Emergency department response to SARS, Taiwan

Area of Science:

• Infectious Disease Epidemiology
• Hospital Preparedness
• Public Health Response

Background:

• The response of diverse emergency departments (EDs) to large-scale contagious diseases remains poorly understood.
• The severe acute respiratory syndrome (SARS) outbreak in Taiwan provided a critical case study for evaluating ED preparedness.

Purpose of the Study:

• To retrospectively analyze the personal protective equipment (PPE) usage and infection control measures (ICMs) implemented by 100 EDs during the SARS outbreak.
• To identify factors influencing PPE and ICM adoption and their effectiveness across different hospital types and sizes.

Main Methods:

• Retrospective analysis of data from 100 emergency departments in Taiwan.
• Assessment of PPE use, ICM implementation, and sources of procedural guidance.
• Correlation analysis between implementation difficulty and ICM effectiveness.

Main Results:

• ED workers in large hospitals were disproportionately affected by the SARS epidemic.
• Larger and public hospitals showed higher rates of respirator use, while smaller hospitals adopted stricter ICMs.
• A majority of EDs provided PPE (80%) and implemented ICMs (66%) late in the outbreak, with instructions often originating from ED administrators.
• Implementation difficulty was negatively correlated with ICM effectiveness.

Conclusions:

• Hospital preparedness and response capabilities for emerging infectious diseases vary significantly.
• Centralizing infectious patients early in the outbreak is a potentially effective strategy to limit epidemic spread.