Italy and South Korea saw their first coronavirus cases in late January but they both had different testing responses and dramatically different outcomes. The takeaway: aggressive and sustained testing is a powerful tool for fighting the virus
MILAN/SEOUL - In Italy, millions are locked down and more than 1,000 people have died from the coronavirus. In South Korea, hit by the disease at about the same time, only a few thousand are quarantined and 67 people have died. As the virus courses through the world, the story of two outbreaks illustrates a coming problem for countries now grappling with an explosion in cases.
Thousands of miles away in South Korea, authorities have a different response to a similar-sized outbreak. They are testing hundreds of thousands of people for infections and tracking potential carriers like detectives, using cell phone and satellite technology. “I’m uncomfortable with enforced lockdown-type movement restrictions,” he said. “China did that, but China is able to do that. China has a population that will comply with that.”
This includes enforcing a law that grants the government wide authority to access data: CCTV footage, GPS tracking data from phones and cars, credit card transactions, immigration entry information, and other personal details of people confirmed to have an infectious disease. The authorities can then make some of this public, so anyone who may have been exposed can get themselves - or their friends and family members - tested.
“Disclosing information about patients always comes with privacy infringement issues,” said Choi Jaewook, a preventive medicine professor at Korea University and a senior official at the Korean Medical Association. Disclosures “should be strictly limited” to patients’ movements, and “it shouldn’t be about their age, their sex, or their employers.”
Decisions about testing hinge partly on what can be done with people who test positive, at a time when the healthcare system is already under stress. In Italy at first, regional authorities tested widely and counted all positive results in the published total, even if people did not have symptoms. Now, that system has been knocked off balance. Staff are being brought into accident and emergency departments, holidays have been canceled and doctors say they are delaying non-urgent operations to free up intensive care beds.
Intensive care facilities face the most intense pressure. They require specialist staff and expensive equipment and are not set up for mass epidemics. In total, Italy has around 5,000 intensive care beds. In the winter months, some of these are already occupied by patients with respiratory problems. Lombardy and Veneto have just over 1,800 intensive care beds between public and private systems, only some of which can be set aside for COVID-19 patients.
“You can do that if the number of cases remains two to three,” the doctor said. “But if they grow, something has to give. The system will implode if we continue to test everyone actively and then have to do all this.”In South Korea as in Italy, an early case of COVID-19 was identified when a medical officer followed their intuition, rather than the official guidelines, on testing.
Once the church cluster was identified, South Korea opened around 50 drive-through testing facilities around the country.
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