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Systematic assessment of South Korea's capabilities to control COVID-19.

ABSTRACT: South Korea's COVID-19 control strategy has been widely emulated. Korea's ability to rapidly achieve disease control in early 2020 without a "Great Lockdown" despite its proximity to China and high population density make its achievement particularly intriguing. This paper helps explain Korea's pre-existing capabilities which enabled the rapid and effective implementation of its COVID-19 control strategies. A systematic assessment across multiple domains demonstrates that South Korea's advantages in controlling its epidemic are owed tremendously to legal and organizational reforms enacted after the MERS outbreak in 2015. Successful implementation of the Korean strategy required more than just a set of actions, measures and policies. It relied on a pre-existing legal framework, financing arrangements, governance and a workforce experienced in outbreak management.

SUBMITTER: Yoo KJ

PROVIDER: S-EPMC7927652 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Systematic assessment of South Korea's capabilities to control COVID-19.

Yoo Katelyn J KJ Kwon Soonman S Choi Yoonjung Y Bishai David M DM

Health policy (Amsterdam, Netherlands) 20210303 5

South Korea's COVID-19 control strategy has been widely emulated. Korea's ability to rapidly achieve disease control in early 2020 without a "Great Lockdown" despite its proximity to China and high population density make its achievement particularly intriguing. This paper helps explain Korea's pre-existing capabilities which enabled the rapid and effective implementation of its COVID-19 control strategies. A systematic assessment across multiple domains demonstrates that South Korea's advantage ...[more]

PMID: 33692005

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Project description:IntroductionThe coronavirus disease 2019 (COVID-19) is a viral respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has led to one of the world's largest infectious disease outbreaks. COVID-19 first emerged in Wuhan, Hubei, China, in December 2019, and the emergence was especially concerning to the U.S. Forces Korea (USFK) stationed in the Republic of Korea (ROK, South Korea), which remains vital to peace and security of the East Asian region. The first wave of cases emerged in South Korea from China before a globally established response, which forced USFK into a challenging position to combat a novel virus with countless unknowns regarding effective control and portended impact.Materials and methodsAs cases began to emerge in South Korea, USFK in early February began to proactively formulate peninsula-wide preventative health measures to protect the force. Eventually, USFK spearheaded a uniquely proactive Operation Kill the Virus that targeted COVID-19 as an enemy that must be rigorously defended against. Through the operation, USFK systematically employed eight key principles to successfully combat the pandemic, which are documented in this article.ResultsThe operation's eight principles focused on (1) Treat it like a combat operation, (2) Protect the force to protect the mission, (3) Stay one step ahead of the curve by exercising an abundance of caution, (4) Use predictive analysis, (5) Maintain open and transparent dialog with the community every day, (6) Be empathetic but prepare the community for lifestyle and culture changes, (7) Follow and enforce rules, and finally (8) Keep your foot on the gas and fight complacency. By closely collaborating with the ROK government, especially the Korean Centers for Disease Control and Prevention, USFK effectively limited the number of locally acquired cases, including service members, families, and civilians, to 24 by April 2020. Vital to that success was ensuring a sufficient capability and capacity to test, trace, treat, and logistically support with personal protective equipment and sufficient infrastructure for quarantine and isolation. As the pandemic shifted to the USA and Europe, new cases in the ROK shifted from locally acquired to imported from international travelers. Fundamental to USFK's sustained preservation of readiness and training included aggressive quarantine and testing of all arrivals from the United States of America (USA), identification of hotspots in all installations, and perpetual fine-tuning of the operation's principles in collaboration with the ROK's aggressive approach to eradicate COVID-19 from the peninsula.ConclusionsIn successfully executing the operation, USFK imparts three main lessons for future outbreaks. First, a military command should execute a health response similar to how it executes combat operations against a battlefield enemy. Second, the command should maintain flexibility to new changes or risks that alter courses of action. And finally, engagement with the local community, host nation, and international partners should not be compromised when formulating strategies. The USFK's immediate recognition of the public health threat by all levels of leadership and medical personnel enabled a unique and highly effective Operation Kill the Virus that engaged all members of the community, both local and international.

Project description:Countries around the world have taken control measures to mitigate the spread of COVID-19, including Korea. Social distancing is considered an essential strategy to reduce transmission in the absence of vaccination or treatment. While interventions have been successful in controlling COVID-19 in Korea, maintaining the current restrictions incurs great social costs. Thus, it is important to analyze the impact of different polices on the spread of the epidemic. To model the COVID-19 outbreak, we use an extended age-structured SEIR model with quarantine and isolation compartments. The model is calibrated to age-specific cumulative confirmed cases provided by the Korea Disease Control and Prevention Agency (KDCA). Four control measures-school closure, social distancing, quarantine, and isolation-are investigated. Because the infectiousness of the exposed has been controversial, we study two major scenarios, considering contributions to infection of the exposed, the quarantined, and the isolated. Assuming the transmission rate would increase more than 1.7 times after the end of social distancing, a second outbreak is expected in the first scenario. The epidemic threshold for increase of contacts between teenagers after school reopening is 3.3 times, which brings the net reproduction number to 1. The threshold values are higher in the second scenario. If the average time taken until isolation and quarantine reduces from three days to two, cumulative cases are reduced by 60% and 47% in the first scenario, respectively. Meanwhile, the reduction is 33% and 41%, respectively, for rapid isolation and quarantine in the second scenario. Without social distancing, a second wave is possible, irrespective of whether we assume risk of infection by the exposed. In the non-infectivity of the exposed scenario, early detection and isolation are significantly more effective than quarantine. Furthermore, quarantining the exposed is as important as isolating the infectious when we assume that the exposed also contribute to infection.

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Systematic assessment of South Korea's capabilities to control COVID-19.

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Systematic assessment of South Korea's capabilities to control COVID-19.

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