As one of China’s East Asian neighbors, South Korea was infected with SARS-CoV-2 mere weeks after China reported the emergence of a strange disease in the Hubei Province. By late February, South Korea ranked as the country with the second highest number of coronavirus cases in the world, and a national emergency was declared. Citizens of the country and abroad feared for the virus’s spread. However, by mid-March, South Korean coronavirus cases began to level off. Today, the country, despite seeing many more initial cases than their Western counterparts, has careful control over the outbreak as well as some of the most favorable medical and economic conditions in the world. How did South Korea reach this standing? More importantly, what can a severely affected country like the United States learn from the South Korean response?
Looking Deeper into South Korea’s Success
In 2015, South Korea was plagued with an outbreak of Middle Eastern Respiratory Syndrome (MERS), an illness also caused by a type of coronavirus. South Korea was unprepared, and healthcare facilities failed to address the outbreak and initiate testing until after the virus had been transmitted on a wide scale. In the end, South Korea contained the largest number of MERS infections outside of Saudi Arabia and its surrounding parts, the origin of the virus. By the time the outbreak was declared over, South Korean officials realized that testing needed to be more widespread and that movement had to be better contained.
The lessons learned from the 2015 outbreak ultimately prepared South Korea for COVID-19. As soon as COVID-19 hit South Korea, South Korean healthcare workers and researchers began developing test kits, allowing them to accumulate the tools necessary to carefully surveil the virus when the number of cases grew. In the next step of containment, South Korean healthcare facilities and the South Korean government cooperated. Together, they undertook a viral surveillance project that used contact tracing, a method of testing and containing individuals with whom infected individuals made contact, to keep a detailed record of cases and curb the virus’s spread. However, merely testing individuals was not enough. Since the coronavirus is capable of surviving on surfaces like doors and railings, all locations that infected individuals visited also had to be avoided. To ensure the safety of their citizens, the South Korean government kept a frequently-updated record of which locations could have potentially contained the virus and displayed it to the public. If individuals found out that they visited an infected location, they would have gone to a healthcare facility and contained themselves. As a result, the rate of infection has slowed dramatically.
Fundamental Differences in Psychology
The U.S. has a larger economy than South Korea, and American medical technology ranks as some of the best in the world. So why could we not contain the outbreak as effectively as the South Korean government? An analysis of the coronavirus timeline in South Korea suggests that this is due to structural differences in the mindsets of South Koreans and Americans.
The reason that South Korea was able to surveil the virus so efficiently was because it was able to harvest a wealth of information from infected citizens. This required that citizens sacrifice their privacy in the name of protecting public health, a trade-off that many Americans fear. Aside from contact tracing, following the COVID-19 outbreak, the South Korean government gave themselves the authority to analyze patients’ personal information surveillance footage during health crises. Every day, individuals in South Korea must give themselves a diagnostic test with an app that every citizen and foreigner is required to use. Additionally, anyone who tests positive for coronavirus is put under direct surveillance and has their movements recorded. South Korean citizens are able to know precisely who is infected and who visited which location, and because of this, many are able to evade infection.
Do these measures sound scary and imposing? For many Americans, the answer would probably be yes. In the United States, the traditional aversion against strong government power makes mass surveillance projects like South Korea’s unimaginable. In major cities around the U.S., citizens and journalists complain of their restricted liberties amid the outbreak and criticize stay-at-home orders. Right-wing organizations have staged protests against state governors’ protective and restrictive decisions, and CEOs are frustrated by lost productivity and economic downturn.
All of these parties—which consist of a considerable number of Americans—would resist tough government action, as such would prevent them from achieving their restraint-free goals. Such action was able to be passed in South Korea simply because South Koreans and Americans do not entirely share the same values. According to Jung Eun-kyeong, the director of Korea Centers for Disease Control and Prevention (KCDC), South Koreans prioritize safety over human rights when it comes to dangerous situations like the COVID-19 outbreak. This general consensus is much more difficult to be reached within the United States, and because of this, future ambitious attempts by federal and state governments to combat the outbreak will likely be disapproved by many citizens.
South Korea’s Future in the Pandemic
Today, in contrast to the empty streets of the United States and many European countries, the streets of South Korea are bustling with pedestrians and traffic. South Korea continues to closely survey the path of the virus and contain its rate of infection. This is especially important in light of a recent South Korean finding that over 150 recovered patients have once again tested positive for the virus, raising concern that previous infection does not yield immunity. A resurgence of cases as was recently seen in Wuhan, China would be a disastrous outcome of South Korea’s protective measures. Even in a country that has largely restricted the growth of coronavirus cases, it is important to maintain caution and protect all citizens, even those who have already experienced and recovered from an infection.
On its agenda, South Korea is looking mainly to do two things: strengthen resistance against coronavirus and maintain its economy. The South Korean government is looking to increase test kit production and has distributed more of its budget to hospitals. Public officials have discussed making citizens who violated quarantine rules wear tracking bracelets, provided that they give their consent. Information gathered from these bracelets as well as other factors like credit card transactions and surveillance camera tapes would be added to a database that allows public health officials to map the virus’s spread more efficiently and isolate the infected more quickly. To avoid issues of privacy, authorities agreed that this database would only be available to specific officials and would be deleted after the outbreak’s end. Under better circumstances for the health of its citizens, the South Korean government will continue to discourage large gatherings but is looking to lift official stay-at-home orders, which officials hope will keep the economy rolling.
What Can We Do?
For many American public health officials, South Korea is a role model. Many experts agree that the United States should pursue some of the measures that South Korea has taken, including aggressive social distancing. However, as often has been the case, American public health officials are at odds with Washington’s politics. While American public health officials encourage governors to continue enforcing social distancing orders to preserve the vitality of U.S. hospitals as much as possible, the U.S. is experiencing severe economic consequences, and President Trump and his allies want to reopen the country to normalized business procedures.
A look at South Korea’s goals of relaxing social distancing measures may reconcile these opposing viewpoints. If officials are able to efficiently contain infected individuals and sanitize public locations, some areas may be able to be lifted out of lockdown, and some workers may be able to return to their jobs. This is a desirable end to achieve, but South Korea’s means may be hard to replicate. If the federal government decides to implement surveillance as widespread as that overseen by South Korea, resistance will inevitably follow. We will all have to ask ourselves, what is most important: our safety or our privacy? Additionally, our healthcare system may simply not be able to handle the crisis that Korea’s single-payer system did as efficiently or as equitably. If we are able to manage gaining control over the outbreak, will the most vulnerable Americans be left in the dust, as they always have been?
Even with all this uncertainty, one measure that South Korea heavily enforced has proven to be effective in many countries. That measure is widespread testing. Even though the U.S. may not be able to perform contact tracing with its large population as effectively as South Korea, it can allocate more of its national budget towards hospitals and producing accessible test kits. More tests are always valuable for pinpointing infections, and any contact tracing is still favorable. As officials more accurately track coronavirus infections and effectively contain the infected, public locations can be opened one by one, and the U.S. economy’s downturn can be mitigated. After the 2015 MERS outbreak, South Korea emerged as a stronger country with more vigilant officials and more efficient institutions. From the COVID-19 outbreak, our outcome will likely be the same.
0
0
Great analysis, Eric!
I do have to point out a couple of things you did not mention in your writing.
1. The “surveillance” measures in South Korea are not the types that many outsiders imagine them to be.
The govt. in S. Korea only used data available via one’s cell phone – the type of data that citizens are providing to GPS systems, Google, etc. The info. available for the public did not include any personal/ identifying information for an infected patient. It just notified those who may have come into contact with the infected patient. Nothing more invasive than my Google Map notifying me of an accident on Route 287 on my drive to MLHS.
2. There was also no country or statewide lock down/ shelter-in-place anywhere in South Korea (measures that many S. Koreans would be furiously opposed to), even when the infection curve was spiking upward.
Citizens themselves wore masks without the govt. prompting them to, socially distanced themselves in public, did not go out unless it was absolutely necessary, etc. Many restaurants operated as usual. It’s just that many people just chose to do only curbside takeouts because they refused to put others at risk.
3. I also noticed some fundamental differences in the ways that the govt. approached the pandemic. When masks were recommended by physicians in S. Korea early February, there was an immediate increase in the demand for masks. So the central govt. planned and aided the individual suppliers and pharmacies in selling these masks to the regular citizens without gouging the prices.
The central govt. invested significant efforts to have masks available to ALL citizens, including Korean citizens residing abroad and their families.
I and my American family via my significant other, have received benefits from this distribution of personal protective equipment. For citizens residing in nations where access to medical care was difficult, for instance Chad or Burundi in Africa, the govt. chartered airplanes to bring the citizens home if they wished. (They even brought some Japanese citizens on the same plane as a goodwill gesture to the neighboring nation.)
4. Like you mentioned in the article, there is a single-payer universal healthcare system in S. Korea. This healthcare policy extends to foreign residents in the nation as well. Foreign residents can use the medical services provided as long as they paid premium into the national insurance system while they worked in the country.
There were also efforts to test and bring medical care to those who were “undocumented” in the nation (many smaller communities have workers from southeast Asia, China, Africa, Latin America, etc. who work in smaller factories and farms) without fear of deportation. That helped in curbing infection among these workers who were often living in multi-family dwellings where social distancing was not always possible.
—
I do think that the Covid-19 pandemic brought the humanity in us everywhere.
I’m sure all of us can greatly appreciate the healthcare workers and other essential workers who risk their lives every day to help us live another day during this odd period. I hope that things return to normal in the New Jersey soon.