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‘Seoul hospitals on the brink of being overwhelmed’

Experts suggest prioritizing urgent cases to ease bed shortages

Dr. Bang Ji-hwan of the National Medical Center speaks to reporters during a briefing Sunday. (Yonhap)
Dr. Bang Ji-hwan of the National Medical Center speaks to reporters during a briefing Sunday. (Yonhap)

Korea has to raise the bar of admitting COVID-19 patients to hospitals based on likelihood of severe illness to prevent bed shortages, doctors at the National Medical Center said Sunday.

“Most mildly ill patients recover from COVID-19 without needing interventions. These patients can be discharged faster to free up space for more severe patients,” said Dr. Oh Myoung-don, leading the central clinical committee for emerging infectious diseases.

Based on the committee’s analysis of 3,060 patients aged 18 or older whose clinical course has been observed for at least four weeks, only 1.8 percent of “low-risk” patients developed severe symptoms requiring oxygen support. Patients falling under the low-risk category are adults younger than 50 years without underlying health conditions and who did not have symptoms such as shortness of breath or breathing difficulties at the time of diagnosis, Oh explained.

The state-run hospital’s Director Dr. Chung Ki-hyun said if the criteria for admission at and discharge from hospital go unrevised, the bed shortage crisis witnessed in Daegu and North Gyeongsang Province -- which suffered Korea’s biggest outbreak -- will be “inevitable” in the metropolitan region.

Now, a patient has to test negative twice in a row with a 24-hour interval in order to be deemed recovered and released.

Dr. Bang Ji-hwan, who is also on the NMC committee, said high-risk groups should be given priorities in getting a hospital bed to reduce the fatality rate.

While there existed a fraction of cases in which low-risk patients progressed to severe stages, the costs of keeping them at hospitals and subsequently delaying care for patients in at-risk groups were far too high, he said.

“COVID-19 isn’t a disease that can be stamped out like the Middle East respiratory syndrome. This is a marathon, not a sprint,” he said. “The realistic objective has to be minimizing deaths from the virus rather than stopping the transmission altogether.”

He said the catastrophe in Daegu is largely attributable to the adherence to the MERS standards when there was less understanding of COVID-19.

“Patients who were only minimally sick were kept hospitalized for isolation purposes, in turn denying treatment opportunity for more vulnerable patients.”

At the worst peak, patients had died waiting for beds in Daegu back in March.

Hospitals in Seoul, which have been site of newly identified outbreaks, are running out of intensive care unit beds.

Out of 1,986 beds in negative-pressure rooms across the country, only 749 are available at the most -- 115 of which are for critical care patients and 634 for non-critical care patients.

In the 24 hours ending Saturday at midnight, Korea confirmed 48 cases of COVID-19. Forty of those were locally transmitted, and the remaining eight imported.

“No place is safe from the coronavirus. Outbreaks are being discovered all over the country,” said the Korea Centers for Disease Control and Prevention’s Deputy Director Kwon Jun-wook said in a Saturday briefing.

According to the KCDC data, former epicenters Daegu and North Gyeongsang Province still accounted for majority of the nationwide total at 8,283 or 66 percent. Seoul, Gyeonggi Province and Incheon made up 21.4 percent at 2,664.

In addition to the fresh local outbreaks, recent trends show an uptick in imported cases as well.

A tally reported the previous day showed 31 out of 67 newly confirmed cases were linked to overseas travel, exceeding 30 for the first time since April 5.

While Korea requires all incoming travelers to self-quarantine, experts say testing is necessary before the quarantine order is lifted at the end of the 14 days, considering the disease’s incubation period. Currently, testing is only mandatory for people who have symptoms.

“Strict restrictions need to be placed on arrivals from regions experiencing active outbreaks to stem infections coming from outside the country,” said infectious disease specialist Dr. Kim Woo-joo of Korea University Hospital in Seoul’s southern Guro.

“Symptoms may not be a reliable marker of coronavirus infections given the large proportion of asymptomatic patients.”

Minister of Health and Welfare Park Neung-hoo said in a briefing held Sunday afternoon the government will review limiting flights to and from countries with large caseloads.

“The influx of infections from overseas may add to overwhelming disease control capacities,” he said.

So far, the month of June has seen an average of 45.7 cases a day, which is almost double the May’s average of 23.5.

Health authorities have dispelled earlier hopes of the coronavirus proving seasonal and subsiding in the summer.

The KCDC chief Jung Eun-kyeong said in a Wednesday briefing that “the spread of COVID-19 is likely to continue, undaunted by changing seasons until there is treatment or vaccine.”

“The pandemic’s challenges are persisting despite the advent of summer. In fact, countries are seeing renewed waves of infections,” she said.

To date, 12,421 people have been infected, of whom 280 have died.

By Kim Arin (arin@heraldcorp.com)

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