Korea’s response to COVID-19: Early lessons in tackling the pandemic

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The Republic of Korea was one of the first countries to tackle the COVID-19 crisis. Facing a rapid, exponential increase in infections after the first positive case was identified on January 20, the country took decisive action to contain the virus. Although the total number of cases is high, daily increases have been declining steadily from a peak of just above 900 in late February to around 100 by the second week of March (Figure 1). Recovered cases now far outnumber new cases, and deaths have been kept just above 100 as of this writing.

Figure 1.  Coronavirus cases in Korea

Figure 1. Coronavirus cases in Korea (Source: Central Disaster and Safety Countermeasures Headquarters.)
Source: Central Disaster and Safety Countermeasures Headquarters.

While health authorities remain on high alert, many are optimistic that the country has turned the corner. Korea offers a model for other countries battling COVID-19 , as noted recently by the World Health Organization.

Applying lessons learned from the MERS outbreak in 2015, Korea has been strengthening its infectious disease surveillance and response capacity.  Recent legislation established a comprehensive framework to address infectious disease and gives the government specific levers to allocate resources, collect data, and mobilize public and private stakeholders to combat infectious disease. Clear responsibilities have been assigned throughout the government on prevention and containment, on-the-ground response, and treatment and quarantine. 

The Korea Centers for Disease Control and Prevention (KCDC) has also been upgraded through increased staffing and training, particularly in epidemiology.  Specialized divisions have been established for risk assessment, emergency operations, crisis communication, and partner coordination. Hospitals have also strengthened their capacity for infectious disease prevention and control; this has lowered infection risks for health care workers during the current crisis.

COVID-19 activated the country’s highest infectious disease alert level, at which the Central Disaster and Safety Countermeasures Headquarters, headed by the Prime Minister, plans and directs responses. The KCDC centrally coordinates with provincial and municipal governments and specialized hospitals. Subnational Centers for Epidemic Countermeasures have been established in these local governments to coordinate with central authorities.

Multi-level approach

Korea is managing the COVID-19 crisis by emphasizing transparency and open communication, public-private partnerships, evidence-based deployment of public health measures, and innovative use of technology and data.  

Transparency and communication have helped allay fear and prevent panic. The government rolled out a massive public information campaign on personal hygiene and social distancing. It has conducted twice-daily press briefings, updated its online information continuously, and sent out targeted text messages.  Combined with a massive rollout of testing and information on the results, fear and misinformation have been minimized. Experience with the MERS may also have made Koreans better prepared to follow public health communication on COVID-19.

The government restricted large gatherings, closed schools and daycare centers, and asked employers to offer flexible work arrangements. Daegu city and three counties in North Gyeongsang were designated as special care zones and later declared disaster areas so that they could benefit from additional resources and health professionals. But the government largely avoided restricting or controlling the movement of people, and international borders have remained relatively open to travelers from affected countries. The only outright bans have been for travelers from China’s Hubei province.

The KCDC used emergency procedures to fast-track development of testing. Korea now can conduct up to 18,000 tests a day and is exporting test kits to other countries. The government is helping make testing affordable and has used innovative drive-through testing facilities  (Figure 2) to encourage the public to get tested. More than 316,000 people have been tested (as of March 20), with Korea having one of the highest testing rates per capita (Figure 3). This has allowed rapid case identification and isolation without requiring far-reaching mobility restrictions or business closures. The high rate of testing may also explain the country’s low fatality rate, as even mild cases have been systematically tested and isolated.

Figure 2.  Drive-through testing facilities

A COVID-19 drive-through testing site in Incheon, Korea. (Photo: Incheon Metropolitan City)
Source: Incheon Metropolitan City.

Korea has used Big Data, such as GPS tracking data from phones and cars, credit card transactions, travel histories, CCTV footage, and artificial intelligence to identify high-priority cases and track the routes of infected individuals.  Smartphone apps have been deployed for inbound international travelers who are undergoing the 14-day self-monitoring period and for suspected coronavirus cases who are in mandatory self-isolation. By facilitating self-monitoring and reporting data to the government, this prevented a ban on entry by international travelers. Hospitals have introduced remote diagnosis for patients with mild symptoms, helping free up medical professionals to focus on those with more serious symptoms.

Figure 3.  Total COVID-19 testing per million people

Figure 3. Total COVID-19 testing per millions people (Source: https://ourworldindata.org/coronavirus-testing-source-data. Downloaded on March 23, 2020.)
Source: https://ourworldindata.org/coronavirus-testing-source-data. Downloaded on March 23, 2020.

Partnering on public health crisis preparedness

Since 2018, the KCDC has been working with the Korea International Cooperation Agency (KOICA), the country’s bilateral development agency, on infectious disease-related projects, as part of the country’s contribution to the global public health agenda.

Korea has also encouraged public-private partnerships to leverage technology for better health outcomes.  For example, KT, a major Korean ICT company, has developed its Global Epidemic Prevention Platform (GEPP), an infectious disease prevention platform that it is piloting in Ghana and Kenya, with plans for expansion in East Asia. A smartphone app alerts mobile phone users of nearby outbreaks and lets them communicate their health conditions to authorities.

KT’s GEPP and other innovative technologies were highlighted at Korea Innovation Week at World Bank Group headquarters in February 2020.  The country’s public and private partners seek to collaborate further on global health, including with the World Bank Group as it rolls out its $14 billion facility to help developing countries deal with the COVID-19 crisis and build capacity for response to future crises.

 

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Authors

Dawoon Chung

Senior Operations Officer

Hoon Sahib Soh

Special Representative/Country Manager, World Bank Group Korea Office

Join the Conversation

Anna
March 24, 2020

Early lessons

Prasanna Lal Das
March 24, 2020

Excellent blog and congratulations to the Korean authorities for the stupendous effort. The government's use of big data - understandable as it was in an emergency - has however raised questions about the boundaries between state surveillance and citizen privacy. A recent article in NYT describes a website where 'South Korean authorities began posting detailed location histories on each person who tested positive for the coronavirus. The site...included a wealth of information — such as details about when people left for work, whether they wore masks in the subway, the name of the stations where they changed trains, the massage parlors and karaoke bars they frequented and the names of the clinics where they were tested for the virus.'. Soon afterwards 'internet mobs exploited patient data disclosed by the government site to identify people by name and hound them.'

This is not to fault the government's use of big data - they after all had a calamitous situation at hand. It does however highlight the importance of establishing data sharing policies (and ideally international standards for them) that anticipate urgent situations but also create the ground for more responsible (and innovative) data management during more routine times.