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Medical workers at a drive-thru screening center in the parking lot of Seoul Sports Complex on Apr. 13. (Yonhap News)

The number of “reactivation” cases in South Korea, where novel coronavirus patients test positive again after testing negative and being released from quarantine, rose to 116 as of Apr. 13. The number of patients hospitalized for four or more weeks also reportedly exceeded 1,000. Even as the number of newly diagnosed cases has declined, instances of patients being re-diagnosed or requiring long-term hospitalization have emerged as an unexpected danger.

“As of midnight on Apr. 13, a total of 116 people had tested positive a second time after being released from quarantine,” Korea Centers for Disease Control and Prevention (KCDC) Director Jung Eun-kyeong said in a regular briefing on Apr. 13. The numbers mean that 1.1% out of 10,537 cases have tested positive a second time. Many of the cases of patients being re-diagnosed have arisen in Daegu and North Gyeongsang Province, which have accounted for over half of the cumulative patient total. The reactivation cases include 48 in Daegu, 35 in North Gyeongsang, and 10 in Gyeonggi Province.

Commenting on the reactivation cases, Jung said, “This is still a novel virus, and there’s quite a bit of information that remains unknown about it.”

“Given that [the patients] tested positive shortly after they were released from quarantine, this is very likely to be a case of the virus becoming reactivated due to factors involving the patient’s immune system or the virus’s own properties rather than a matter of becoming infected a second time,” she added.

To date, no cases have been reported of a patient spreading the virus after being re-diagnosed. Jung said, “No instances of secondary transmission from a re-diagnosed patient have been reported.”

“Some cases are currently being monitored, so we also plan to monitor whether there are any secondary transmissions while increasing our controls on re-diagnosed patients,” she explained.

The first case of a patient testing positive a second time in South Korea occurred on Feb. 27. The 25th patient, who tested positive on Feb. 9, was discharged on Feb. 22 after treatment but tested positive again five days later, becoming the first reactivation case. As more and more reactivation cases began emerging, the city of Daegu conducted a telephone survey of recovered patients on Apr. 7-8, which found 6.6% of them (316 patients) to have suffered suspected coronavirus symptoms including fever and coughing. The World Health Organization (WHO) is also looking into cases of patients testing positive after a previous negative test, including those in South Korea.

Jung said, “We are instituting more comprehensive public health education and self-isolation recommendations at the time of release from quarantine [after completing treatment] and enhancing our public health monitoring systems so that patients can report when symptoms have occurred [again].”

“We’re currently supplementing our monitoring guidelines for when symptoms appear after release from quarantine,” she said.

The number of patients requiring long-term hospitalization has also emerged as a headache for disease control authorities. In her remarks on Apr. 13, Jung noted, “Over 1,000 patients have exceeded a quarantine period of four weeks,” explaining that “around 37% of the 2,873 total patients in quarantine” have been undergoing treatment for four weeks or more. As of 12 am on Apr. 13, 66 patients were classified as being in severe or critical condition, suggesting that most of those receiving long-term hospitalization are suffering mild symptoms.

With no treatments available, the number of reactivation cases and patients requiring long-term hospitalization could grow even if the virus’s spread is stopped. This week, the South Korean government plans to launch a “joint private/government pan-governmental support team” to support the swift and successful development of coronavirus treatments and vaccines. On Apr. 13, the KCDC-affiliated Korea National Institute of Health (NIH) and the company Celltrion, which was selected in a recruitment effort for emergency research, announced that they had acquired 38 coronavirus antibody candidate groups.

In the case of convalescent plasma, which is likely to be administered in place of medications, only the extraction guidelines have been established so far. Jung explained that the matter was still under discussion due to differences among experts on how to use the plasma and on which patients.

The total number of new cases diagnosed in South Korea stood at 27 on Apr. 14 and at 25 the previous day. Among the new cases on Apr. 13, 16 were tentatively estimated to have come from overseas (one from Indonesia, three from Europe, and 12 from North America).

“At the moment, disease control authorities are fully focused on quickly locating the asymptomatic and mildly symptomatic patients that we have been unable to identify,” Jung said.

“Hopefully, this week will see the different local governments reviewing their regional health response systems as we identify the community infection links through thorough epidemiological investigation,” she added.

By Choi Ha-yan, staff reporter

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