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Volume 27, Number 11—November 2021
Synopsis

Policy Review and Modeling Analysis of Mitigation Measures for Coronavirus Disease Epidemic Control, Health System, and Disease Burden, South Korea

Hae-Young Kim, In-Hwan Oh, Jacob Lee, Jeong-Yeon Seon, Woo-Hwi Jeon, Jae Seok Park, Sung-Il Nam, Niket Thakkar, Prashanth Selvaraj, Jessica McGillen, Daniel Klein, Scott Braithwaite, Anna Bershteyn, and Seung Heon LeeComments to Author 
Author affiliations: New York University Grossman School of Medicine, New York, NY, USA (H.-Y. Kim, J. McGillen, S. Braithwaite, A. Bershteyn); Kyung Hee University School of Medicine, Seoul, South Korea (I.-H. Oh, J.-Y. Seon, W.-H. Jeon); Hallym University Kangnam Hospital, Seoul (J. Lee); Keimyung University School of Medicine, Daegu, South Korea (J.S. Park, S.-I. Nam); Institute of Disease Modeling, Seattle, Washington, USA (N. Thakkar, P. Selvaraj, D. Klein); Korea University Ansan Hospital, Ansan, South Korea (S.H. Lee)

Main Article

Table 1

Summary of key policies and practices for COVID-19 epidemic control and responses, South Korea, January 1‒May 15, 2020 (8)*

Pillars Category Description
Country-level coordination, planning, and monitoring
 School closure
 Postpone nationwide school opening after winter break.
Workplace closure
 Voluntary participation of employers to enable work from home and closure of nonessential business.
Public events cancellation
 Recommended cancelling religious services and large in-person gatherings.
Public transport
 All public transport systems remained open. The Seoul Metro system made it mandatory to wear a mask when riding the subway.
Restriction of internal movement
 Daegu City and Gyungbuk Province were designated as special management regions for COVID-19 on February 23, but no city-wide lockdown or stay-at-home restrictions were imposed. However, many persons voluntarily refrained from movement and gatherings.
Promotion of personal protective measures
 Promoted mask wearing in all public locations and frequent handwashing.
National hotline for case reporting and testing
 Opened a national hotline (#1339) for anyone who had fever, cough, or difficulty breathing to report and provided tests at screening stations.
Risk communication and community engagement
 Rapid policy updates
 The KCDC held daily briefings to provide status updates and policy guidance.
Public disclosure of the trajectories of confirmed cases and alert system
 The government publicly shared the trajectories of confirmed cases and sent alerts to those living in the areas where the cases were confirmed.
Surveillance, rapid-response teams, and case investigation
 Contact tracing of direct contacts
 Contact tracers called and traced all direct contacts of confirmed cases, where direct contacts were defined as anyone exposed to a confirmed COVID-19 case from 2 d (or 1 d since April 3) before symptom onset (or confirmed testing date for asymptomatic cases) to the last day of quarantine of the index case. For example, >99% of Shincheonji Church members were traced. A mobile app was launched on March 29 to trace the trajectories of confirmed cases in 10 min by linking the data from 28 related national institutions.
Self-quarantine of contacts
 All close contacts of confirmed case were required to self-quarantine for at least 2 weeks.
Active monitoring and wide testing of potential contacts
 Anyone who had overlapping trajectories with cases was alerted and offered free testing.
Points of entry, international travel, and transport
 Self-quarantine and monitoring of in-bound travelers
 At entry screening, travelers entering South Korea (both Korean and foreign nationals) were tested if they have fever or respiratory symptom. Korean nationals or foreign nationals on long-term visas were asked to self-quarantine since March 19. Foreign nationals on a short-term visa were quarantined at a temporary quarantine facility. A self-health check app has been used to monitor the health of in-bound travelers at least once daily for the 14 d following their arrival date.
Travel history monitoring at hospitals
 Tracing and alarm system (DUR/ITS) connected to the national insurance system filtered and screened persons who had an international travel history.
National laboratories
 Rapid increase in testing capacity
 Rapid set-up for RT-PCR for COVID-19 diagnosis in late January.
RT-PCR became available in 46 laboratories by February 7, and 77 laboratories by February 20 with a testing capacity for 13,000 tests/day by the end of March.
Infection prevention and control
 Designated hospitals for nonrespiratory medical visits only
 From February 21, national safe hospitals were designated for medical visits related to nonrespiratory symptoms to separate these patients from potential COVID-19 patients.
Preparation of negative pressure beds in hospitals
 50 beds in NPIRs were added in Daegu on February 21 and additional 120 beds with NPIR on March 17.
Preparation of personal protective equipment in hospitals
 Healthcare workers were prioritized to receive public mask supply.
Screening residents in long-term facilities (i.e., nursing homes)
 Thorough investigation for unexplained pneumonia and COVID-19 testing were performed among the residents in 450 nursing homes on March 5.
Case management
 Isolation of confirmed cases
 Asymptomatic case-patients were isolated in designated CTCs starting on March 2. Symptomatic case-patients who had moderate and severe symptoms were isolated in hospitals. Anyone who violates the self-quarantine rule was to be charged a penalty of up to $10,000 or 1-y imprisonment.
Triage of severe cases
 Introduced a COVID-19 triage system based on disease severity (grades 1 to 4).
Reallocation of hospital and ICU beds
 Prioritization and reallocation of hospital and ICU beds for critically ill patients.
Operational support and logistics
 Staff surge capacity and deployment at hospitals and airports
 Special health workforce of ≈2,000, including 750 public health doctors, 172 specialists, 346 physicians, and 728 nurses were recruited and dispatched to hospitals in Daegu and Gyeongsangbuk Province to support COVID-19 case management as of March 9.
Approximately 300 military doctors and nursing officers had supported screening and quarantine at airports and seaports until April 27.
Face mask supply
 The government rapidly increased the supply chain to produce 12 million disposable masks per day and set a mask rationing system to secure mask supplies and meet demands. Each person was permitted to buy 2 masks/week on an assigned weekday based on the last digit of the person’s birth year.
Preparation of public health centers, hospital beds, and medical equipment
 Total number of hospital beds with NIPRs was expanded from 198 to 1,077 beds by February 22.
Screening stations
 523 screening clinics were launched nationwide including drive-thru and walk-thru screening stations that had reversible negative/positive pressure booths.
Maintaining essential health services and systems
 Triage and separation of non-COVID-19 patients
 Daegu Dongsan Hospital and Daegu medical centers were designated as COVID-19 central hospitals where a massive surge developed on February 21; admitted patients with other disease were evacuated to other hospitals on February 23.
National safe hospitals were designated where only nonrespiratory patients could seek medical care.

*COVID-19, coronavirus disease; CTC, community treatment center; DUR/ITS, drug utilization review/international traveler system; ICU, intensive care unit; KCDC, Korea Centers for Disease Control and Prevention; NPIRs, negative-pressure isolation rooms; RT-PCR, reverse transcription PCR.

Main Article

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Page created: July 27, 2021
Page updated: October 19, 2021
Page reviewed: October 19, 2021
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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