Coronavirus cases have dropped sharply in South Korea. What’s the secret to its success? | Science
Europe is now the epicenter of the COVID-19 pandemic. Case counts and deaths are hovering in Italy, Spain, France, and Germany, and plenty of international locations have imposed lockdowns and closed borders. Meanwhile, the United States, hampered by a fiasco with delayed and defective check kits, is simply guessing at its COVID-19 burden, although consultants consider it’s on the similar trajectory as international locations in Europe.
Amid these dire traits, South Korea has emerged as an indication of hope and a mannequin to emulate. The nation of 50 million seems to have vastly slowed its epidemic; it reported solely 74 new cases as we speak, down from 909 at its peak on 29 February. And it has completed so with out locking down total cities or taking a few of the different authoritarian measures that helped China deliver its epidemic underneath management. “South Korea is a democratic republic, we feel a lockdown is not a reasonable choice,” says Kim Woo-Joo, an infectious illness specialist at Korea University. South Korea’s success could maintain classes for different international locations—and likewise a warning: Even after driving case numbers down, the nation is braced for a resurgence.
Behind its success thus far has been the most expansive and well-organized testing program in the world, mixed with intensive efforts to isolate contaminated folks and hint and quarantine their contacts. South Korea has examined greater than 270,000 folks, which quantities to greater than 5200 checks per million inhabitants—greater than every other nation besides tiny Bahrain, in accordance to the Worldometer web site. The United States has thus far carried out 74 checks per 1 million inhabitants, knowledge from the U.S. Centers for Disease Control and Prevention present.
South Korea’s expertise reveals that “diagnostic capacity at scale is key to epidemic control,” says Raina MacIntyre, an rising infectious illness scholar at the University of New South Wales, Sydney. “Contact tracing is also very influential in epidemic control, as is case isolation,” she says.
Yet whether or not the success will maintain is unclear. New case numbers are declining largely as a result of the herculean effort to examine an enormous cluster of greater than 5000 cases—60% of the nation’s whole—linked to the Shincheonji Church of Jesus, a secretive, messianic megachurch, is winding down. But due to that effort, “We have not looked hard in other parts of Korea,” says Oh Myoung-Don, an infectious illness specialist at Seoul National University.
New clusters are actually showing. Since final week, authorities have reported 129 new infections, most linked to a Seoul name middle. “This could be the initiation of community spread,” by means of Seoul and its surrounding Gyeonggi province, Kim says. The area is dwelling to 23 million folks.
Lessons from MERS
South Korea realized the significance of preparedness the onerous approach. In 2015, a South Korean businessman got here down with Middle East respiratory syndrome (MERS) after coming back from a go to to three Middle Eastern international locations. He was handled at three South Korean well being services earlier than he was recognized with MERS and remoted. By then, he had set off a series of transmission that contaminated 186 and killed 36, together with many sufferers hospitalized for different illnesses, guests, and hospital workers. Tracing, testing, and quarantining practically 17,000 folks quashed the outbreak after 2 months. The specter of a runaway epidemic alarmed the nation and dented the financial system.
“That experience showed that laboratory testing is essential to control an emerging infectious disease,” Kim says. In addition, Oh says, “The MERS experience certainly helped us to improve hospital infection prevention and control.” So far, there aren’t any studies of infections of COVID-19 amongst South Korean well being care staff, he says.
Legislation enacted since then gave the authorities authority to gather cell phone, bank card, and different knowledge from those that check optimistic to reconstruct their current whereabouts. That info, stripped of non-public identifiers, is shared on social media apps that permit others to decide whether or not they could have crossed paths with an contaminated individual.
After the novel coronavirus emerged in China, Korea Centers for Disease Control and Prevention (KCDC) raced to develop its checks and cooperated with diagnostic producers to develop business check kits. The first check was permitted on 7 February, when the nation had only a few cases, and distributed to regional well being facilities. Just 11 days later, a 61-year-old girl, often called “Case 31,” examined optimistic. She had attended 9 and 16 February companies at the Shincheonji megachurch in Daegu, about 240 kilometers southeast of Seoul, already feeling barely in poor health. Upward of 500 attendees sit shoulder to shoulder on the flooring of the church throughout 2-hour companies, in accordance to native information studies.
The nation recognized greater than 2900 new cases simply in the subsequent 12 days, the overwhelming majority Shincheonji members. On 29 February alone, KCDC reported greater than 900 new cases, bringing the cumulative whole to 3150 and making the outbreak the largest by far outdoors mainland China. The surge initially overwhelmed testing capabilities and KCDC’s 130 illness detectives couldn’t sustain, Kim says. Contact tracing efforts have been focused on the Shincheonji cluster, in which 80% of these reporting respiratory signs proved optimistic, in contrast with solely 10% in different clusters.
High-risk sufferers with underlying diseases get precedence for hospitalization, Chun says. Those with average signs are despatched to repurposed company coaching services and areas supplied by public establishments, the place they get primary medical help and remark. Those who recuperate and check unfavourable twice are launched. Close contacts and people with minimal signs whose members of the family are freed from power illnesses and who can measure their very own temperatures are ordered to self-quarantine for two weeks. An area monitoring crew calls twice day by day to be certain the quarantined keep put and to ask about signs. Quarantine violators face up to three million received ($2500) fines. If a current invoice turns into legislation, the nice will go up to 10 million received and as a lot as a yr in jail.
In spite of the efforts, the Daegu-Gyeongbuk area ran out of house for the critically in poor health. Four folks remoted at dwelling, ready for hospital beds, have been rushed to emergency rooms when their circumstances deteriorated, solely to die there, in accordance to native media.
Still, the numbers of latest cases have dropped the previous 2 weeks, aided by voluntary social distancing, each in the Daegu-Gyeongbuk area and nationwide. The authorities suggested folks to put on masks, wash their arms, keep away from crowds and conferences, work remotely, and to be a part of on-line spiritual companies as a substitute of going to church buildings. Those with fevers or respiratory diseases are urged to keep dwelling and watch their signs for three to four days. “People were shocked by the Shincheonji cluster,” Chun says, which boosted compliance. Less than 1 month after Case 31 emerged, “The cluster is coming under control,” Oh says.
Yet new clusters are rising, and for 20% of confirmed cases, it’s unclear how they turned contaminated, suggesting there may be nonetheless undetected group unfold. “As long as this uncertainty remains, we cannot say that the outbreak has peaked,” Chun says.
More knowledge wanted
The authorities hopes to management new clusters in the similar approach it confronted the one in Shincheonji. The nationwide testing capability has reached a staggering 15,000 checks per day. There are 43 drive-through testing stations nationwide, an idea now copied in the United States, Canada, and the United Kingdom. In the first week of March, the Ministry of the Interior additionally rolled out a smartphone app that may observe the quarantined and gather knowledge on signs.
Chun Byung-Chul, an epidemiologist at Korea University, says scientists are keen to see extra epidemiological knowledge. “We are literally stamping our feet,” Chun says. KCDC releases the primary counts of sufferers, their age and gender, and what number of are linked to clusters. “That is not enough,” Chun says. He and others would love to research detailed particular person affected person knowledge, which might allow epidemiologists to mannequin the outbreak and decide the variety of new infections triggered by every case, also referred to as the primary reproductive quantity or Rzero; the time from an infection to the onset of signs; and whether or not early analysis improved sufferers’ outcomes. (South Korea has had 75 deaths thus far, an unusually low mortality charge, though the proven fact that Shincheonji church members are largely younger could have contributed.) Chun says a bunch of epidemiologists and scientists has proposed partnering with KCDC to collect and share such info, “and we are waiting for their response.”
Kim says medical medical doctors are additionally planning to share particulars of the scientific options of COVID-19 cases in the nation in forthcoming publications. “We hope our experience will help other countries control this COVID-19 outbreak.”
With reporting by Ahn Mi-Young in Seoul.