The system can’t be sustained

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The system can’t be sustained

 Kim Yoon
The author is a professor of health policy and management at Seoul National University and a member of health division for the JoongAng Ilbo’s Reset Korea campaign.

Herd immunity appears an impossible goal. Even if the entire population is vaccinated, it is very hard to achieve, given the highly contagious Delta variant and its resistance to vaccines. The U.K. and Israel are living proof as daily cases in the two countries, which have neared the threshold 70-percent vaccination rate, exceed ten times the number in Korea. In Israel, where 60 percent of its populations are fully vaccinated, many more new daily cases are being reported as a percentage of its population compared to Korea. We must come up with a plan to respond to regular Covid-19 outbreaks in years to come.

The current public health system is not sustainable. We cannot go on living under a de facto lockdown — Level 4 mitigation rules — simply because daily counts exceed 1,000. The damage is much greater than the benefits of such harsh rules. Four times more people are expected to have died from the social distancing measures last year than from Covid-19. Unaccountable social damage, like from the sick, elderly and disabled being left unattended due to a lack of care, are even greater. The economic toll on the self-employed and small merchants are estimated at 20 trillion won ($17.1 million) last year. Whether the government has the will and capacity to keep up compensating for such massive losses cannot be certain.

The fatality rate from Covid-19 has eased significantly. A death rate that hovered at 1.5 percent last year fell to below 0.2 percent in July. That means our environment has changed due to vaccinations of seniors and vulnerable groups. Covid-19 has turned into something like a flu owing to vaccine programs. Even if new cases increase as a result of eased distancing guidelines, deaths from Covid-19 won’t likely increase that much. If the fatality rate is contained at the level of influenza, deaths will likely remain at last year’s level even with 3,000 daily cases.

Our response should shift to sustainability. Instead of focusing on reducing new infections, public health authorities are required to lessen the fatality rate by offering better treatment to critical patients than before. The restrictions on private gatherings and head counts in public facilities like restaurants and cafes should be lifted first because the measures have hardened and fatigued people. Even after private gathering regulations are eased, the authorities need to require people to wear masks and get tested after coming into contact with infected people to contain a surge in new cases.

The turning point in our approach can come in mid-September once adults aged 50 and older are mostly vaccinated. After they are vaccinated, the death rate could come down to the level of influenza. Readiness from now on to the quarantine system change could ensure a number of beds, medical professionals and test capabilities even when patients increase. If 15 percent of the intensive care units are reserved for Covid-19 patients, beds won’t be short even when daily cases reach 10,000. Intensive care beds would be enough if less urgent patients defer surgeries.

The government must stop its crying-wolf-like approach. It has anguished the people by extending the rigorous social distancing measures every two weeks without specific goals or strategy. What it initially promised to be a “tough and short” period of Level 4 has lasted more than six weeks. Distancing measures have been barely effective in containing the virus. Even under such rigid rules, daily cases have soared to 2,000.

The government must set clearer goals and strategy on Covid-19. It must announce when people can dine freely with family and friends after they are inoculated. It must clearly explain the target for serious infections and fatality levels to balance the quarantine and daily lives. It is as important to gain understanding and support from the people in shifting the public health system as preparing administrative steps according to the transition.
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