MERS revealed flaws in systems

When Korea’s first Middle East respiratory syndrome (MERS) patient was confirmed positive on May 20, the country knew little about the potentially fatal virus.

The learning curve was steep and the price of slowly figuring out how to deal with it high. South Korea’s outbreak was soon the largest outside Saudi Arabia, where the camel-borne disease was first detected in 2012. As of Sunday, the total death toll in Korea rose to 32. Fifteen out of 182 MERS patients are in critical condition and 2,562 people remain quarantined. The effect on the local economy has been severe enough to prompt a supplementary budget by the government.

The news that the number of patients remained unchanged Sunday from the day before for the first time in eight days was a ray of hope that the worst was over.

But analysts say an overhaul of Korea’s health system is needed if the country hopes to respond to future crises any better.

A joint mission by the World Health Organization (WHO) and Korea’s Ministry of Health and Welfare offered several insights into how the country fumbled so badly in the early stages of dealing with the outbreak. Its main points: the government failed to act swiftly on the release of information; regional governments failed to anticipate the MERS outbreak in their areas; physicians showed a lack of knowledge about the infection; and the overall culture of medical facilities was not geared up for defensive action.

In a series of interviews with reporters from the JoongAng Ilbo, professors from leading medical institutions said the crux of the problem might be something more fundamental. Many say a restructuring of relevant governmental organizations is absolutely needed.

“The greatest reason why this catastrophe has grown so out of control,” said Kim Yun, a professor at Seoul National University College of Medicine, “is the failure of the initial response.

“There needs to be a clear, legal basis explaining who the center of crisis control will be in such a state of emergency, what authority it holds and how they will manage to deal with the situation,” he said.

Kim said the role of the Korea Centers for Disease Control and Prevention (CDC), a research center affiliated with the Ministry of Health and Welfare, needs to be strengthened.

“For the CDC to demonstrate their professionalism [at times like these], they should be guaranteed independence [from the central government] and be able to train personnel from within their own pool,” said Kim.

“They shouldn’t be wasting time visiting laymen in the [top ministerial posts] and the presidential office to brief them about MERS.”

But a former insider said he does not have much hope for the CDC considering the way it is managed in the government.

“There’s no way the CDC can operate properly when you have the Health Ministry taking personnel from the research center whenever they want, and replenishing those vacancies with people who are just short of retirement, or utterly incompetent.”

Jun Byung-yool, a former head of the CDC and now a professor at the Graduate School of Public Health at Yonsei University, offered more details about that authority over personnel, arguing that the lack of autonomy is what kept his staff from feeling pride in their work.

That is especially the case when in Korea, private doctors are often hired by the government to temporarily work as health officials in national emergencies like MERS.

“What’s the use of running the CDC [when private doctors are doing most of the work it should be doing]?” asked Jun.

The country must prove to young, aspiring medical workers that they can have promising futures at the CDC, working with pride by contributing to the country and society, Jun added.

Ever since the CDC was founded in 2004, the number of staff has dwindled from 481 to 427 in spite of the center’s constant requests to the government for an increase. More than half of the 427 workers - 268 - hold temporary positions. Of the permanent employees, only two are epidemiologists.

In explaining why the CDC lacks a competitive edge, Jeong Rye-hyeon, chief of general affairs at the center, cited the meager paychecks staff receive compared to their colleagues in the private sector. The very location of the CDC is an issue.

“It’s headquartered in the Osong industrial site in North Chungcheong,” Jeong said. “Who would ever want to come all the way down here?”

Osong is 130 kilometers (80.77 miles) south of Seoul.

Some experts claim that the Ministry of Health and Welfare should be split into two ministries, one focusing on health and the other welfare. That idea is backed by recent data showing the ministry had funneled most of its budget to the welfare sector this year.

Of its 53.4 trillion won ($47.5 billion) annual budget, only 4 percent goes to health and medical treatment.

BY SPECIAL REPORTING TEAM [lee.sungeun@joongang.co.kr ]