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Health workers disinfect a nursing center in Bonghwa County, North Gyeongsang Province, where a small transmission cluster of the novel coronavirus has been discovered. (Yonhap News)

Mar. 9 marked the 50th day since the first confirmed novel coronavirus case in South Korea. Arriving from China, the virus ran into an unpredicted variable with the Shincheonji religious sect, which became the epicenter of a “supercluster” event that led to infections in local communities. The rate of increase in new diagnoses dropped off notably over the course of the weekend, but experts all agreed that the important focus going forward will be on preventing additional deaths. Some are also suggesting that the day-to-day infectious disease response system will need to be overhauled in the intermediate to long term, with the assumption that the coronavirus will become a global pandemic.

In a regular briefing on Mar. 9, Jung Eun-kyeong, director of the Korea Centers for Disease Control and Prevention (KCDC), explained, “When [the coronavirus] first arrived from overseas, people were predicting a scenario where [infections] would occur chiefly among people who had been in contact [with infected persons], and that it could proceed toward general regional infections as it went through a stage of community-level infections before becoming amplified once again through healthcare institutions and social welfare facilities.”

“With the early emergence of ‘special circumstances’ with the Shincheonji Church of Jesus, we saw an explosive increase in patients all at once, which is seen as having hastened infections at the community level,” she said. Jung’s conclusion was that over the period between South Korea’s first coronavirus diagnosis -- involving a 35-year-old Chinese woman who arrived from Wuhan in China’s Hubei Province on Jan. 20 ahead of the Lunar New Year holiday -- and the emergence of a 30th patient on Feb. 16, the virus was spread at a steady rate chiefly through introduction from overseas or contact with infected persons.

The situation took a decisive turn on Feb. 18, when it was discovered that the 31st patient was a Shincheonji member. Fourteen out of 20 new cases diagnosed in Daegu and North Gyeongsang Province the following day were members of a religious sect commonly characterized as a cult. Following a Feb. 18 test of around 1,000 people who had attended services with the 31st patient, a full-scale study of around 9,000 church members was launched on Feb. 20, and a massive number of coronavirus infections were found in Daegu and North Gyeongsang. From 104 on Feb. 20, the cumulative number of diagnosed cases soared to over 1,000 by Feb. 26, over 2,000 by Feb. 28, and over 3,000 by Feb. 29. The largest single-day increase in new diagnoses occurred on Mar. 3, when the number rose to 851 as of 4 o’clock that afternoon. While the rate of increase subsequently dropped off, new diagnoses continued to number in the hundreds daily, with a total of 7,513 confirmed infections as of Mar. 10. Around 60% of the patients have confirmed associations with the Shincheonji Church of Jesus.

A thermal camera and an employee with a staff thermometer monitor the temperatures of passengers at Seosan Bus Terminal in South Chungcheong Province on Mar. 6. (provided by the city of Seosan)

Infectious disease experts said that barring any surprise variables along Shincheonji lines, no further spikes in new diagnoses are expected. Instead, they said the important order of business now is managing the situation to prevent further deaths from occurring.

Lee Jae-gap, a professor at Hallym University Kangnam Sacred Heart Hospital, said, “A lot of patients in the Daegu and North Gyeongsang region have been unable to undergo hospitalization. The key thing will be to quickly hospitalize patients with severe symptoms [among those already diagnosed] so they can receive appropriate treatment.” Lee’s argument is that care should be focused on the estimated 65 patients with severe symptoms as of Mar. 9, while those who have yet to be assigned hospitals or treatment centers should be quickly brought into the “control visibility zone.”

Also needed are prevention efforts for the potential emergence of patients in nursing facilities and other settings where large numbers of senior citizens vulnerable to infection live in groups. Kim Yoon, a professor of healthcare management at the Seoul National University medical school, said, “The full-scale examinations of nursing homes and nursing hospitals that the government has pledged to perform will be important, but a key element is going to be establishing the proper systems with authority and personnel to identify and manage infections within facilities.”

Coronavirus is currently spreading like wildfire around the world, with local infections rising sharply in 53 countries -- including Italy and Iran as well as China -- and over 200 confirmed diagnoses in countries including France, Germany, the US, and Japan. Jung Eun-kyeong explained, “The KCDC is continuing to monitor the situation in different countries and provide the public with timely information, and we are currently considering intensified quarantines for symptomatic persons entering from countries where local community transmissions have occurred as a way of minimizing reintroduction.”

Infectious disease experts said that with the coronavirus situation having already reached global pandemic proportions, the intermediate- to long-term infectious disease response system itself should be reviewed and overhauled alongside the increased quarantine efforts.

“This moment could be the beginning of a real pandemic,” warned Eom Joong-sik, a professor of infectious diseases at Gachon University Gil Medical Center.

“We’re going to need a reexamination of our overall infectious disease response measures, including the reinforcement of and division of roles among additional epidemiological study and disease prevention response personnel, renewed discussions of cooperation and a division of duties between local government and the central government, and changes to hospital infection prevention protocols,” Eom suggested.

Ki Mo-ran, a professor at the National Cancer Center, said, “It’s already been made clear that barring people from entering and leaving the country is not effective when it comes to the coronavirus.”

“It’s time for us to consider a system of international coordination, including confirmation of health status before departures and after arrivals in the country in question, as along with the system of overseas testing in cases of irregularities,” Ki advised.

By Lee Yu-jin, Choi Won-hyung, and Cho Hye-jeong staff reporters

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