South Korea: Aggressive COVID-19 Strategies

David Posnett — Sun, 22 Mar 2020 20:16:43 +0000

S. Korea is one of the few countries that have “flattened the curve”. How did they do it?

South Korea learned its successful Covid-19 strategy from a previous coronavirus outbreak: MERS

By HyunJung Kim, March 20, 2020

This is a fascinating story. Here is an excerpt:

Korea’s response to Covid-19 is highlighting a strong public health approach to reigning in the outbreak, one that provides a lesson for the rest of the world. For the country’s health officials, however, it’s a lesson they learned the hard way. Korea’s traumatic experience with a 2015 outbreak of Middle East Respiratory Syndrome, or MERS, paved the way for many of the successful strategies the government is deploying this time around. Read more about the MERS experience here.

After news of the coronavirus outbreak began to emerge from Wuhan, China, earlier this year, the Korean government activated a 24/7 emergency response system to screen all travelers entering the country from that city. A woman was stopped at Incheon Airport en route for Japan at a fever monitoring station and transferred to a hospital where she was quarantined for 14 days. The Covid-19 diagnosis was confirmed on January 20. As it happens, that’s the same day the first US case was reported.

Since the first cases were confirmed, Korean public health authorities and local governments collaborated to precisely document the movement of infected people down to the minute. Authorities sought testimony, watched closed-circuit television, investigated smartphone GPS data and more, publicizing the so-called moving histories of Covid-19 patients. All local governments share information through websites, text messages, and media. Companies have developed apps that allow users to visualize the information. Koreans can now learn where infected people went, when they were there, and how they got there. If someone learns they might have been exposed, they can quickly visit a doctor and begin self-quarantine if they have similar symptoms.

On February 4, the Korea Centers for Disease Control and Prevention took advantage of the post-MERS reform and authorized an unlicensed Covid-19 test; the government went on to test an extraordinary number of people. By February 26, Korea had tested 46,127 cases, while by that point, Japan had tested just 1,846 cases and the United States only 426.

The Terminology of Keeping Distance

David Posnett — Fri, 20 Mar 2020 03:46:50 +0000

The concepts of social distancing, quarantine and isolation are being interpreted in a variety of ways, not always correctly. Here’s a guide to help you make the right decisions. It comes mostly from a NYT article on ‘social distancing’ by Tara Parker-Pope from March 19th, 2020.

The terminology comes from the public health field but most of us struggle to comprehend the exact meaning and what should be applied in our own situation.

Social Distancing

“Social Distancing: This Is Not a Snow Day.” To slow the coronavirus, wrote Dr. Asaf Bitton, we must act quickly and start “making daily choices to stay away from each other as much as possible.”

Social distancing is ultimately about creating physical distance between people who don’t live together. It means closing schools and workplaces, canceling concerts and Broadway shows. For individuals, it means keeping six feet of distance between you and others and avoiding physical contact.

It means no dinner parties, no playdates, no birthday parties even with a few friends.

Who should do this? Everyone.

Shelter in Place

This means stay home. Don’t leave the house unless you absolutely have to. Don’t socialize with people outside your family. Don’t go to a friend’s house for dinner or invite a trusted friend over.

You are allowed to go outside for essentials (groceries or prescriptions) but you should limit those trips to no more than once a week if possible. People with essential jobs — public safety, medical, sanitation or grocery worker — can still go to work. And you can visit someone if you are their caregiver.

You can walk the dog or exercise outside as long as you keep a six-foot distance from others.

Continue reading the main story

Who should do this? Everyone who lives in an area with a mandatory shelter-in-place order (Northern California and possibly, soon, New York City). But many infectious disease experts say that everyone else should voluntarily shelter in place.

Self-Monitoring

Checking your temperature, and watching for signs of coronavirus infection (fever, shortness of breath and coughing, flu-like symptoms.) A person who is self-monitoring should already be staying home and limiting interactions with others.

Who should do this?those with possible exposure to the virus but had only distant contact with the infected person.

Self-Quarantine

This term is used to separate and restrict the movement of someone who is well but who recently had close contact with a person who later was diagnosed with the virus. A person in self-quarantine should follow all the rules of sheltering in place, except they should avoid going to stores or interacting with the public even on a limited basis for a 14-day period. (A friend should bring you groceries.)

A person in self-quarantine should sleep in a separate space from other family members.

Who should do this? Persons without symptoms, but with a contact history (with someone who later became ill.)

Self-Isolation

Isolation is used to separate a person who has a diagnosed case or someone who has distinct symptoms including a cough, fever and shortness of breath, but hasn’t yet been tested or received test results. A person in isolation should be confined to a separate room with no or minimal contact with the rest of the household (including pets) and use a separate bathroom if possible. Most of the time, a sick person will feel a bit miserable, but he or she can pick up food trays left at the door. Sanitize a shared bathroom after using it.

Who should do this? Anyone with a confirmed case of Covid-19, a person waiting for test results or a person with obvious symptoms who is still waiting to be tested. Everyone else in the household should self-quarantine.

Official or Mandatory Quarantine

A government-imposed lockdown on a community, as has happened in Italy, in which movements are severely restricted. People can still go out for essentials and to get fresh air, but they can do so only under strictly controlled conditions or on a specific schedule imposed by public safety officials.

Who should do this? Everyone who lives in an area under quarantine. “We haven’t seen this in the U.S.,” according to Dr. Bitton, but certainly in Wuhan, Hubei, Italy, and other countries.

self-quarantine – R&R – Reachout and Rebuild