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Commentary: Covid-19 Lessons from South Korea

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By Dr Visham Bhimull

 

THE Novel Coronavirus outbreak of 2019 that resulted in pandemic proportions is not the first Coronavirus outbreak with which the world has to battle.

The common cold that circulates among human populations time immemorial is a Coronavirus. There have been such occurrences in the past of severe respiratory illnesses due to Coronaviruses:

  • SARS – Severe Acute Respiratory Syndrome (China 2003); mortality rate 9.6%
  • MERS – Middle Eastern Respiratory Syndrome (Saudi Arabia 2012); mortality rate 34%

 

After the MERS outbreak in South Korea that started in 2012, this triggered proactive planning in the event that another such outbreak would happen. The lessons learned came into to play when the current outbreak started.

After the identification of the outbreak of the Novel Coronavirus (Covid-19) in Wuhan, China, in the coming weeks, as the outbreak was spreading internationally, South Korea only reported 30 confirmed cases of the virus. But, despite the low numbers, health authorities had already started working with biotech companies to develop a test for Covid-19.

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Soon they had thousands of test kits ready to go. They prepared for the worst which quickly followed. By late February 2020, the total number of Covid-19 cases rose dramatically crossing 3,000. This made South Korea’s outbreak the largest outside of mainland China. But by this time healthcare intuitions were well equipped with Covid-19 tests.
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“Websites and public applications compile that information allowing everyone to see if a person who is a confirmed case of Coronavirus went to a pharmacy, hospital or anywhere else and how recently it was.”

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Thus, doctors were able to test those who fit the criteria for testing as well as those identified via contact tracing whether symptomatic or not. Many of those identified by contact tracing also tested positive and quickly isolated and treated at home or at an institution.

The further contact tracing on these individuals also identified more who were tested. This efficient contact tracing and effective testing allowed South Korea to test over 9,000 people who had been in contact with someone who had tested positive.

South Korea was able to achieve testing around the country. Private and national healthcare systems joined forces to set up a mostly free testing effort that includes more than 600 locations that screened as many as 20,000 people per day.

Through this system, the government was able to test and trace contacts of those testing positive to continue to break the transmission chain of Covid-19 on a large scale. But this was simply the human-human transmission.

Transmission can also occur by touching infected surfaces called fomites. These fomites would have virus present on a surface touched by an infected person e.g. subway poles and door handles.

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“This ability to find and treat infected people have allowed South Korea to avoid aggressive lock downs.”

 ———————————————————————————————————————————————————————————————-South Korea had prepared for this as well. After the MERS outbreak, when they were not able to trace the movements of the virus, a law was changed allowing the government to collect patients’ data and security footage during an outbreak.

All their information is logged and then shared to alert people to stay away from the path of infection. Websites and public applications compile that information allowing everyone to see if a person who is a confirmed case of Coronavirus went to a pharmacy, hospital or anywhere else and how recently it was.

This crucial information lets a person know if they have cross paths with an infected person, so they can go get tested. If they were positive, contact tracing starts all over again. Tracing people’s every move can be controversial but many in South Korea prioritise public health over privacy in an outbreak.

Via these effective measures, South Korea was able to test hundreds of thousands of people -more than any other country at the time. This made it much easier for authorities to see the virus, where it is located and where it may be lurking. This ability to find and treat infected people has allowed South Korea to avoid aggressive lock downs. And it has helped bend the curve of the outbreak that started out dangerously steep.

For now, South Korea has turned a corner, but they continue to be prepared even if there is a second wave. It is this kind of vigilance that set South Korea apart in the Coronavirus pandemic.

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Other places like Singapore, Taiwan and other neighbours saw the benefits of widespread testing. Now countries like Germany and the UK are starting to implement aggressive testing and even the US where the government has failed to provide the adequate testing is now scrambling to test more people.

South Korea’s strategy of contact tracing might not be easy to replicate in countries with much larger populations but the country’s success with wide spread testing still offers a way out for most countries that are stuck in lockdowns.

TT seems to be doing well regarding its social distancing measures through lockdown, as the incidence rate appears to have decreased with the implementation measures gradually.

But we must remember this pretty picture of a reduced incidence rate is only limited to how aggressive we are testing.
Dr Visham Bhimull MBBS (UWI) has a Diploma in Family Medicine (UWI)

 

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