When the gradual recovery of daily life (with Corona) started on November 1, last year, the government presented a 75% utilization rate for critically ill beds as an ’emergency plan’ standard. If the intensive care unit is more than three-quarters full, it will stop normal recovery and strengthen social distancing.
After recovering from daily life, the number of new coronavirus infection (COVID-19) confirmed cases increased, and the utilization rate of intensive care beds in the metropolitan area recorded 76.4% in just a week. At the time, experts raised their voices, saying, “You should immediately stop your daily recovery.” However, the quarantine authorities strengthened the quarantine to ‘6 people in the metropolitan area and 8 people in the non-metropolitan area’ only on December 6, three weeks ago. Two days later, on the 8th, the daily number of confirmed cases soared to 7,173, and on the 18th, the number of severe cases exceeded 1,000, and a medical vacuum became a reality.
After about two months, the quarantine authorities again stood at a crossroads. This time, the problem is the timing of the transition to the ‘response phase’ of the omicron mutation. At the time of the announcement on the 14th of this month, the government said, “If the daily number of confirmed cases exceeds 7,000 in a single day, we will enter the response stage.” This criterion was met with 7008 new confirmed cases on the 22nd. Experts say, “We must not repeat the mistakes of the fourth wave,” but the government is hesitating again.
○ Expect 40,000 or 50,000 a day after Lunar New Year… “To change the system now”
In December of last year, when the delta mutation was the dominant species, the medical system reached its limit when there were 7,000 confirmed cases per day. Omicron mutations have a severity rate of one-fourth that of delta. Considering this, it is estimated that the ‘threshold’ of daily confirmed cases during the Omicron epidemic is about 30,000, four times the level at the time. The problem is that, because of the explosive propagation power of ohmic mutations, it is highly likely that this threshold will soon be exceeded. Kim Tak, a professor of infectious disease at Soonchunhyang University Bucheon Hospital, said, “The number of confirmed cases almost doubled in a week. “There will be 40,000 to 50,000 daily confirmed cases,” he said. As expected, there are only ten days left before the health care system reaches its limits.
The government seems to be delaying the transition to the Omicron response stage. On the 20th, the quarantine authorities changed the standard for the transition period from ‘7,000 daily confirmed cases’ to ‘average of 7,000 cases in Korea alone’. On the 21st, he said, “I will decide based on not only the mechanical ratio, but also the inconvenience and acceptability of the people.” Eom Joong-sik, a professor of infectious diseases at Gachon University Gil Hospital, said, “We need to shift to the Omicron response stage right now and prepare for an explosion of patients after the Lunar New Year holiday.”
○ The medical community criticized for “lack of time due to lack of government preparation”
It is also urgent to reorganize the operating system of medical institutions, which is the core of Omicron’s response stage. In preparation for an increase in the number of mild and asymptomatic patients, the government’s original plan was to strengthen the roles of local clinics and respiratory clinics, and to focus on treating patients with severe symptoms in infectious disease hospitals and large medical institutions above the general hospital level.
However, only 43 respiratory clinics in Gwangju, Jeollanam-do, Pyeongtaek-si, and Anseong-si, where the spread of Omicron is steep, decided to take charge of diagnosis and treatment of COVID-19 from the 26th. According to the quarantine authorities, there are currently 654 respiratory clinics across the country, but only about 100 of them have negative pressure facilities. Kim Nam-joong, a professor of infectious disease at Seoul National University College of Medicine, said, “It is expected that we will even have to see patients with COVID-19 at a respiratory clinic that does not have a negative pressure facility.”
Even if frontline lawmakers want to participate in COVID-19 treatment, unrealistic guidelines such as ‘a 24-hour doctor must be on duty’ are blocking the way. Another problem is that the drug administration system for edible drugs is not properly utilized in the field. Kim Woo-joo, a professor of infectious disease at Korea University Guro Hospital, said, “In the end, because of the lack of preparation in advance, even if the government wants to change the quarantine system, it cannot do it.”
Reporter Lee Ji-woon easy@donga.com
Correspondent Kim So-young ksy@donga.com
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