How villages in Taiwan extinguished the "delta" outbreak

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How villages in Taiwan extinguished the "delta" outbreak
How villages in Taiwan extinguished the "delta" outbreak

In the south of Taiwan, there is the Fangshan rural municipality with four villages, where 5, 5 thousand people live. It is one of the poorest places on the island and lacks a lot. When a variant of the delta coronavirus appeared there, local residents and authorities were not at a loss. Thanks to their efforts, only one person died during the outbreak. Their story is told by The Guardian.

In Fangshan, they do not live crowded, spend a lot of time on the street, and the residents are obedient. But the local health care system is not adequately resourced, every fifth resident is over 65 years old, almost no one is vaccinated, and there were no protocols in case of a "delta" occurrence.

In June, Fangshan saw an increase in new cases of COVID-19. At that time, the "alpha" variant spread in Taiwan, but since several infected people returned from abroad, it was decided to decipher the genomes of the coronavirus. It turned out to be a more contagious "delta" variant. Local authorities were discouraged by this news.

Probably, the "delta" came to Fangshan with people who returned from Peru. Even before the results of the genetic tests were ready, a three-day partial lockdown was announced over loudspeakers in two villages. Food and basic necessities were brought to each house. The authorities set up an operational headquarters.

The residents began to be isolated. In total, 667 people were quarantined or hospitalized, including about a hundred contacts of the infected taxi driver: passengers, relatives, friends and their relatives. 14 thousand people tested. The central government sent 1,200 doses of vaccines to those who tested negative. For three days, the villages were disinfected.

Many locals were offended. The outbreak and lockdown occurred during the mango harvest, and farmers lost their income. The interviewed taxi driver said that he had not fully recovered, but for two months after being discharged, they had never inquired about him. His elderly mother is still ill and has been denied financial assistance for his care. Locals also blame the Central Epidemic Command Center for allowing some, after returning to Taiwan, to quarantine at home rather than in hotels.

Nevertheless, the measures taken have proven to be significantly more effective than in many other places around the world. The outbreak ended in 19 days. In total, 17 people were infected, and only one died - a 72-year-old woman.

New argument for masks

In the early months of the pandemic, there was a lot of controversy over masks. Since then, the benefits of wearing them have been confirmed in several studies, but some have not been convinced either. New proof was obtained by scientists from Bangladesh, who conducted a unique experiment of its kind. Nature writes about their work.

The effectiveness of something is well tested in randomized trials, where participants are divided into two groups and one is given something, and the other is left for comparison. But for masks such studies are just lacking - and it is this gap that scientists from Bangladesh have closed. They watched nearly 350 thousand people in hundreds of villages.

In some villages, people were reminded to wear masks, and in others not. Thanks to this, in the experimental group, masks were worn three times more often (42% versus 13%), and the incidence of symptomatic COVID-19 was 9% lower. In reality, the risk may have dropped even further - testing was limited. Surgical masks have proven themselves much better than cloth masks: the risk decreased by 11% and 5%, respectively. This is consistent with the results of laboratory experiments given in the same scientific article: even after ten washings, a surgical mask retains 76% of small particles, and a new fabric mask of three layers - only 37%.

Experts interviewed believe the Bangladesh study should end the controversy and that people should swap out cloth masks for surgical masks.

New clinical trials of vaccines stalled

The world needs more advanced COVID-19 vaccines and knowledge on how to better use existing ones. Both cannot be obtained without new clinical trials, but pharmaceutical companies make them difficult and sometimes impossible. This is stated in an open letter from the Coalition for Epidemic Preparedness Innovation (CEPI), which STAT talks about.

First-generation vaccines were tested in clinical trials, where some of the volunteers were injected with the drug, and the rest were given a dummy. Then the scientists looked at how many people were infected in each group, and from this data they calculated the effectiveness. Several vaccines have been successfully tested and released into the market. That is why it is unethical to organize such research further: why introduce a useless pacifier when there are drugs that reliably protect against disease.

The problem is, getting approved vaccines for new research is nearly impossible. All doses have been sold out, and there are strict restrictions in the supply contracts. Often, a batch can only be used in the country that bought it, and only for COVID-19 prevention, not research. Because of this, it is difficult not only to test new vaccines, but also to compare old ones (for example, there is still no firm certainty whether it makes sense to combine drugs, as well as in what combinations, dosages and with what break).

Developers and manufacturers of approved vaccines are not interested in new research being conducted with their products. If it turns out that another drug is more effective for primary vaccination or better suited for repeated vaccination, then this will not increase sales in the future (it does not matter now - the demand far exceeds the supply).

We still manage to check something. South Korean company SK Bioscience has begun the third phase of clinical trials of its vaccine, which will compare with the drug AstraZeneca (SK Bioscience also manufactures this drug). And in the United States and Great Britain, vaccines approved in these countries are compared, but what is used in other countries has remained outside the scope of these two studies.

CEPI is ready to fund further work, but cannot obtain vaccines, although a few hundred doses would be sufficient somewhere. The problem would be solved if countries revised contracts with drug developers and manufacturers. Several states even volunteered, but this was not so easy to do.

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