COVID-19: Lessons from South Korea

America can learn from what South Korea is doing right.

Confirmed cases of COVID-19 are rising in the United States and equity and debt markets are responding with panic and volatility—but South Korea may offer a practical model for community mitigation and hope for a prompt economic recovery. South Korea has just reported another drop in new daily cases after a week-long period of sustained escalation that saw its number of confirmed cases jump by 599 percent. Updating from Monday, the Korea Centers for Disease Control & Prevention (KCDC) reported 131 new cases—the lowest such figure since its peak of 909 on February 29. This decrease in newly confirmed cases may reflect successful implementation of South Korea’s strategy to control the COVID-19 epidemic. The outbreak is centered in one city, Daegu, and particularly among one religious sect, Shincheonji. Members presumably brought the virus back from a trip to Wuhan.

Surveillance and Diagnosis

In response, the government has been testing all members of Shincheonji as well as many others. The country’s testing program is available to all individuals—inclusive of undocumented immigrants—and is free to those with symptoms or a clinician referral. In addition to these relaxed criteria, the government has expanded access, making tests available at a large scale via 10 minute drive-through clinics. While this approach has created some controversy, the strategy may be working to slow the spread of COVID-19. This regime may offer lessons to the United States. A country less than one-sixth of the United States’ population has implemented a testing program that may be more than 200 times larger than ours per capita (although this calculation is limited by lack of public data from the U.S. Center for Disease Control). In contrast, the United States’ public health system has been slow in diagnostic test development and adoption, test kit procurement, and lab approval. While there are cultural, political, religious, and geographic differences between these two countries that limit direct replication of South Korea’s strategy, the slowdown in new cases in South Korea suggests that substantial mitigation can be achieved without locking down whole cities by government fiat.

Transparency

The South Korean government's open and timely provision of information is something we can learn from. These data reflect that the KCDC appears to be more transparent than our own CDC. Korean public health leadership is providing daily updates with a 48 hour lag—a sharp contrast to the lack of consolidated information on testing and new cases across the United States. In addition, the KCDC has moved with clarity and transparency to deal with identified cases. Individual quarantine and/or isolation was quickly imposed, schools closed weeks ago, and knowledge on effective treatments was documented. Announcements on affected communities and regions—as well as suspected sources of infection—are included in press releases updated daily at midnight. As we in the United States continue to mount a response to this outbreak, attention to the content and tone of our public health messaging will be increasingly important. The COVID-19 epidemic presents major challenges to our healthcare system, economy, and public welfare. Yet we have the advantage of being able to learn from the experiences of other nations. We can learn from South Korea’s approach of widespread testing in coordination with federal and state authorities, education of the public, and transparency with regular briefs. That is, if we choose to. Each day the window of opportunity to get in front of this epidemic narrows. Now is when our nation’s leadership matters most.