What is South Korea doing to quickly detect COVID-19 cases and what can we learn from it?
What is South Korea doing to quickly detect COVID-19 cases and what can we learn from it? By José Carlos Cordero Cote La Noticia, March 25, 2020 (Also available in Spanish here.)
The COVID-19 pandemic exposed countries’ readiness to act in the face of the global spread of a virus. South Korea is one of them, and so far, it seems to have had positive results with its health policies fighting the virus. Case in point, it has the lowest COVID-19 mortality rate in Asia.
For many analysts, one of the keys to South Korea’s success is its public policies, fundamentally aimed at detecting the most COVID-19 cases as quickly as possible, for which it counted on the work of private companies in charge of developing the testing kit for thousands of Koreans.
In addition, authorities’ transparency with information about the spread of the virus in the country, and a populace that is cooperating with government strategies, are other key elements that can serve as an example to other countries.
Next, we will explain the strategies implemented by South Korea to act against the COVID-19 pandemic, a disease caused by a new coronavirus whose scientific name is SARS-CoV-2.
1. PUBLIC POLICY BASED ON RAPID TESTING
The rapid testing campaign as a public policy in South Korea arose as a result of lessons learned by that country after an outbreak of Middle East respiratory syndrome (MERS) that occurred in 2015 from another type of coronavirus.
Investigations carried out to find out what mistakes were made in South Korea during the 2015 outbreak concluded that the lack of tests to detect the disease forced many infected people to travel all around cities in search of a medical center to perform the testing.
The journey of infected people from hospital to hospital resulted in a massive proliferation of MERS, which in turn generated the contagion of 185 people and killed 38 of them, according to figures from the World Health Organization (WHO).
For this reason, a law was enacted in South Korea to allow the government to take immediate action to approve testing systems in the event of a health emergency. This is how four Korean companies were appointed to make the COVID-19 tests based on the WHO formula. One of them is Seegene Inc., which started developing Allplex 2019-nCoV Assay to detect coronavirus in late January.
The mass production of tests, along with the establishment of 633 free testing sites scattered throughout the country, made it so that even low-income people could be tested.
Accordingly, South Korea has been conducting more than 10,000 tests daily on its people, with the results being delivered in three days via text message (SMS ).
Moreover, one of the innovations led by the country has been the establishment of drive-thru testing sites in the style of fast food restaurants.
CBS News has shown images of the Korean city of Goyang, where medical and nursing personnel in protective suits have been deployed to various locations to conduct rapid testing in which they take the patients’ temperature and collect a sample of their salivary and nasal secretions.
This was crucial to figuring out where the infection was and where it was not, and then they used this knowledge to direct their public health efforts, Dr. William Schaffner, professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center, told ProPublica.
Thus, the country has the highest number of people tested per capita, with close to 300,000 screening tests administered. Therefore, South Korea’s health care system can track not only the number of COVID-19 cases, but also where they are located, so that it can prevent the virus’ spread. This is the basis for the second strategy implemented by the country to face the outbreak of the disease.
2. PUBLIC INFORMATION ABOUT THE INFECTED
South Korea has not yet closed down cities, as China did in Wuhan, epicenter of the COVID-19 outbreak. This is because the government has publicly released information about the location of infected individuals and their movements around the country.
In a measure that has sparked a debate over civil liberties and privacy, the legal reforms made in the wake of the 2015 outbreak also authorized the government to publish this information. The Korean government extracts information from its citizens from phone records and credit card transactions.
Although the names of infected individuals are not released, websites and smartphone applications have been created that include the geographic information of those infected. In some cases, detailed information about their movements is provided so that others who pass through those areas can be cautious.
Various Internet sites report the geographical location of those infected, and users can access an online chat feature through the KakaoTalk application to get official data related to COVID-19 infections in the country.
The website nature.com notes that an alert can include the age, gender, real-time movements, and even the establishments visited by the infected, thanks to a trace on their credit cards and information from their smartphone. In other districts, public information includes areas of a building they visited, use of bathrooms, and whether they wore masks.
The use of technology to make information publicly accessible in South Korea contrasts with China, whose government hid information about the outbreak in the country for multiple days.
EARLY DETECTION
South Korea saw a jump from 31 cases to more than 4,200 in a matter of weeks. Most were located in the Daegu region, where 73 of all cases detected in the country have been concentrated, according to CNN.
The outbreak in Daegu was caused by a woman who attended religious gatherings of a sect called Shincheonji Church of Jesus. The 61-year-old woman turned out to be the 31st case detected in South Korea, but 10 days before she tested positive, she had attended two of the religious sect’s services.
In this way, members of the Shincheonji Church of Jesus sect caused the spread of COVID-19, making South Korea the country with the largest number of cases detected after China.
3. SOCIAL DISTANCING
Along with the social distancing prompted by the published information about infected individuals, other social distancing measures have been taken to prevent the spread of the virus. Some of these include the suspension of school and university activities, people working from home (telecommuting), the use of face masks on public transportation, and the suspension of activities that generate crowds, such as public events.
There is also an ongoing campaign by the Korea Centers for Disease Control & Prevention urging the population to maintain hygiene habits that prevent the spread of the disease.
Media outlets have messages aimed at promoting hand washing and the use of masks, while the police monitor compliance with these guidelines in the streets of the country.
Price controls were also enacted on medical supplies such as masks. This was to prevent price gouging and to instead make them accessible to all sectors of the population, which also allowed fair distribution among the country’s residents.
RESULTS
The death rates from COVID-19 in South Korea are the lowest in all of Asia, with a 0.99 mortality rate in detected cases. The figure contrasts with the 4.21 death rate from the virus in China, according to WHO figures.
Similarly, in the United States, as of March 20, COVID-19 cases reached 7,087 with a mortality rate of 1.41 and 100 deaths nationwide.
Although there are several variables that have influenced the low mortality rates in South Korea, its early detection techniques, combined with transparent information strategies, have been the key to stopping the rapid spread of the virus.
Free screening tests have reduced deaths caused by the virus by providing prompt attention to people infected with the virus, which reached nearly 210,000 cases detected around the world, with an overall mortality rate of 4.18.
RAPID TESTING IN THE UNITED STATES?
Some experts see the case of South Korea as an example to follow to detect cases of COVID-19 and minimize its spread. This is the belief of Doctors Shantanu Nundy, professor at George Washington University, and Kavita Patel, fellow at the Brookings Institution.
Both scientists have written an article in which they propose other forms of testing based on experiences such as those in South Korea. In a recent piece published by the Seattle Times, it is indicated that the Bill and Melinda Gates Foundation is developing an at-home testing kit for COVID-19. The initiative will only be launched in Seattle, Washington; however, it represents a novel effort to accelerate the diagnosis of COVID-19 in the United States.
The proposal is to deliver the kits to patients who suspect they are infected. To determine this, the Gates Foundation will post a questionnaire online where people will indicate their symptoms.
If there is a match with symptoms caused by the SARS-CoV-2 virus, individuals can request a kit to be delivered to their home. Samples taken by those people will be collected, and the results of the test will be ready within two days.
Nundy and Patel believe this type of testing will prevent shortages of supplies in medical centers as happened in Italy, where it took more than 11 days to diagnose a doctor with COVID-19 because the tests were only available for patients with confirmed exposure to infected people.
Home testing would decentralize care and promote social distancing, particularly for older adults who have already been identified as high risk because of the increased mortality for adults over 50 years of age, experts say in an article published on JAMA Network (The Journal of the American Medical Association).
Likewise, Nundy and Patel propose other benefits of home testing for COVID-19, such as allowing medical centers to focus on patients with the greatest need for in-person care, thus reducing the risks of infection in hospitals, clinics, and emergency departments.
Additionally, experts indicate that detection through this type of testing could allow workers to be easily diagnosed and reduce barriers such as finding transportation to a medical center.
MEASURES DESIGNED FOR EACH COUNTRY
In the face of the COVID-19 pandemic, the WHO has asked countries to increase levels of medical preparedness and action in the presence of new cases of COVID-19.
Countries should prepare to respond to different public health scenarios, recognizing that there is no one-size-fits-all approach to managing cases and outbreaks of COVID-19, the WHO indicates on its website.
Furthermore, the international entity emphasized not only reducing the transmission of the new coronavirus, but also reducing its economic, public, and social impacts– an appeal made in the context of the tremendous drop in the global stock market.
The New York Stock Exchange has temporarily closed its trading floor and moved to electronic trading after two people received a diagnosis of COVID-19.
In addition, the price of oil fell 24 last Wednesday, capping off three days of dropping oil prices, reaching an 18-year low. Similarly, the volatile cryptocurrency market suffered a setback with the price of Bitcoin falling from 8,900 at the beginning of March to over 6,000 on March 20.
All this is happening due to expectations of a recession caused by the widespread proliferation of the virus. This compels countries to implement efficient measures for disease prevention and care in order to turn around the economic situation generated by the pandemic.
South Korea has given the world an answer by facing COVID-19 with different strategies, implemented in a cohesive manner among different sectors and actors in its society.
While we await a vaccine, the COVID-19 pandemic could be reversed through early detection, fluid information management, social distancing, and economic mitigation measures.
