Covid-19 broke out in Korea and Italy almost in the same period, but the epidemic situation in the two countries was changing in two different directions, especially the number of deaths.
In Italy, tens of millions of people are living in a blockade imposed across the country amid the death toll of Covid-19 in the country that surpassed the 1,000 mark. But in South Korea, the time when the outbreak was similar to Italy, only a few tens of thousands of people were frozen and only 67 died.
As the virus continues to spread and rapidly around the world, the story of Korea and Italy has become a clear illustration of the problem that other countries will encounter, if the number of infections suddenly soars.
What to do when unable to do like China?
It would be unrealistic to test Covid-19 for all people potentially at risk of infection, but for health officials from other countries, the best answer is to isolate by region and then test to localize it. the spread of disease.
Italy started by implementing a blockade on a large scale, then narrowing the siege and focusing on areas with high levels of infection. This would save them from having to process hundreds of thousands of samples every day, but there was one trade-off: they would overwhelm the nation of 60 million people because of the blockade.
Even Pope Francis, who is suffering from a cold and must perform Vatican ceremonies online, said he felt like “locked up in the library”.
Tens of thousands of kilometers away in South Korea, the government takes a relatively different approach to a Covid-19 outbreak of the same size as that of Italy. Hundreds of thousands of people have been tested for coronavirus and suspected people are monitored and controlled through satellite technology and smartphones.
Both countries detected the first cases in late January, and since then Korea has recorded 67 deaths out of a total of 8,000, after testing more than 222,000 people. Italy, meanwhile, has recorded 1,266 deaths and more than 17,000 infections while testing only 73,000 people.
Epidemiologists say that it is difficult to directly compare the numbers of the two countries, but these differences suggest that they are subjected to large-scale drastic testing as an effective tool to combat spread. of the virus.
Jeremy Konyndyk, senior researcher at the Center for Global Development, a Washington-based thinktank, said that extensive testing could give countries a more complete picture of the extent of outbreaks. Translate. But if testing capacity is limited, he thinks the government must take more daring actions to limit the movement of people.
“I feel uncomfortable with imposing travel restrictions. China does that, but China can do it because the Chinese will comply with that,” Konyndyk said.
Compared to China, South Korea and Italy are more suitable models for the United States or other European countries to learn in the event of a Covid-19 outbreak.
South Korea relies on technology and big data
South Korea, with a population of 50 million, has about 29,000 people quarantining themselves. The blockade took place on a small scale, with at least one residential area where the infection rate was high. So far, no region of Korea has been completely blockaded.
Seoul said the government learned the lesson from the MERS outbreak in 2015 and tried to make the information as transparent and broadly as possible to the public. South Korea conducts tests on a large scale, including those with mild or asymptomatic symptoms.
The government also collects and processes big data from a variety of sources: public cameras, GPS from smartphone and car mapping applications, credit card transaction history, log-in and information history personal information – then publish this data so people can actively test if they think they might be infected.
In addition to helping monitor infected people, Korea’s large data system also helps hospitals manage patients well. People who are positive for Covid-19 will be isolated and monitored remotely via the smartphone app, and checked regularly by phone calls from medical staff.
When an empty bed is available, an ambulance will pick you up and take you to the quarantine hospital, all for free.
However, this approach must also be exchanged for something that is the privacy of citizens. It is unacceptable to publish personal information and travel history of infected people in Western societies. Although China and Singapore also apply similar measures, many South Koreans are outraged.
“Disclosure of patient information is always accompanied by privacy issues,” said Choi Jae Wook, a professor of preventive medicine at Korea University.
Kim Gang Lip, Deputy Minister of Health and Welfare of Korea, said traditional measures such as blockade and isolation were only effective to a certain extent, and would have a negative impact on social life. . According to Mr. Kim, such an approach is “conservative, coercive and inflexible”.
Italy has difficulty due to limited testing capacity
Tens of thousands of kilometers apart, there are many similarities between Italy and South Korea: the outbreak was a small community, instead of a megacity. As a result, the healthcare systems in these towns soon became overloaded.
In Italy, it all started a month ago when the 38-year-old man went to the hospital with flu-like symptoms, but doctors did not test him for Covid-19 because he did not go to China – a test criterion in official instructions – instead of sending the person home.
When the symptoms did not go away, the person returned to the hospital but was still not tested, until a doctor decided to ignore the regulations and take the Covid-19 test for the patient. As a result, this man was positive, and could have infected many people during that precious time. Experts now think he got Covid-19 from Germany, not China.
The determination of testing criteria is always very difficult, in the context that testing capacity is limited and the health system is overloaded. In Italy, the government initially mandates extensive testing, and statistics of all positive cases even if the patient is asymptomatic.
After a while, Italy changed its testing tactics, applying and statistics only symptomatic cases. Officials say this will help make more efficient use of resources because the risk of infection of asymptomatic people is lower, and less testing also results in faster results. However, the greatest risk of this approach is that people who are asymptomatic can still contract the virus and spread the disease to others.
On the other hand, the more tests you get, the more you’ll get Covid-19, and that will overwhelm the health system. Although Italy has a highly regarded health system, with the same level of public health expenditure as South Korea, it is currently operating outside of the designed capacity, especially with specialized care rooms. distinct.
The health system is pushed to the limit
Pier Luigi Viale, head of the department of infectious diseases at Sant’Orsola-Malpighi Hospital in Blogna, is working around the clock in three different hospitals. His hospital is treating a series of Covid-19 infections. His doctors are busy helping other hospitals and clinics in the area. In addition, there are serious patients who suffer from other illnesses.
“If things go on for weeks or months, we will need more reinforcements,” he told Reuters.
Last week, the mayor of Castiglione d’Adda, a 5,000-people town in Lombardy, went online to call for emergency relief. He said the small hospital in the town had to close because of full capacity, and he had only one doctor treating more than 100 patients with Covid-19. Three of the town’s four doctors are in isolation.
“Doctors and nurses are on the limit. If you have to take care of ventilators, you need to monitor them constantly, you won’t be able to take care of new patients,” said a Lombardy nurse. know.
The study found that each case of Covid-19 infection would infect two people on average, so local officials in Lombardy warned that the healthcare system there would be in crisis if the trend spread. continue as it is now. And if the disease spreads to the less developed southern region of Italy, the situation would be many times worse.
The most pressing is the intensive care unit (ICU). To operate, these facilities require specialized doctors and expensive equipment, and are not designed for widespread disease outbreaks. Italy has about 5,000 intensive care beds, and during the winter months, many beds will be available for patients with respiratory problems.
Lombardy and Veneto are the two most developed regions of the country, and there are about 1,800 ICU beds here, including private and public hospitals.
Another burden is on Italy’s health care system, and the reliance on health workers to keep track of people exposed to people with Covid-19.
A doctor in Bologna, who requested anonymity, told Reuters he had to spend 12 hours a day monitoring the health of people who were in contact with a positive patient, to ensure timely detection of the case. next.
“You can do that if the number of cases is 2 or 3. But if it goes up, you’ll have to skip something. The system will be shattered if we continue to actively test people and then work. like this, “said the doctor.