Why are women in their 20s more susceptible to coronavirus in Korea?

Shinchonji Church founder and chairman Lee Man-hee speaks about the coronavirus during a news conference at the cult's mansion "the peace palace" in Gapyeong, Gyeonggi Province, on Mar. 2. / Yonhap

Japan's lessons for Korea in COVID-19 fight

By Oh In-gyu

It's been over two months since the outbreak of the Coronavirus, or COVID-19. As of March 9th, Japan has 1,198 confirmed patients (705 of which are aboard the Diamond Princess cruise ship) with 14 deaths, while South Korea has 7,313 patients with 50 deaths.

Why is there this huge difference in both patient numbers and deaths?

The reason is threefold. First, Japan and South Korea have different quarantine policies for the epidemic; second, their social institutions are widely different; and third, Korean attitudes toward young women are harsher than in Japan.

The South Korea epidemic data stands out as a unique case. While most patients are males in their 50s and over in most countries, in South Korea it is the women in their 20s who are most affected. As of March 5th, 63 percent of total COVID-19 patients in South Korea are women, while it is only 38 percent in Japan. Without expecting this blatant outbreak among women, the government concentrated on testing male patients in their 50s and over, especially those who had travelled to Wuhan, China. Initially, health officials could successfully curtail the outbreak by relying on their world class testing kits and methods. Until Feb. 20 the number of confirmed patients had not surpassed 104.

The success of the initial response by the government to the epidemic, however, made the officials in South Korea overly proud and confident. President Moon, for example, appeared on TV and even proclaimed the foreseeable end of the epidemic in South Korea on Feb. 13th.

The quarantine policy in Japan was quite different from the Korean counterpart due to the incident of the Diamond Princess which anchored in Yokohama on Feb. 3. Quarantine officers were not equipped with rapid testing kits, nor were they instructed about the procedures of testing and quarantining a mammoth ferry ship. Due to the initial difficulty of testing and sequestering infected patients from the rest, Japanese authorities decided to quarantine the entire ship. While those who tested negative twice were finally allowed to depart from the ferry on Feb. 19th, the ship remains sequestered from the rest of society.

Therefore, the Japanese policy from the beginning was shutting down big structures, such as mammoth ferry ships, public buildings, baseball parks, and schools that attract mass congregating. The government also launched a campaign of asking citizens to behave cautiously by avoiding unnecessary gatherings and contact with other people.

The second difference between the two countries is not only the quarantine policy per se, but the sociological aspect of the epidemic as well. When any epidemic occurs, it has both pathological and sociological causes and consequences. To fight the disease, each government therefore must address both aspects of the problem. The South Korean government failed to address the sociological side of the problem.

Oh In-gyu, professor of Social Policy at Kansai Gaidai University, Japan / Courtesy of Oh In-gyu

During the MERS epidemic in 2015, scholars in South Korea noticed that hospitals had been important epicenters of the epidemic, as it is traditionally part of Korean culture for family members and friends to visit patients to give care and stay with them until late at night. Hospitals have also been culturally reticent by not strictly enforcing Western style visiting policies. Consequently, many hospital visitors were infected after such visits. Five years later, the same incident occurred in Daenam Hospital, Cheongdo, where 108 people were diagnosed with COVID-19.

What is more serious than the failure of quarantining hospitals is the lack of the government intention to analyze the structure of social institutions. Sociologically speaking, South Korea has several socially salient organizations where massive numbers of people gather routinely. Those culturally specific mega structures are schools (ten million students), churches (seven million protestants), and army bases (600,000 soldiers). These three mega structures are where interpersonal contacts are very frequent in terms of handshakes, sitting next to each other very closely for a prolonged period, and eating together or sharing food and drinks together.

Today, the biggest epicenter of the epidemic is the Sincheonji Church in Daegu, where congregation members are mostly women in their 20s. The total number of the infected patients in Daegu alone is 4,326 people (78 percent of total patients) as of March 5th. The Diamond Princess is to Japan what Shincheonji is to South Korea. Had the government paid attention to these mega structures and restricted mass gatherings in time, the entire fiasco would have had a totally different outcome. Although schools were shut down in time, the army barracks were slow to quarantine their premises by allowing returning and new soldiers without testing or quarantining. The R.O.K. Army now has 34 infected patients with 5,920 others remaining in quarantine.

Largely missing from Japanese society are the incompetent hospitals, the gigantic protestant churches (280,000 followers), and the immense army bases (240,000 personnel) as super spreaders. Japanese hospitals do not have lenient visitation practices, making them free of mass infections. Given the small size in each church, no coronavirus outbreak has been reported among church goers. According to the Defense Department report of Feb. 25th, the military has also strictly cancelled all activities that involve inviting outsiders to maintain its full quarantine status.

Finally, the third difference is the large outbreak among women in their 20s in South Korea. This augurs the failure of South Korean society to fight mental depression among young women. The country has the world's highest female suicide rate as of 2016 (14.1 suicides per 100,000 people). This is far higher than the third ranked Japan with 8 suicides per 100,000 people. Why so many women decide to take their own lives in South Korea is a complicated sociological issue. What is clear is that these women have no social support system other than the church.

Japan and South Korea are model democracies with economic affluence in Asia. However, their handling of the COVID-19 epidemic is widely dissimilar. The sociological aspect of the epidemic deserves both governmental and professional attention.

Oh In-gyu is a professor of Social Policy at Kansai Gaidai University, Japan. He has been working in a government funded research team in South Korea for the study of epidemics (2016-2020). He has also worked in Seoul for a private think tank that specializes in the prevention of nuclear catastrophes (2012-2014).