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People wait in line at a COVID-19 screening station in Seoul’s Songpa District for rapid antigen tests. (Yonhap News)

Since the Omicron variant of COVID-19 began sweeping across South Korea this year, daily reports about record-setting caseloads have sharpened a sense of crisis. Even the experts responsible for making pandemic predictions have felt pressured to guess how many tens of thousands of people will be infected on a given date.

But as the paradigm of disease control shifts from preventing infections to minimizing their impact and as various government policies change accordingly, the accuracy of such predictions is bound to decrease.

If caseload prediction models still have a purpose, it’s not to predict how many people will be infected tomorrow, but rather to provide a time frame for when the current wave will crest, so that the government can prepare for new policies. That will allow the government to estimate the maximum demand for medical care at the peak of the wave and to set aside the resources needed to treat the sick.

Several experts on the spread of COVID-19 in Korea are predicting that we’ll hit the apex of the curve in early or mid-March with over 250,000 daily cases. But confirmed cases of COVID-19 don’t tell the whole story. Last year, experts believed that the Korean authorities were only detecting about half of all infections, and during the Omicron wave, confirmed cases likely make up an even lower percentage of the total.

A more important factor is whether the number of critically ill patients will overrun the capacity of the intensive care units the authorities are preparing. The current view is that the health care system can handle the surge of cases, albeit with difficulty, thanks to Korea’s high vaccination rate, the prescription of oral antivirals and the low incidence of serious cases with the Omicron strain.

To say we can handle this huge number of patients has less to do with the lower risk that Omicron poses than with our lack of alternatives, given the capabilities of our health care system. That has led to a major turning point in Korea’s pandemic policy this month.

First, the very paradigm of disease control policy has changed. Up to and throughout the Delta wave, policy was focused on stopping the spread of COVID-19 to reduce the number of cases. But now, we have transitioned to a strategy of tolerating the spread while minimizing the damage it causes.

This policy shift was inevitable given the lack of alternatives: the Omicron variant is extremely transmissible, and fewer than 5% of Korean adults remain unvaccinated. In other words, the current shift in our pandemic policy wasn’t really a choice at all.

Second, the change of paradigms forced us to abandon the strategy of testing, tracing and quarantining that we’d hitherto maintained. The PCR-based testing regime was no longer sustainable, and contact tracing in the field was halted.

Our testing regime was instantaneously reorganized around rapid antigen tests, which had been regarded as less accurate. That has caused the spread to accelerate and the confirmed case rate to fall, but the public has been poorly informed about what this change in policy really means.

Korea’s public health authorities said Tuesday that the authorities were beginning to move toward treating COVID-19 as an endemic disease while continuing to monitor the risk posed by Omicron.

Medically speaking, there’s no bright line between a pandemic disease and an endemic disease. There’s only a process by which pandemic diseases become endemic through changing circumstances and past action. But there are some basic prerequisites that must be in place before the endemic shift can occur.

First, the level of overall immunity must be high enough — whether thanks to vaccination or infection — for the number of new cases to decline significantly. Second, there must be a major drop in the number of critically ill individuals as previous infections, oral antivirals and vaccines prevent cases from growing serious. Finally, the public needs to regard COVID-19 as no longer being as dangerous as it used to be.

Korean society has endured enormous sacrifices to meet those three conditions. And March 2022 will be a brutal time that will test our capabilities, as well as our limits.

But the dark time we have endured is nearly past, and the return to everyday life is almost here.

Jung Jae-hun

By Jung Hae-hun, professor of preventive medicine at Gachon University College of Medicine

Please direct questions or comments to [english@hani.co.kr]