Key rule in public health crisis: communication

A healthcare worker takes a specimen from a passenger at a drive-thru COVID-19 testing facility at Kyungpook National University Chilgok Hospital compound in Daegu, Feb. 27. /Korea Times file

This is the fourth in a five-part series on Korea's response to COVID-19, produced in collaboration with the Korea Foundation _ ED.

By Kim Se-jeong

Late in the night of Feb. 18, directors of big hospitals in Daegu including the Kyungpook National University, Keimyung University Daegu Dongsan were all active in a Kakao group chat with the city's mayor and other officials.

Earlier in the day, the city's first COVID-19 case had been confirmed, followed by 10 additional cases through the night.

Medical doctors, including Min Pok-kee, a dermatologist and the vice president of Daegu Medical Association, stressed the priority would be getting enough beds and shared ideas.

The next morning, Min called Cho Chi-heum, director of the Keimyung University Daegu Dongsan Hospital, and got his agreement to empty out one of their two medical centers to receive only patients suffering from COVID-19.

At the time, Daegu only had 25 patient beds in an area with negative pressure ventilation installed.

Min also called the Armed Forces Daegu Hospital located just outside the city for help in getting extra beds ready and wrote letters to the Ministry of National Defense and the Ministry of Health and Welfare requesting approval for the plans.

By Feb. 24, six days after the first case had been reported in Daegu, the Armed Forces Daegu Hospital had 303 beds with negative pressure ventilation, and Dongsan Hospital had almost 400 rooms ready for COVID-19 patients.

Those who were in the Kakao group chat were members of Medi-City Daegu, an association founded in 2009 to improve the quality of medical services for residents and promote quality medical services for patients outside Korea, and they had been routinely communicating through offline meetings and online chats.

Min Pok-kee, a dermatologist and the vice president of Daegu Medical Association/ Courtesy of Min Pok-kee

"Without the communication among members of Medi-City Daegu and the fast decision-making process, the COVID-19 outbreak in Daegu would have resulted in a collapse of the city's medical system and a mega-size medical crisis for the country," Min said during an interview with The Korea Times.

Min headed the Daegu Medical Association's response to the COVID-19 pandemic which gave him a rare opportunity to see the city's response to the virus from the first day.

Min also noted Medi-City Daegu's network in China for Daegu's successful response.

"As early as January, we had information from China that many people had been dying from a virus whose infection route and source were unknown. We knew for sure that Korea would come under attack because of its vicinity and Medi-City Daegu members were already discussing how to respond to it."

Daegu experienced the worst of the country's pandemic.

Following its first case on Feb. 18, the number of accumulated infection cases spiked to 1,017 by Feb. 27. On Feb. 29 alone, 741 new cases were reported. Most of the patients were members of the Shincheonji Church of Jesus and those who had been in contact with them.

However, on April 10, less than two months after the first case was reported, the number of new cases went down to zero. As of Monday, the total number of infected cases in Daegu was 6,934, with 186 deaths. Nationwide, the total number of cases was 11,704 with 296 deaths on Sunday.

Daegu's success offers essential instruction for Korea's successful COVID-19 response which has been praised by government officials and healthcare service providers from many countries around the world grappling with the new infectious disease. It proves the importance of communication in a crisis.

The core pillars of Korea's anti-COVID-19 efforts are aggressive virus testing and actively tracing the whereabouts of patients' contacts in order to contain the spread of the virus.

Daegu had the aggressive testing too.

The city had a drive-thru testing facility, the nation's first, installed at Kyungpook National University Chilgok Hospital, Feb. 22. By March 13, it had become a national standard for such virus testing facilities.

"This enabled increased testing. With our existing equipment and human resources, we could only take a maximum 640 specimens per day," Min said. By July 5, 288,713 virus tests had been done.

What other cities didn't have was healthcare service providers moving around the city taking specimens from people with disabilities.

"Almost 400 public health doctors ― including medical students doing their military service ― were dispatched to Daegu from all over Korea and they moved from one city's elderly care facility to the next and a home of one Shincheonji Church of Jesus member to the next to take specimens," Min said. "They really did a lot of work. They're unsung heroes."

And the city authorities were busy tracking phone calls of the patients to find potential virus carriers.

Min also noted the work of officials from the Ministry of Health and Welfare and the Korea Centers for Disease Control and Infection (KCDC) in the field in facilitating the response effort.

For example, they required the emergency rooms in Daegu to stay closed for two days after receiving each virus patient for quarantine.

"But how can they stay closed for two days when you only have a limited number of ERs in the city? With so many new cases every day that could mean all the ERs closed. Also, keeping ERs closed presented risks to other patients needing urgent care," Min said.

The health ministry and KCDC officers in Daegu took note of changes that were needed urgently and communicated with colleagues at their headquarters so that the rules could be revised.

"We needed rule changes and saw them happening," Min recalled.