Insensitivity is the culpritWhy is Middle East respiratory syndrome (MERS) spreading so quickly? There is no clear answer and people are uneasy. It was thought that one patient infects less than one person on average, but in Korea, one patient infected more than 15.
Has the MERS virus, which has a high fatality rate, become more infectious? We do not have an answer to that question either. Tests are currently ongoing.
Have Korean authorities failed to contain the situation at the early stage? Do small clinics and mid-size hospitals in Korea lack proper infection prevention protocol? Does the public have a low understanding of safety? We know the answers to those questions because the answers are all the same: Yes.
First, the authority has failed to track the movements of the first patient. After showing symptoms, he visited four hospitals until the health authority was notified. Because the authority failed to quickly track him down, along with the people he contacted at the hospitals, thousands of people had to be quarantined.
The government also hesitated because it feared complaints about the quarantine. The authority also failed to think about the hands of the many medical workers at the hospitals, as well as the door knobs and faucets of the poorly managed hospital wards.
Officials did not check the risks themselves by visiting the wards, so they could not see that there was no ventilation system to prevent the easy spread of the virus to other patients, families and caretakers. Because they just relied on clinical tests, they could not identify the people contacted by the infected and take necessary measures to break the epidemiological chain. This is the direct cause of the failed MERS containment.
The government should have declared a large quarantine area and controlled the people.
Second, it has been three years since it was predicted that the virus would enter the country from the Middle East and spread at hospitals, but the government failed to take proper precautions. In order to prevent infections at hospitals, doctors and medical workers should have been educated thoroughly so that they would ask patients about any history of travel to the Middle East. Any possible MERS patients should have been treated by medical staff wearing protective gear. And yet, none such measures were taken.
Of course, doctors and medical workers have things to say. They should have been notified at least by telephone that patients with fevers are visiting, they say, but that was never the case. That is the result of the lack of promotion by the government and the medical community.
All suspected patients should be moved to a single room, hand sanitizers should have been placed at all wards and visitors should have been strictly restricted. But all of these steps failed because of the poor condition of Korea’s small and mid-size hospitals. Although it is late, the cost of using a single patient ward for a MERS patient must be rationalized and the medical system should be modified so that infected patients are not treated separately.
Third, Korean society still has no sense of public safety. The government should have warned people visiting the Middle East to stay away from camel farms, refrain from consuming camel dairy products and contacting MERS patients. It is unclear if immigration and quarantine authorities have been informing travelers properly and if the Ministry of Foreign Affairs has been effectively warning them through mobile phone messages.
We must also think about whether the Ministry of Culture, Sports and Tourism had informed the travel agencies properly about trips to the Middle East.
One of the patients had visited Saudi Arabia but failed to mention that to the medical authorities. We must also think about whether he failed to disclose this because of a poor sense of safety or some fault of the government.
Fourth, it was wrong to treat MERS with an outdated manual to counter a new infectious disease. It has been three years since the disease was discovered. Is it really a new disease? If we do not know about this disease, it should have been treated as a new epidemic. But there are already enough cases and experience with MERS, so it is wrong to call it a new disease.
There is already a law governing how to counter the SARS virus. Now is the time to include the menacing Category 4 infectious diseases in the Category 1 and treat them. Regulations should be established to provide medical expenses for quarantines and forcing businesses to shut down.
More than 20 million people cross our border every year. A quick medical response team and an epidemiologic research organization for infectious diseases from overseas must be created and their work should be handled by professionals.
Fifth, there is neither a vaccine nor a cure for MERS, and the supply of test reagents was limited. Who is to be blamed for having failed to properly invest in this? The private market was not created because there were so few patients. That does not mean that the government should not invest for the safety of the public. An infectious disease is a field in which the government must invest first and open up a market for private businesses.
Last, there is a need to quickly stop the negative attitude toward international cooperation and global health security. The international community concluded that there was no need, until now, to restrict trips to Korea based on trust in the government’s countermeasures to fight infectious diseases. But since a patient left the country, the government must quickly and transparently provide data to avoid any possible doubts.
In order to reduce negative impacts on tourism, the government must share information with other countries about the virus and other patient information in order to maintain international confidence. Some foreign media’s negative reports should be countered quickly by the government by providing accurate statistics and information.
When the Ebola outbreak started, Korea cooperated with other countries. Now there is a reason for us to cooperate with other countries again. The World Health Organization should also be utilized to overcome this crisis.
Translation by the Korea JoongAng Daily staff.
JoongAng Ilbo, June 5, Page 29
*The author is the director of JW Lee Center for Global Medicine at Seoul National University and the former head of the Korea Center for Disease Control and Prevention
by Lee Jong-koo