Successful prevention of COVID-19 outbreak at elderly care institutions in Taiwan

Taiwan is highly successful in the initial rapid containment of COVID-19 pandemic.1 As of May 14th, 2020, there have been 440 total confirmed cases in Taiwan, and only 55 cases internal cases.In April, 17th, LSE researchers published an analysis of 7 official national data, including Australia, Singapore, Belgium, Canada, France, Ireland and Norway, and the reported share of care home residents whose deaths are linked to COVID-19 were from 14% to 64%. 2 Therefore, it is worth reporting that Taiwan has no cluster infection in the total of 62,651 beds at 1091 care institutions.Only one single case (No. 156) was related to a nursing home RN among a total of 27,513 employees.3,4 WHO stressed the system and service coordination to provide long term care in its Interim Guidance on March 21st, 2020.5 Thus, we present an analysis based on the system theory, namely to discover the strengths on the macro, mezzo and micro levels of care institutions in Taiwan.On the macro level, since SARS, infection prevention and control (IPC) has become a key value for the care industry, rather than simply a practice matter or certain procedures performed by individual employees.The culture of institutional care in Taiwan endorses high diligence in IPC.Clear regulations, self-audits, and accreditation standards are set and strictly implemented.Hand washing is practiced before