hankyoreh

A medical worker at a dedicated COVID-19 hospital in Gyeonggi Province’s Pyeongtaek rushes to attend to patients on Monday. (Yonhap News)

After most countries in the world began administering vaccines and easing restrictions through so-called living with COVID-19 campaigns, the virus’s case fatality rate dropped. Yet after pursuing the same path, Korea has seen an increase in the COVID-19 case fatality rate. Some are pointing to a lack of preparation on the part of the government in implementing its step-by-step recovery plan, which has now resulted in steps backward instead.

According to an analysis by statistic site Our World in Data on Monday, Korea's COVID-19 case fatality rate as of Wednesday was 1.46% — the highest among major economies such as the US, Japan, Germany, UK and Singapore.

Wednesday also marked one month since South Korea began lifting restrictions to restore normal daily activities. On the same day, the UK's COVID-19 case fatality rate was 0.3% — one-fifth that of Korea. Singapore (0.32%), Germany (0.6%) and Japan (0.94%) also sharply contrasted the situation in Korea. Moreover, the US, where the Delta variant has spread rampantly due to stagnant vaccination rates, also had a mortality rate of 0.96%. The global average case fatality rate for the virus currently stands at 1.31% — undercutting the rate in South Korea.

Although other countries started their own “living with COVID-19” campaigns before South Korea did, they did not see a similar increase in the COVID-19 case fatality rate. The UK, for example, which had a case fatality rate of 3% last winter, declared an easing of restrictions on July 19 yet managed to maintain a fatality rate of 0.3-0.4% since then.

Another case is Singapore. Considered one of the most exemplary countries in terms of its handling of the pandemic, it also had faced increased case fatality rates at one time. The country’s mortality rate for COVID-19 soared to 1.5% after restrictions were lifted on Aug. 10. Nevertheless, they managed to get the figures stabilized within a week and are now maintaining the death rate at around 0.4%.

Germany, where the case fatality rate soared to around 5% in the winter of last year, implemented its so-called 3G measures including vaccination (Geimpft), recovery after infection (Genesen), and negative PCR tests (Getestet) at the end of August. As a result, it has consistently maintained a case fatality rate of less than 1%. Similarly, Japan, which was facing a crisis situation with the death rate exceeding 2% ahead of the easing of restrictions in November, seems to have started to stabilize in recent weeks, with both the number of confirmed cases and the daily death toll plummeting.

Experts explained the drop in COVID-19 case fatality by saying that over time, countries that suffered major crises after the first waves of COVID-19 in 2020 have been able to establish increasingly adequate medical response systems.

The most immediate way to evaluate a country’s health care system and response to the pandemic is by looking at the case fatality rate figures. One epidemiologist speaking on the condition of anonymity said, “The case fatality rate is an indicator of how well the country has saved the lives of patients.”

“The government may not disclose the number of patients waiting for beds or details regarding the specifics of hospital bed shortages, but the case fatality rate accurately shows the response to infectious diseases because it’s impossible to hide figures of patients who lost their lives,” he added.

Until early October, Korea was classified as a country with a low COVID-19 case fatality rate, standing at less than 0.5%. However, the mortality rate exceeded 1% on Nov. 2, a day after the start of the country’s transition to “living with” the virus. The current numbers are hovering around 1.5%.

The jump in South Korea’s case fatality rate can be tied to the increase in the number of infections among older populations, who are vulnerable to infection, and the lack of hospital beds. The emergence of the Delta variation and time elapsed since vaccination has also led to an increase in breakthrough infections among older populations.

The number of deaths due to not receiving timely treatment has also increased, leading to a higher fatality rate. Statistics show that the case fatality rate began to rise in early to mid-October when cluster infections were discovered in nursing facilities and that the rate surged again in mid-November due to a shortage of beds in the greater Seoul area.

Speaking with the Hankyoreh on Monday, professor Kim Yoon of Seoul National University said, “No countries across the world are seeing an increase in case fatality rate. In the end, only Korea’s figures are increasing as a result of pushing forward with an easing of restrictions that was not thought out.”

"The case fatality rate reached 1.01% in November, 2.5 times higher than that of May (0.44%), which is higher than the figures were before the administration of vaccines began," he added.

The bigger problem is that there are no government measures to lower the increased mortality rate. As of the end of the day Sunday, a total of 1,012 patients were awaiting beds. Of the 982 patients waiting for beds in the greater Seoul area, 309 had been waiting for one for more than 4 days.

Among those waiting for beds in the Seoul metropolitan area, 547 (55.7%) were identified as patients aged 70 or older. Between Nov. 21 to 27, 10 patients died while waiting to be assigned a bed — triple the 3 deaths in the week prior.

According to Kim, "The government has implemented special disease control measures before, but considering the emergence of the Omicron variant and seasonal factors, the number of older and critically ill patients will not decrease and the number of deaths will also not decrease for the next two to three weeks.”

"From now on, if we do not secure beds and medical personnel to treat patients and lower the case fatality rate, the four-week emergency plan [currently in place] will continue until next spring," he said.

Jung Jae-hun, a professor of preventive medicine at Gachon University, also said, "In order to implement a phased daily recovery plan after the four-week emergency period, additional vaccinations for high-risk groups should be actively promoted and medical capabilities such as beds should be expanded.”

By Lee Jae-ho, staff reporter

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