How South Korea is suppressing COVID-19

Date: March 25, 2020 | Author: Denis McClean | Source: United Nations Office for Disaster Risk Reduction

Dr. Wang-Jun Lee and colleagues at today's webinar on COVID-19
Dr. Wang-Jun Lee (centre) with colleagues, who spoke at the UNDRR webinar on COVID-19

GENEVA, 25 March, 2020 – Trace, test and treat. That sums up the strategy pursued by the Republic of Korea since it detected its first case of COVID-19 on January 20 and its first death on February 20, without imposing a lockdown.

The country has managed to keep its mortality rate at 1.4% compared to a global mortality rate of 4.34% despite an outbreak triggered by the activities of a religious organization in Daegu, Gyungbuk, which contributed to a spike in confirmed cases in late February.

The highest recorded number of infections on a single day in Seoul where 25 million people live, was 75 compared to 735 on a single day in Daegu, population 2.5 million. To date, 85% of the confirmed cases can be traced to Daegu.

The strategy pursued by Korea was explained in some detail today to an online audience of 900 disaster management and health specialists from 105 countries, by Dr. Wang-Jun Lee, CEO and Chairman of Myoungi Hospital and Executive Chairman of the Korean Hospital Association in a webinar organized by the UN Office for Disaster Risk Reduction’s office in Incheon, Korea and the World Health Organization.

“As of today, total confirmed cases are 9,137 among them 3,730 were discharged after recovery and 126 died. So until now fully recovered patients percentage is 41% and mortality rate is 1.4%,” said Dr. Lee who went on to describe the three distinct phases of the epidemiological curve in Korea.

From January 20 until February 17, the number of new infections was low but during phase two from February 18 till March 11, the curve started to trend upwards with patient number 31 associated with the religious group in Daegu. The curve peaked at the end of February and started to level off.

“Phase three started from March 12 till now when we have seen a downward trend in new cases with sporadic new clusters of infections,” he said.

Dr. Lee pointed out that unlike in China, more women (61.4%) than men (38.6%) were infected and the most infected demographic is aged 20-39 recorded 2,419 infections. These unique statistics were linked to members of the religious organization in Daegu.  

Nonetheless, as in China, most deaths were among older patients with underlying diseases with a mortality rate of 10% for people in their 80s.

Dr. Lee outlined the Government’s four main policies to prevent the spread of COVID-19.

The first policy is one of complete openness and transparency in sharing updated information on new infections through the Korean Centre for Disease Control, simultaneously with all stakeholders, including the media, on where, when and how the infections were discovered and investigated.

Dr. Lee said this was a key learning from the outbreak of MERS (Middle East Respiratory Syndrome) in 2015 and the result is that there is no confusion among the public about what needs to be done to avoid spreading the virus.  No cities have been locked down, no transport closed, and international entry is still open.

The second policy is containment and mitigation. Containment was started after the first case was identified in China on December 30, 2019, and the focus is on identifying infected patients immediately and isolating them to interrupt transmission. “We track all suspected cases and trace all the confirmed cases,” he said.

Mitigation seeks to lower the peak of the outbreak to make it within Korea’s capacity to respond primarily through a social distancing campaign introduced just after the big outbreak in Daegu at the end of February.

It was also decided to close all schools and to recommend voluntary restrictions including no large gatherings and working from home.

“We are so proud of the promoted participation of the patients,” he said.           

The third policy is the triage and treatment system developed as a result of the experience of the MERS outbreak.  In any outbreak the biggest challenge is the overflow of the patients exceeding the capacity of the hospital staff, said Dr. Lee.

To overcome this, a triage system was created comprising five isolation hospitals to take care of 19% of cases designated critical and severe, while mild to moderate cases are handled by a network of public community hospitals. Bed spaces have also been created through revamped hotels, gyms and residential centres.

The fourth policy promotes massive screening and fast tracking of suspect cases, underpinned by the accelerated production of emergency diagnostic kits with a weekly diagnostic capability of 430,000.  Dr. Lee said the main weapon is the diagnostic kits combined with drive-through and walk-through test centres.

Korea has more than 100 labs working round the clock with daily testing capacity of 20,000 and this has been crucial in keeping COVID-19 at bay.

In opening remarks, Dr. Stella Chungong, WHO Director, Health Security and Preparedness, said: “This webinar is timely as it is very important to learn and apply the lessons learnt and best practices in Covid Response, and to identify challenges in preparing for, and managing COVID-19 across the world.”

‘Pandemics do not recognise borders, so a united international response is vital under the guidance of WHO’

Source: The Times of India | Date: March 23, 2020

UN Office for Disaster Risk Reduction (UNDRR) head Mami Mizutori has been an advocate of a comprehensive approach to deal with disasters, backed by international collaboration. She explains this approach to Pradeep Thakur in the context of the Covid-19 outbreak:

The global attention on Covid-19 is unprecedented. Is this because the rich are more affected?

Like many disease outbreaks, Covid-19 does not distinguish between rich and poor. There is worldwide attention on it because it threatens every country regardless of development status. Disasters affect all, however disasters don’t affect everyone equally and in the case of Covid-19, it is also true. This is why, developed countries with more resources available to respond to the outbreak will need to attend first and foremost to the safety and well-being of their own citizens, but there also must be international support to low- and middle-income countries that are struggling to cope with the outbreak. Pandemics do not recognise borders so a united international response is vital under the leadership and guidance of the World Health Organization.

We have seen Ebola and bird flu. How different is Covid-19?

Covid-19 is not an epidemic confined to a few countries. It has been declared a pandemic by the WHO. There is a crucial difference. The list of countries reporting outbreaks is growing daily. There is no nation on Earth that can claim to be immune from the threat. Thousands have died and many more thousands are fighting for their lives in hospitals around the world. We are still in the early stages of the pandemic. It is urgent that countries which have yet to experience the full brunt of the disease should observe and learn from those who have been most impacted, notably China, Italy, Iran and the Republic of Korea. There are many lessons we can learn from these countries.

How can India effectively deal with risks arising out of disasters?

India has a very robust policy on disaster risk management, and this is evident from its zero tolerance approach to casualties in disaster events and its full embrace of the Sendai Framework. The Coalition for Disaster Resilient Infrastructure, launched by Prime Minister Narendra Modi at the UN Climate Action Summit in 2019, and supported by UNDRR emphasises the importance of public health infrastructure.

India does not see the Covid-19 outbreak as simply a health issue but has taken an all-of-government, all-of-society approach which is very much in the spirit of the Sendai Framework. The public health authorities are working closely with bodies such as the NDMA and government ministries responsible for civil aviation and shipping and the production of textiles including protective materials such as masks.

India is also using mobile technology in a smart way that could be adopted by other countries. Anyone making a mobile phone call must listen to a health message in the language of their choice before their call commences. This is a great way of communicating with a population of 1.3 billion people.

India is also showing leadership at the regional level. I understand also that while the number of cases currently is low, India is stepping up its response and surveillance capacity and mapping its resources. At the same time, it has made donations to a regional response fund and expressed its willingness to help other nations with their response. This is international solidarity of the highest order and I can only commend India for its approach.

Could Europe and the US have handled things better?

Hindsight is a great teacher. The Covid-19 outbreak is a step into the unknown. Nobody could reasonably claim to have been fully prepared for what is unfolding now across the globe. I would like to call attention to a critical observation about the changing nature of risk, which UNDRR highlighted in the Global Assessment of Risk report published in May 2019. GAR 2019 is very clear that risk is increasingly systemic. We are seeing this with Covid-19 rattling the global economy. The only way of fighting systemic risk is with a joined-up systemic prevention and response approach. This means that we cannot work in silos, we must map and model how risk cascades into other risks, and importantly we must be able to work trans-boundary, in a unified fashion and not take nationalistic stances to risks – which, as we very well know, are no respecters of borders.

Many countries have curtailed economic activities. How should governments mitigate the impact?

Poverty eradication is the No 1 sustainable development goal. In this current crisis it is important that provision is made for those who are especially vulnerable. This can take many forms including cash payments, emergency shelter and food distribution programmes. The most important thing is that the poor be consulted about their needs and be included in the response planning process.

UNDRR urges disaster management agencies to prioritize biological hazards

Source: United Nations Office for Disaster Risk Reduction | Author: Denis McClean | Date: March 12, 2020

GENEVA, 12 March, 2020 – The UN Secretary-General’s Special Representative for Disaster Risk Reduction, Mami Mizutori, today acknowledged WHO’s declaration of a pandemic in relation to the global outbreak of the COVID19 virus which has claimed over 4,000 lives to date.

Ms. Mizutori who also heads the UN Office for Disaster Risk Reduction (UNDRR), urged national disaster management agencies to continue with the development of their preparedness and response capacities to include health emergencies as a top priority, alongside earthquakes, floods, storms and other natural hazards.

“Events such as the COVID19 pandemic, Ebola epidemics and Zika virus outbreaks underline how important it is to break down the silos in disaster prevention and management. We need to recognize the multiple ways in which such outbreaks can have a ripple effect across sectors of society and lead to the breakdown of systems that we take for granted, including health care, the provision of education, global supply chains, travel, trade and financial services.

“It is understandable that there is a strong disaster management focus on natural hazards. They are visible, and affect over 100 million people every year, but this machinery must also be ready for deployment in public health emergencies when the trigger is a virus like COVID19.

“This is a red-letter year for disaster risk reduction. UN Member States adopted the global plan to reduce disaster losses, the Sendai Framework for Disaster Risk Reduction on 18 March 2015 and committed to have national and local strategies for disaster risk reduction in place by this year. It is essential now that these strategies are revisited to ensure that they prioritize the management of biological hazards and resilient health systems.

“The Sendai Framework is a valuable instrument for ensuring better health outcomes in disasters. It emphasizes the need for resilient health systems and the integration of disaster risk management into health care provision at all levels.

“Its full implementation will help break down any silos that exist between disaster managers and health workers. It will also help to shift the focus from disaster response and management to preparedness, surveillance and disaster risk management in the health context.”