On February 16, 2020, the Central Epidemic Command Center (CECC) pointed out that the 19th confirmed case in Taiwan developed cough on January 27 and was hospitalized for shortness of breath on February 3; although he had suspected symptoms, the case didn’t meet reporting criteria for coronavirus disease 2019 (COVID-19) at that time as he had neither travel history nor known close contact with any confirmed cases. Moreover, pneumonia can be caused by a variety of infections, such as influenza, measles or pneumococcal disease. Thus, the physician diagnosed him as severe influenza complicated with pneumonia, and placed and treated him in a negative pressure isolation ward in the intensive care unit for medical treatment the same day.

     As more cases without relevant travel history have been reported in neighboring countries such as Singapore and Japan, after discussing with experts, the CECC decided to make the resolution requiring severe complicated influenza cases reported by healthcare facilities on and after January 31 and tested negative for influenza to be tested for COVID-19 starting February 12. As of February 15, 113 tissue specimens have been tested, and the patient was the only case tested positive for COVID-19, indicated by the CECC.