Preemptive action is key

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Preemptive action is key

Korea’s Patient No. 80 was treated for Middle East Respiratory Syndrome (MERS) for 116 days - so far, the longest period worldwide - and finally made a full recovery just a few days ago.

Following this development, the country can finally declare that the nationwide MERS outbreak will be officially over as of Oct. 29. Such outbreaks had a great impact on global society last year and again in 2015.

As an internal medicine doctor treating infectious diseases and witnessing firsthand the effects of the Ebola epidemic in Africa and the MERS outbreak here, I have experienced both the good and the bad in our society.

I was dispatched to Sierra Leone in February as the head of Korea’s second emergency relief team to fight the Ebola outbreak there. It was the first time Korea had sent a relief team to an international epidemic site. Although various countries volunteered to send medical teams, only about 10 countries were actually capable of treating Ebola patients, and Korea was one of them.

Most impressive was the principle of wearing protective suits and gear, which could never be loosened in the field. During my third week into the tour, I became so used to wearing it, but a field worker who was checking on my condition ordered me to change my suit twice due to a small scratch. The temperature was over 35 degrees Celsius (95 degrees Fahrenheit) and my body was covered in sweat, but it reminded me that wearing a safe and protective suit was fundamental for protecting myself. I learned an important lesson: The readiness to fight an infectious disease starts with staying loyal to these fundamental protections.

After the government decided to send a team to the field and those teams were actually dispatched, officials discussed various measures in case of a possible outbreak in Korea. But once our mission ended in March 2015, all these policies that were cited as necessary quietly disappeared.

After the Ebola epidemic was forgotten, news spread that Korea had confirmed its first MERS patient on May 20. After an infection was reported at Samsung Medical Center’s emergency room on May 29, I realized the situation was serious. I knew that, once again, an aggressive response in the early stages was the only way to prevent the spread of an infectious disease.

On June 8, the government and the medical sector created a joint task force of quick response teams, and I became a member. I visited a mid-size clinic outside Seoul where the infection had spread to provide consultation on managing the MERS patients, those exposed to them and the hospital’s recovery process.

As I observed MERS infections in several hospitals and consulted with staff there, I reached the conclusion that the following measures are necessary:

First, mid-size hospitals must improve their infection control capabilities. Currently, an infection management office is required for hospitals with more than 200 beds and intensive care units. But this is an opportunity for all hospitals to establish infection management offices. This can only be accomplished with financial support from the government, which then must reinforce the monitoring of these operations.

Second, an inter-ministerial team must be established in the government to support infection management and education at small and midsize hospitals, and administrative support must be provided over the long term.

Third, local clinics and hospitals should form cooperative ties with university hospitals in the region.

I also have some suggestions for the country’s medical system to counter the infectious diseases:

First, the government must introduce standardized negative pressure rooms to manage infectious respiratory diseases.

Second, the state-run health insurance program must pay for preemptive one-person ward quarantine measures until a diagnosis is made on a respiratory infection.

Third, an improved nursing system should be established as soon as possible so that patients’ families aren’t left having to assist their sick relatives. Visiting hours should also be restricted.

Fourth, the government must provide financial assistance to resolve the high flow of patients in general hospital emergency rooms and create treatment quarters for infectious and non-infectious cases inside emergency rooms.

Five, a hospital specialized in infectious diseases should be created to handle a nationwide outbreak in the initial stage. In normal times, it should be used to study the global trend of different outbreaks and collect information.

Six, training the manpower capable of handling an outbreak is urgent. Training enough nurses, internal medicine doctors and epidemiologists is the stepping stone for managing infectious diseases.

Infectious disease control and prevention are long-term tasks. Enough financial resources should be allotted and an environment should be created in which to allow hospitals and clinics to voluntarily join this system. Many policies presented by the Centers for Disease Control and Prevention and civilian experts have often been scaled down or scrapped during the budget evaluation process.

Even after the influenza pandemic in Asia and global panic over Ebola, Korea’s policy on infectious diseases has not changed significantly.

The MERS outbreak, therefore, dealt a serious blow to the country. Foreign tourists avoided visiting Korea and the economy was shaken by the decline in domestic consumption. It is my hope that the painful experience of the MERS outbreak will serve as a bitter but important reminder that Korea’s policy on infectious diseases must be updated and drastically overhauled.

Translation by the Korea JoongAng Daily staff.

*The author is professor of infectious disease at Hallym University Medical Center.

by Lee Jae-gap

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