Volume 27, Number 11—November 2021
Policy Review and Modeling Analysis of Mitigation Measures for Coronavirus Disease Epidemic Control, Health System, and Disease Burden, South Korea
|Country-level coordination, planning, and monitoring
||Postpone nationwide school opening after winter break.
||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.
||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.
||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.
||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.
||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.
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