South Korea: COVID-19 Strategy - Health Systems Facts

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“Key features of the response to date included specific strategies and strong national leadership and work to ensure effective coordinated and intersectoral response. The strategies included the following (Table 1):

“Early recognition of the threat and rapid activation of national response protocols led by national leadership;
“Rapid establishment of widespread diagnostic capacity;
“Scale-up of measures for preventing community transmission, including contact tracing, quarantine, and isolation; and
“Redesigning the triage and treatment systems and mobilizing the necessary resources for case management.”

Source: Juhwan Oh, Jong-Koo Lee, Dan Schwarz, Hannah L. Ratcliffe, Jeffrey F. Markuns & Lisa R. Hirschhorn (2020) National Response to COVID-19 in the Republic of Korea and Lessons Learned for Other Countries, Health Systems & Reform, 6:1, DOI: 10.1080/23288604.2020.1753464
https://www.tandfonline.com /doi/full/10.1080/23288604.2020.1753464

“We used a starting date of the 100th case rather than calendar dates to allow for comparisons between South Korea and the United States from the respective starting times of the epidemic based on data availability from the United States. The strategy of rapid testing scale-up and the use of meticulous contact tracing (below) facilitated earlier and more effective containment of viral spread compared with other countries such as the United States, where scale-up of diagnostic capacity after the 100th case occurred later and with much more limited use of contact tracing. Reflecting these differences, South Korea had much lower cumulative positivity rate (ratio of positive to negative tests) compared with the United States (2.9% versus 17.4%, respectively, 19 days after the 100th case), as well as daily positivity rates at that time (2.9% versus 25.7%, respectively). In South Korea, positivity rates have continued to decline (101 of 11,290 [0.9%] of tests on April 1, 2020), reflecting the sustained strategy of aggressive testing.”

“Finally, South Korea implemented national isolation protocols that adhered strictly to the International Health Regulations, which did not entail closing national borders to travelers from affected countries.⁸ (South Korea did block inflow from Wuhan, China—the epicenter of the outbreak—but only after China also applied a lockdown to the same region.) Rather than close its borders, South Korea instituted a strict program of self-quarantine and contact tracing for all incoming travelers, including through a mandatory telephone software application. Additionally, as of the last week of March, South Korea has instituted a mandatory two-week quarantine for travelers from some European countries. The number of cases detected in quarantine increased from three between January 19 and January 25 to 321 in the last week in March, with the highest proportions coming from Europe and the United States. These cases represented six cases per 10,000 incoming travelers in January, increasing to 22 per 10,000 in February (the number of travelers for March was not available at the time of submission).⁹ The open border policy has been unpopular with some groups who have sought to blame imported cases as the cause of the domestic epidemic,¹⁰ but the government has sustained a policy of “no blaming of the victimized population,” in part to prevent a global and domestic economic downturn.”

“This success has not come without challenges. For example, in response to an urgent call from the Daegu Medical Association, many physicians and nurses volunteered to provide care in facilities with a high density of patients per medical personnel (in part due to the loss of some medical personnel resulting from COVID-19 infection). However, this influx of workers was not enough to meet workforce needs and was complicated by the exhaustive workloads with extended use of PPE and need to stay in nearby hotels instead of their homes for several weeks. Some of the challenges arose in part because neither the government nor the Korea Medical Association—despite being inclusive of most physicians in South Korea—have direct authority over the largely public-sector health workforce. In response, the government is considering establishing a legal framework for reallocating human resources for health during an epidemic. Additionally, despite forecasting, insufficient PPE supplies such as masks and gloves often became a problem at an institutional level. Finally, though South Korea has managed to slow the epidemic, experts still do not know how many sporadic cases are about to appear in communities and what newly imported cases may be arriving from other countries. The future of the pandemic in South Korea will continue to evolve, and time will show whether the government and society of South Korea will continue to contain the COVID-19 epidemic through existing or new strategies.”

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This page was last updated May 21, 2020 by Doug McVay, Senior Policy Analyst.