hankyoreh

A screening clinic in front of Myungsung Presbyterian Church in Seoul’s Gangdong District, where two confirmed novel coronavirus patients attended a recent service. (Kim Hye-yun, staff photographer)

South Korea confirmed 334 new cases of the novel coronavirus on Feb. 27, topping the previous record for new cases in a single day and bringing the total of infections to over a thousand. As the transmission cluster connected to the Daegu branch of the Shincheonji religious sect continues to grow, more than 20,000 people have been placed under self-quarantine. Because of the steep increase in the number of patients, medical staff are proposing that patients with mild symptoms be placed under self-quarantine instead of being admitted to the hospital.

South Korea’s Centers for Disease Control and Prevention (KCDC) announced that the number of confirmed cases of COVID-19, the disease caused by the coronavirus, in the country had increased to 1,595 as of Feb. 27, 10:30 am. Nearly 80% of Daegu’s cases are directly linked with Shincheonji. A 74-year-old man connected with the Shincheonji religious sect’s Daegu branch was reported to have died on Wednesday, bringing the number of fatalities to 12.

Concerns are also growing about another small cluster of infections. The assistant pastor of Myungsung Presbyterian Church, in Seoul’s Gangdong District, contracted COVID-19 after attending a funeral at Daenam Hospital in Cheongdo County, North Gyeongsang Province. While initial reports suggested that the assistant pastor had only attended one service after being infected, it turns out that he’d actually attended a total of eight. Gangdong District Office has announced that it will test the 348 people who came into contact with the assistant pastor and will place everyone who attended the services with him under active surveillance.

The authorities are also investigating whether there are additional infections connected with a tour of holy sites in Israel by members of the Catholic Diocese of Andong, in North Gyeongsang Province. The previous day, a Korean Air flight attendant on their flight tested positive for COVID-19. The KCDC announced that it was surveying the people who’d come into contact [with the flight attendant] while aboard flight KE958, which departed from Tel Aviv, Israel, on Feb. 15 and arrived in Incheon on Feb. 16.

Given the rapid increase in the number of cases, the public health authorities are no longer able to maintain their previous epidemiological approach, in which they carefully tracked movements and transmission route for each individual case. Instead, they’re focusing their epidemiological resources on quickly identifying and quarantining those who came into contact with infected individuals and, in areas with a cluster of infections, to select those with suspicious symptoms for testing.

On Feb. 25, 20 public servants were assigned to epidemiological research in Daegu, where the majority of the country’s cases has been confirmed. They’ve been focusing on finding people who came into contact with patients at public facilities that attract large crowds, such as hospitals and department stores. “At first, we were tracking the source of infection by looking at [the patient’s] movements during the two weeks before symptoms appeared, but we’re not able to determine all that anymore. Currently, we’re focusing on tracking their movements after symptoms appeared and identifying people who came into contact and might have been infected,” said an epidemiological researcher in Daegu.

Nor is it feasible to apply the same methods of treatment to all patients. There continues to be a shortage of hospital beds relative to the number of new patients. On Wednesday, the city of Daegu said that 309 patients were still waiting for a hospital bed.

“It takes a considerable amount of time to transfer patients after triage, and we’re getting more than 150 new patients every day. That means we’re going to be seeing people waiting for quarantine [in our figures] for some time,” explained KCDC Director Jung Eun-kyeong.

That’s why some are suggesting that patients with mild symptoms be placed under self-quarantine. “We need to take the approach of aggressively lowering the fatality rate by moving patients with mild symptoms into self-quarantine, sending more serious patients, those with pneumonia, to bigger hospitals, and assigning the most serious of all to medical facilities that can handle them, the kind that have artificial respirators,” the New Infectious Disease Central Clinical Committee said in a press conference on Wednesday.

For now, the requirements for moving patients to self-quarantine are that the disease has virtually no likelihood of becoming serious and that conditions at home make it unlikely that the disease will spread. For example, the house should be divided into at least two rooms, to lower the risk of other family members being infected, and none of the family members should have respiratory or heart conditions.

“Since the number of patients is increasing faster than we can prepare hospital beds, it’s inevitable that [for the time being] some people testing positive will be put on the waiting list, which means they’ll be placed under self-quarantine at home. We have to create a priority list of symptoms — acute pneumonia, viral pneumonia, bronchitis, cold-like symptoms, and no symptoms — and assign patients to hospital beds on that basis,” said Kim Shin-woo, a professor of infectious disease at Kyungpook National University.

By Park Da-hae, Lee Yu-jin, Park Su-ji, and Noh Ji-won, staff reporters

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