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Staff at the Songpa District Office in Seoul stand in front of a monitor that displays the record-shattering number of new COVID-19 cases announced on Wednesday. (Kim Tae-hyeong/The Hankyoreh)

After the South Korean government signaled that it will be relaxing social distancing regulations this week, the country’s daily COVID-19 caseload continues to edge closer to 100,000 new infections per day. Disease authorities reported Thursday that 93,135 people had tested positive for COVID-19 the previous day, the largest number since the beginning of the pandemic.

The number of daily cases has been doubling every week, from just 20,000 in early February to more than 90,000 on Thursday. Given that trend, the number of cases will reach 180,000 next week. Korea is racing toward a higher peak, and at a faster pace, than the government’s estimate of 130,000-170,000 cases by the end of February.

The public health authorities emphasize that serious and critical cases remain stable, but experts are concerned about serious deficiencies in measures to maintain the health care system and essential social services and in the system for managing patients in at-home care.

The government will be announcing adjustments to its social distancing scheme Friday. Current measures are likely to be relaxed to allow private gatherings of up to eight people and businesses to remain open until 10 pm.

Many are raising concerns about the government’s attempts to ease social distancing rules. Their concerns derive from their experience of the healthcare system becoming paralyzed after the government ignored the growing number of patients in serious or critical condition and moved toward gradually restoring everyday routines in November last year.

Therefore, some analysts say the government needs to look closely at indicators such as the number of hospitalized patients and the number of patients in serious or critical conditions before adjusting social distancing measures.

The number of patients in serious or critical condition had been below 300 since Jan. 29 but rose above that threshold once more on Monday. The Wednesday tally was down one from the previous day, but still at 313. The number of hospitalized patients has also risen from 1,202 on Feb. 2 to 1,686 on Wednesday.

Korea’s public health authorities note, however, that there are fewer critically ill patients here than in other countries. There are 6.0 such patients per 1 million population in Korea, which is lower than France (49), the US (46.3), Germany (29.5), Canada (23.7), Japan (14.6, as of Feb. 9) and the UK (6.1, as of Feb. 11).

The case fatality rate is rising along with the number of critically ill patients. The case fatality rate for the Omicron variant of the coronavirus rose from 0.15% on Jan. 31 to 0.19% on Feb. 12.

“The percentage of infected people who are in their 60s and above is going up even as the immunity provided by vaccination is declining. As the number of people in the high-risk cohort (older people) increases, we’re seeing a corresponding increase, albeit a small one, in the case fatality rate,” explained Park Young-joon, head of the epidemiological research team at the Central Disease Control Headquarters, in a press briefing on Wednesday afternoon.

Given the greater number of patients and indicators about critically ill patients, experts are exercising caution on the idea of easing social distancing regulations.

“It’s important to relax disease control restrictions in a way that minimizes risk. To stay on the safe side, we shouldn’t send any signals [such as easing pandemic restrictions] until we’ve reached the peak [of the spread], in the interest of sustaining the healthcare system,” said Jung Jae-hun, a professor of preventive medicine at Gachon University.

Lines of people wait outside a temporary COVID-19 screening station in Seoul’s Mapo District on Sunday. (Kim Hye-yun/The Hankyoreh)

73% of intensive care wards are empty, but 20% of nurses have quit

Another problem is that infection clusters continue to appear in areas that are essential for the functioning of society — including hospitals and other health facilities that are critical while COVID-19 is raging. On Wednesday, 16 more infections at a health facility in Boseong County, South Jeolla Province, brought the total to 97. There have also been 51 cases at a health facility in the Seo District of western Busan.

On Jan. 27, Korea’s Central Disease Control Headquarters and Central Disaster Management Headquarters provided hospitals with guidelines for business continuity plans in the event of an outbreak among their medical staff. The guidelines say that once Korea has entered the “crisis” stage of more than 50,000 daily cases of COVID-19, completely vaccinated medical staff who test positive for COVID-19 can return to work after a three-day quarantine and rapid antigen test, provided they are asymptomatic or have mild symptoms.

Under such a business continuity plan, hospitals are allowed to institute these crisis measures since Korea’s caseload has risen above 90,000. But some say that such measures would be difficult to implement in reality.

“If other patients become infected by a staff member when hospitals are operating with reduced quarantine periods [for medical staff], who will be held responsible? Hospitals are hesitant because they’re still on the hook. No administrative decisions have been made about that,” said Eom Joong-sik, a professor of infectious disease at Gachon University Gil Medical Center.

Intensive care wards were at 27% occupancy as of 5 pm Tuesday, with plenty of space available for more patients. But it also needs to be asked whether that figure can be taken at face value. While 73% of wards are unoccupied, whether there are enough medical workers to staff those wards is another question altogether.

“Around 20% of nurses quit their positions at hospitals during the lull shortly before the Omicron wave. That’s when the people who had held off on resigning because quitting right away would leave a vacancy in their wards finally left,” Eom explained.

General management group needs treatment, transportation options

Another variable is the fact that the at-home treatment system will be reoriented Thursday around what health authorities are calling the “intensive management group.” That group includes patients aged 60 and above and younger patients on oral medication whom local governments deem to require special management, including immunocompromised people and those aged 50 and up with underlying conditions. Everyone else, who falls into the “general management group,” will no longer be eligible for regular monitoring.

As of Wednesday, 266,040 Koreans were being treated at home. As of Thursday, more than 200,000 of them will no longer be monitored by the health authorities.

That has made it more important for people in the general care group not only to communicate accurate information but also to have access to medical care, prescriptions and transportation if their condition worsens.

“There should be YouTube videos or some guidelines explaining what people should do when they experience certain symptoms. People need to use their own vehicles [when they get sick], and I think we’ll need to increase the number of transportation options [such as quarantine taxis],” said Kim Yoon, a professor of health policy and management at Seoul National University.

By Park June-yong and Kwon Ji-dam, staff reporters

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