Introduction:
Taiwan conducts ship sanitation inspections and issues Ship Sanitation Certificates (SSCs) in accordance with the IHR 2005 to prevent the cross-border spread of diseases^1,2. This study aims to analyze the issuance of SSCs in Taiwan from 2018 to 2022 and explore the impact of the COVID-19 pandemic on these operations.

Material and Methods:
A retrospective study was conducted using data from ship sanitation inspections at 10 authorized international ports in Taiwan from 2018 to 2022. The study periods 2018-2019 and 2020-2022 were categorized as "pre-pandemic" and "during pandemic" respectively. Statistical analyses were performed using R, with p-values <0.05 considered significant.

Results:
Among the 6540 cases, 4785 ships underwent sanitation inspections, with 96.57% receiving Ship Sanitation Control Exemption Certificates (SSCECs) and 3.43% receiving Ship Sanitation Control Certificates (SSCCs). Compared to the pre-pandemic period, the odds of SSCC issuance were lower during the pandemic, although the difference was not statistically significant. Non-Taiwanese ships, ships at least 12 years old, ships with gross tonnage below 10000 tons, oil tankers, general cargo ships, and multipurpose ships had higher odds of SSCC issuance (p<0.001). The mean number of inspection findings in the SSCCs was 4.1. However, the proportion of certificate “extensions” increased significantly during the pandemic, from 0.29% to 0.68% (p<0.001). The proportion of “inspections unable to be conducted” also rose, from 0.38% to 1.69% (p<0.001), mainly because ship owners tended to proceed to the next ports for inspections.

Conclusions:
The COVID-19 pandemic disrupted global shipping and may have affected the issuance of ship sanitation certificates. Post-pandemic, it is crucial to resume normal operations quickly and pay attention to ships with health risks to improve public health collaboration^3,4.