E
authors.initials: YE
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: S-C
authors.initials: SC
authors.lastname: Chang
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: D
authors.initials: D
authors.lastname: Armstrong
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hsporen@ntu.edu.tw.
authors.forename: P-R
authors.initials: PR
authors.lastname: Hsueh
mesh_terms: D002959:Civil Defense / Q000379:methods* / Q000458:organization & administration; D003140:Communicable Disease Control / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology; D058873:Pandemics / Q000517:prevention & control*; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology
keywords: H1N1; Pandemic preparedness; Severe acute respiratory syndrome; Six Sigma; Traffic Control Bundles; Vaccination campaigns