South Korea’s coronavirus response is the opposite of China and Italy – and it’s working
Keeping coronavirus in check: South Korea showing the way with transparency and skill
South Korea: drive-through testing, mobile alerts, mass screening
South Korae Active Search Strategy
Each confirmed coronavirus patient’s contacts are traced and offered tests.
The infected person’s movements over the preceeding 14 days – determined through credit card use, CCTV footage and mobile phone tracking – are also posted on government websites, with text message alerts sent to people when a new infection emerges in the area where they live or work.
When a person tests positive, their city or district might send out an alert to people living nearby about their movements before being diagnosed. A typical alert can contain the infected person’s age and gender, and a detailed log of their movements down to the minute — in some cases traced using closed-circuit television and credit-card transactions, with the time and names of businesses they visited. In some districts, public information includes which rooms of a building the person was in, when they visited a toilet and whether or not they wore a mask. Even overnight stays at ‘love motels’ have been noted.
Seoul’s handling of the outbreak – involving a highly coordinated government response that has emphasised transparency and relied heavily on public cooperation in place of hardline measures such as lockdowns – is increasingly viewed by public health experts as a model to emulate for authorities desperate to keep the virus under control.
Whereas China, where the virus originated, and more recently Italy have placed millions of their citizens on lockdown, South Korea has not restricted people’s movements – not even in Daegu, the southeastern city at the centre of the country’s outbreak.
Instead, authorities have focused mandatory quarantine on infected patients and those with whom they have come into close contact, while advising the public to stay indoors, avoid public events, wear masks and practise good hygiene.
South Korean officials termed their strategy – a mix of innovative technology-enabled tracking, transparency with the public, and extensive free testing – a “dynamic response system for open democratic societies”.
No nation’s response has been perfectly effective, but the high degree of transparency and competency of South Korean health officials provides helpful lessons about containment efforts for other countries, and about the nature of this pandemic for the international scientific community.
South Korea Tracks Virus Patients’ Travels—and Publishes Them Online
Health authorities let public check if they crossed paths with those infected; legal powers and technology allow them to pin down people’s movements
A ‘travel log’ of the times in South Korea: Mapping the movements of coronavirus carriers
The South Korean government is publishing the movements of people before they were diagnosed with the virus — retracing their steps using tools such as GPS phone tracking, credit card records, surveillance video and old-fashioned personal interviews with patients.
The idea is to let the public know, via a central website and regional text messages, if they may have crossed paths with carriers, whose names are not made public.
The massive volume of data collected has enabled the authorities to pinpoint clusters of infection to better target their quarantine and disinfection efforts, and send members of the public text-message alerts to inform them of the past movements of infected patients in their area – even down to the names of shops and restaurants they visited.
South Korea Early Detection Test
The linchpin of South Korea’s response has been a testing programme that has screened more people per capita for the virus than any other country by far. By carrying out up to 15,000 tests per day, health officials have been able to screen some 250,000 people – about one in every 200 South Koreans – since January.
To encourage participation, testing is free for anyone referred by a doctor or displaying symptoms after recent contact with a confirmed case or travel to China. For anyone simply concerned about the risk of infection, the cost is a relatively affordable 160,000 won (US$135). Testing is available at hundreds of clinics, as well as some 50 drive-through testing stations that took their inspiration from past counterterrorism drills and can screen suspected patients in minutes.
“This country has a universal health-coverage system for the whole population and the economic burden for testing is very low,” said Kim Dong-hyun, president of the Korean Society of Epidemiology. “Tests are conducted for free if you have proper symptoms.”
Collecting this amount of data has also allowed the South Korean authorities to glean a clearer indication of the potential lethality of the virus, the fatality rate of which has diverged significantly from about 5 per cent in Italy to about 0.8 per cent in South Korea. Although factors including quality of health care, patient age and public awareness can affect the fatality rate of a virus, the scale of testing is among the most influential.
Japan’s Health Ministry has maintained caution about the release of personal travel history and other details, but some Japanese regions have made public information about patients’ movements, including to gyms, restaurants and hospitals.
Japan imposed entry restrictions on travelers from China and South Korea, including Japanese citizens. All travelers from China, including Hong Kong and Macau, and South Korea, are being asked to stay in their homes or hotels for 14 days after arriving in Japan and to not use public transportation.
Japan company launches ‘15-minute testing kit’ as government ramps up screening capacity
Japan has dramatically ramped up production of equipment to test for the presence of the novel coronavirus – including a private company that is selling kits it promises can return a result within 15 minutes.
The country now has the ability to screen as many as 7,000 people a day, but is adhering to a policy of only testing individuals identified as being particularly at risk, according to the Ministry of Health, Labour and Welfare. Between February 18 and March 14, 29,122 tests were carried out across Japan.
The number of tests has varied between 100 and 800 per day, according to the needs of local authorities faced with sudden clusters of cases emerging in certain parts of the country, a ministry spokesman said.
We have a far bigger capacity now and the capability to carry out 6,000 or 7,000 tests every day,” said Takuma Kato, deputy director of the ministry’s Infectious Disease Control Division.
“We believe that we need to prioritise the testing of people who need it. We are not testing people who just say they want to be tested; we are checking people who have been seen by a doctor who then recommends that they undergo the test.”
Japan Firewall Strategy
Japan put more effort into building a firewall against the influx of COVID-19 cases from overseas. The main features of this strategy are bans on the entry of travelers from hard-hit regions of China and quarantines for travelers arriving from other countries/regions with active COVID-19 outbreaks. The Japanese public health strategy is similar to the Japanese military concept of “mizugiwa sakusen (水際作戦),” which refers to the military doctrine of repelling invaders as soon as they reach the shore,. Based on the concept of “mizugiwa,” Japan has developed a disease prevention approach whose goal is to prevent the importation of infectious disease into Japan.
Harbors and airports are core strategic points of the Japanese “mizugiwa” defensive line. The best example of the Japanese mizugiwa concept of disease prevention is the case of the Diamond Princess cruise ship. On February 4, the Japanese government prevented the people onboard the Diamond Princess from disembarking but forced them to stay on the ship anchored in Yokohama harbor.
Korea vs Japan
It seems evident that South Korea gives more weight to actively searching for and diagnosing coronavirus cases in order to break the chain reaction of disease transmission. At the same time, Japan has focused on building the public health equivalent of a firewall around the country to prevent the influx of coronavirus from overseas. Close scrutiny reveals that both pandemic prevention strategies—South Korea’s active search and Japan’s firewall approach – have advantages and disadvantages. Eventually, their respective disease prevention strategies failed, and both countries switched to encouraging social distancing (telework, school closure, etc.)
Early on, Hong Kong took some of the most comprehensive steps to implement “social distancing” – in which events are cancelled and venues closed to minimise contact between people – by shutting schools in late January, while the authorities produced a digital map of confirmed cases to allow people to avoid potentially infected areas.
Hong Kong : temperature checks, closed schools, free hand sanitiser
Hong Kong declared its first case of Covid-19 on January 23rd. As more cases emerged over the next three days, an emergency was declared and more than five days after the first confirmed case, the government began putting some restrictions on travel from mainland China. Schools were ordered not to return from the Lunar New Year holiday on February 3rd. Major theme parks, including the Disneyland resort, have been shut down.
The city of 7.4 million people, which is especially exposed to the virus because of its proximity to mainland China and daily inflow of Chinese visitors, has confirmed only 120 cases as of March 11th. Three people have died.
Online government resources detail Hong Kong’s cases, including the ages of infected patients and what parts of Hong Kong they live in. Maps also show the general location of the thousands of people under quarantine or self-isolation.
Taiwan Early Vigilance Strategy
Taiwan has 10 million masks a day, widespread tracking, and just 1 death despite being close to the outbreak.
Pooled Information From Immigration & Health Insurance Database
Taiwan’s anti-coronavirus strategy utilizes a combination of early vigilance, proactive measures, and information sharing with the public, as well as applying technology in the form of analyzing big data and online platforms.
Taiwan took measures early on, including inspecting plane passengers coming from Wuhan starting Dec. 31, banning Wuhan residents on Jan. 23, suspending tours to China on Jan. 25, and eventually banning all Chinese visitors on Feb. 6.
Recognizing that it had to ensure an adequate supply of medical equipment, including face masks, for health professionals and the public, Taiwan’s government stopped exports of surgical face masks on January 24 while requesting local companies to step up production. Daily production is set to reach 10 million soon, divided between the public, medical, and industrial sectors.
Taiwan set up a unified command center, led by the Ministry of Health and Welfare, which manages resources, holds daily briefings, and is in control of public messaging. The authorities have also moved quickly to track down infected persons and map the cases to show the sources of infection.
In Taiwan, officials have pooled information from immigration and health insurance databases to track people’s travel histories and symptoms, and used phone tracking to ensure compliance with quarantine.
Taiwan: a swift response, mask production, penalties for hoarding
Taiwan has been widely praised as setting best practice with its response to the virus.
The government coordinated its efforts through its national health command centre, established after the Sars outbreak, and integrated data from the national health, immigration and customs systems.
The island’s authorities were responding as early as December 31st when the first reports of a new and unidentified virus in China emerged.
The government promoted health bodies, enacted travel alerts on affected countries, funded military personnel to facilitate mask production, and banned exports of the items to shore up supply, before eventually rationing them. It legislated penalties for hoarding medical supplies, spreading misinformation, and disobeying quarantine orders.
Primary and secondary schools were kept shut until 25 February.
Singapore – Big Fines Strategy
Singapore: financial support, clear messaging, big fines
Singpore, a major business hub with large numbers of international visitors, has a strictly enforced home quarantine system and an exhaustive contact-tracing programme. This is underpinned by clear messaging from officials, who have repeatedly emphasised the need for collective social responsibility, said Fisher. Authorities have also warned of harsh penalties for those who break guidelines.
Since the start of the outbreak thousands of people in Singapore have isolated themselves. Anyone required to do so can be called multiple times a day and asked to click an online link sharing their phone’s location. Officials also carry out spot checks in person to ensure compliance. Those who do not stay home can expect a fine of up to $10,000 or up to six months in prison.
There is some financial support for people who are isolated: self-employed workers have been offered $100 per day, and people who are not able to remain isolated at home can stay in a government facility.
For this quarantining system to be effective, officials must track down affected people as quickly as possible. Contacts are being traced by the Singapore police force, who use CCTV as well as interviews with patients to draw up lists of people who may have been exposed. Though Singapore has introduced charges for visitors who require treatment, tests are free for all.
Singapore has similarly tracked infected patients and traced their contacts, with stiff penalties for those who disobey quarantine or mislead the authorities about where they have travelled.
Macau Shut Down Strategy
How the world’s most densely-populated region fought off the coronavirus
Macau shut down in February for a couple of weeks in order to help keep the coronavirus from spreading. While the local economy definitely suffered as a result, the closure seemed to have served its purpose at the time as, by the end of the lockdown, health officials reported that the gambling city was virus-free.
Thailand – Door To Door
In Thailand, too, public health workers have gone door-to-door to track down contacts, said Thanarak Plipat, deputy director-general of the Disease Control Department of the Health Ministry. “We must go see them ourselves. This is an old public health way. We do our best,” he said.
Universities will be shut and courses moved online, Ms Ratchada Thanadirek, a government spokesman, told reporters separately, adding that places like pubs and boxing stadiums will also be affected.
China stresses success of coronavirus strategy
The Chinese government says the steps it has taken to contain the coronavirus have been successful.
It says more than 80,000 people in mainland China have contracted the virus, but the number of new infections has been declining and was below 50 for the 8th consecutive day on Saturday.
Speed and accuracy are the keys to identification and detection
Within a week of identifying the unknown virus, China successfully sequenced it and reported the genetic information to the World Health Organization (WHO).
In comparison, it took a couple months for SARS to be identified and sequenced in 2003, and a few years in the case of HIV in the 1980s.
The identification of a virus’s genetic sequence is critical to develop a vaccine and therapeutic treatments. The rapid identification of COVID-19 allowed scientists around the world to immediately start developing test kits, treatment options and vaccines.
The city used big data and information technology, like QR codes, to track and stop the spread of the coronavirus
They named the approach “one map, one QR code, and one index.”
Health QR codes were established for everyone in the city and everyone who entered the city. The green code allows you to move freely. The yellow code requires a seven-day self-quarantine. The red code requires a 14-day self-quarantine. The yellow and red codes can be turned green after the quarantine time. This health surveillance system has been applied in most cities in Zhejiang Province, and will be implemented in other provinces.
Each individual must monitor and record their temperature and update their profile daily in order to maintain their health status level.