hankyoreh

People wait in line at a security checkpoint at Gimpo International Airport on Sunday before boarding their flights. (Yonhap News)

The South Korean government suggested that gradual changes to the COVID-19 disease control system may be possible around the upcoming Chuseok holiday in the fourth week of September, by which time 70% of all South Koreans will have received a first vaccine dose.

Recently, the domestic COVID-19 fatality rate has been in the 0.2–0.3% range, much closer to the 0.1% rate associated with the flu. This has led some experts to suggest the need for changes to the current disease control strategy of intensive social distancing based on confirmed case numbers.

The government said it planned to develop a new disease control strategy but still appears to view the current situation as too soon for its implementation.

“The immediate goal of disease control authorities right now is swiftly stabilizing the fourth wave and increasing inoculations according to our plan so that we reach the stated goal,” said Son Young-rae, director of the Central Disaster Management Headquarters social strategy group, in remarks Sunday.

“Once administration of first [vaccine] doses has reached around 70% around the Chuseok holiday, it looks like we will be able to think about whether we can change our disease control regime, for example, by adjusting certain indicators [related to distancing],” he added.

“As far as fully revising our disease control regime to focus on the fatality rate and the number of patients with severe or critical symptoms rather than the number of confirmed cases, as some experts and media have been suggesting, it is still a bit too early to do that based on our current progress with vaccinations and fatality rate level,” he said.

“We will continue to listen to what the experts suggest and monitor the situation in countries that are implementing that kind of system, and once the situation stabilizes, we plan to discuss those kinds of changes,” he continued.

According to the Central Disaster and Safety Countermeasures Headquarters (CDSCH), daily domestic confirmed cases averaged 1780.3 over the past week, an increase of 284.9 from the week before, while the basic reproduction number (R0) was up from 0.99 to 1.1 over the same period.

During a CDSCH meeting the same day, Prime Minister Kim Boo-kyum said, “It’s been over a month since we implemented the highest level of distancing, yet the number of confirmed cases has actually risen recently to around 2,000 [per day].”

“Some experts have been suggesting that it may be time now for a shift in disease control strategy,” he noted.

“But I do not think now is the time for that. If we are lax about our disease control efforts, that could lead to a sharp rise in confirmed cases and severely burden our healthcare response system,” he added.

“Right now, our priority is to move forward quickly with vaccinations and focus on disease control efforts to overcome the fourth wave that we are facing,” he said.

The remarks from government figures come in response to a societal debate over a “with COVID” future of coexistence with the virus, which has been heating up recently as the COVID-19 fatality rate has dropped to nearly the same level as seasonal flu.

The Central Disease Control Headquarters announced Sunday that the cumulative COVID-19 fatality rate stood at 0.96% as of the end of the previous day. This means that of the 223,928 patients who have tested positive since the first domestic case diagnosed in South Korea in January 2020, 2,156 have died.

The cumulative fatality rate dropped below 1% for the first time on Wednesday — the same day that South Korea recorded an all-time daily high of 2,222 new confirmed cases. Between Aug. 1 and 15, the fatality rate has been 0.24%, with 25,589 confirmed cases and 61 deaths.

But one remaining variable is the longer period between diagnosis and death, as the previous vaccination of older adults means that relatively younger patients in their 50s have recently accounted for the largest portion of patients in severe and critical condition. In other words, fatalities could end up rising in the future as the fourth wave spreads.

Experts have recently been suggesting that COVID-19 should be managed along similar lines to the flu, which has a fatality rate of 0.1–0.2%.

In a Friday contribution to the Hankyoreh, Kim Yoon, a professor of health policy and management at Seoul National University, wrote, “Thanks to the vaccinations of high-risk groups, we are now able to manage COVID-19 as an infectious disease along the same lines as the flu.”

But the government sees it as too soon to attempt to manage COVID-19 like the flu.

With no national statistics available on the flu, the government has estimated from past research that around 2.5 to 5 million South Koreans are infected with the seasonal flu each year, or 5–10% of the population, and approximately 2,000 to 4,000 of them die from it. This translates into a fatality rate between 0.05% and 0.1% — which the government believes to be toward the lower end of that range.

In a Friday briefing, Son Young-rae noted, “The cumulative fatality rate for COVID-19 has continued to drop, falling below 1% for the first time last week.”

“The fatality rate last month has been estimated at around 0.2%,” he added.

“Our determination is that these fatality rates need to fall a bit more before we can manage [COVID-19] in a similar way to seasonal flu,” he said.

“The current COVID-19 fatality rate and the numbers of deaths are the result of us managing things as we marshal our healthcare system to locate all the patients and provide an optimum of care,” he also noted.

“If we were to manage it like the flu, that carries the risk of the fatality rate rising as the aspect of finding and treating patients is weakened compared with the current system,” he said.

Meanwhile, President Moon Jae-in provided more details about the vaccination schedule, which involves administering first doses to 70% of all South Koreans before the Chuseok holiday in September and completing the administration of second doses during October.

In a celebratory address for the National Liberation Day holiday on Sunday, Moon said, “In October, 70 percent of the total population will have received their second shots, and vaccination rate targets will be raised once more.”

Remarking on this, Son said, “This means that even when we take into account the two-week period needed for sufficient antibodies to form after second dose administration, we will still achieve our goal ahead of our original schedule, which had us completing vaccinations of 70% of all South Koreans by late November.”

By Kim Ji-hoon, staff photographer

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