By Jubert Marquez (Medicine, Paik Hospital Inje University)
2 months after we have conducted our first Online Kapehan about COVID-19, Korea seems to have “flattened the curve” despite other countries continuing to struggle to contain the spread. What did Korea do correctly to curb the spread, and what can other countries like the Philippines learn from Korea?
In the first part of the second installment of Online Kapehan, I talked to Ph. D. candidates and fellow PIKO members Erica Españo (Life Science in Pharmacy, Korea University Sejong Campus), Paula Cammayo (Preventive Veterinary Medicine, Gyeongsang National University), and Rey Anthony Sanjorjo (Applied Life Science, Gyeongsang National University) and discussed “the golden standard” set by Korea in fighting COVID-19.
Jubert: There have been a lot of changes since we last talked. While countries around the world are still struggling with COVID-19 containment, South Korea has managed to keep the new infection cases to 10 persons a day, down by more than 90% when we last did the interview. Of all the things Korea has done, which one do you think was the biggest factor in “flattening the curve”?
Erica: I think it was the aggressive contact-tracing followed by testing. They’ve managed to identify clusters, trace the contacts, and isolate the possible cases very quickly, thanks to their good information and communication system.
Paui: The fact that SoKor was able to act quickly upon its first detected case on Jan 20 is a big factor in how they were able to flatten the curve. By doing vigorous testing in large quantities (ave 12,000 people a day) the peak was reached sometime around late Feb, contrary to other countries that were just starting to do testing mid-March. Then they are efficient in doing contact tracing also, they have an app and they can go through transactions of positive people, so they were able to inform the public on who might have been exposed and needs to get tested. So those who were positive were isolated or treated immediately. People were also compliant with physical distancing. I’ve noticed that at the time that people heard the news on Daegu, there we fewer and fewer people going outside. Lastly, SoKor was able to give stress on the importance of hygiene, use of masks then having sanitizers or alcohol at the entrance of buildings/elevators, and even some public transportation.
Rey: I agree with Paui and Erica, early and rapid testing along with aggressive contact tracing significantly hampered the transmission. After the MERS-COV epidemic, Korea was the hardest hit region in Asia, this experience allowed them to streamline bureaucratic steps and layout guidelines for the approval of test kit development and production. Also, Korea’s academic institutions immediately developed test kits after the COVID19 genome sequence was first published, then coordinated with the industry for rapid mass production; which is a testament of their solid R&D tradition. Apart from that, the supply chains essential in creating test kits and even masks were numerous and already present allowing them to ramp-up production rapidly. There are already numerous BSL (biosafety labs) capable of testing here and with the abundant biotech professionals, the infrastructure and workforce allowed Korea to coordinate a response effectively.
Jubert: But Korean officials have continuously warned people of a possible “second wave outbreak” if everyone becomes too relaxed. Should we be scared of the “second wave outbreak”, and will it be worse than the first one?
Paui: With the number of detected cases consecutively reaching single digits the past few days, people here are also gradually returning to their normality, so people started to eat at restaurants again or maybe visit the mall the even. At least that is the reality here in our area in Jinju, I’m not so sure with other cities like Seoul or Busan. There is a possibility of a second wave outbreak if we don’t take control measures seriously. So, it just means that we still need to be cautious.
Jubert: Since you’ve mentioned Busan, I just want to share. There have been two instances recently where the local government thought that there would be another outbreak here. One case involves a father in his 50s who works as an administrative officer and his daughter who’s a nurse at a local hospital. The two came in contact with a total of approximately 900 people in the days that they didn’t know they were sick, but fortunately, none of the people got infected from them. The other case just happened last week involving a teenager from Daegu, the hardest-hit city in Korea by COVID-19, who went to Busan to party at a club and came in contact with approximately 500 people. His friend who traveled with him from Daegu got infected but no one else was. It just shows the constant threat of a single person causing an outbreak, in addition to a confluence of different other factors.
Rey: Yes. I think they are anticipating it to come back during the colder season that goes with the flu season. Whether we should be scared or not depends on the availability of treatments. Seasonal flu comes and goes, but we are not scared of it because the vaccine is available and there is an effective course of treatments that have been established.
Erica: Yes. Historically, this has happened (Spanish flu of 1918). The second wave was bigger than the last. And other waves can happen until a vaccine comes out, so we really have to be vigilant. Some studies have pointed out that social (or more like, physical) distancing measures will have to be employed until 2022, which, ideally, is when the vaccine would come out.
Jubert: As a follow-up, what do you think is the biggest contributor to the continued increase of infected patients in other countries such as the Philippines?
Rey: Lack of awareness and information and maybe some behavior driven by socioeconomic reasons. In Barangay Zapatera in Cebu, I remembered there was a photo of a mother feeding her child outside of her house and a health worker behind conducting swab sampling maybe not more than 2 meters away. This is a squatter’s area where houses are typically crowded and in inhospitable conditions.
Erica: Lack of testing capacity, letting go of contacts, not identifying clusters to isolate. I think we have to remember, a lot of the cases in the Philippines (over 1,000) are healthcare workers, suggesting that they also don’t get adequate protection.
Pau: Mga pasaway!!! Some people are uncompliant and lack discipline despite the recommendation of their government.
Part 2 will talk about what the Philippines could have learned from South Korea, and why it failed to do so.
Note: The transcribed interview was edited for brevity.
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