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[Robert J. Fouser] The resurgence of COVID-19

South Korea’s battle with COVID-19 took a turn for the worse as cases started to jump in the middle of August. Unlike the first wave, which centered on Daegu, the recent spike in cases has been nationwide. The government has strengthened rules on social distancing and is considering a national shutdown if the situation worsens.

After its success in squelching the Daegu-centered outbreak in the spring, many nations looked to Korea as a model of how to deal with COVID-19. In the US, major news outlets reported on the country’s response in detail, and politicians in both political parties used the Korean case to bolster their arguments.

Positive views of Korea’s response centered on testing and tracing, the backbone of any response to a pandemic. Widely available testing helped find out who had the disease and effective tracing measures helped find people who might have been exposed to an infected person. Infected and exposed people could isolate themselves, thereby stopping the spread. Because these measures were effective, Korea never needed to move to a strict shutdown. New York, London and Paris shut down. Seoul did not.

In developing a response to the current outbreak, Korea can learn from the experiences of other countries and a growing body of scientific research on the disease. By response, countries have taken two broad responses.

The first is the “strict control” group. New Zealand represents this approach best. When COVID-19 first appeared, the country shut down completely in the hope of eradicating the disease. This worked, and the country went for 102 days without a new case of the disease. A recent outbreak of four cases has caused the largest city of Auckland to shut down for a week.

The second is the “live-with-it” group, as represented by Sweden and, to some extent, Japan. Instead of shutdowns, this approach relies on changes in personal behavior, such as hygiene, mask-wearing and staying at home. In Sweden, the constitution does not allow the government to impose a state of emergency, which is the legal basis for shutdowns, during peacetime. Japan declared a national emergency but did not shut down as strictly as most other countries did. It relied on mask-wearing, closing schools and sheltering at home.

Having gone 102 days without a case of community transmission of COVID-19, New Zealand’s experience shows that a swift and forceful shutdown is effective in stopping the spread. As of Wednesday, New Zealand, with a population of 4,886,000 people had 1,695 cases and 22 deaths, while Sweden, with a population of 10,230,000 people had 86,891 cases and 5,814 deaths. New Zealand’s approach has clearly been more effective than Sweden’s.

The problem with shutdowns is not public health, but politics. In a democracy, shutdowns, particularly strict ones, represent an assertion of state power that few citizens have experienced. In countries where citizens trust the government, people willingly cooperate. In countries where trust in the government is low, resistance builds and the shutdowns become politicized. Once politicized, the focus shifts from public health to political posturing. Part of the inability of the US to deal effectively with the pandemic stems from politicization.

Research on COVID-19 is helping to improve treatment and shed light on how the disease spreads. We know that the disease spreads fastest through contact with people in confined, poorly ventilated spaces. This explains why large gatherings in interior spaces are so dangerous.

As a densely populated country where people crowd into big cities, Korea is fertile ground for COVID-19. Mask-wearing and hand-washing may not be enough to prevent the spread in crowded spaces with poor ventilation. If so, then public health officials should consider reducing crowding and improving ventilation.

COVID-19 is most dangerous to people 55 and older. With a median age of 41.8, South Korea ranks 36th out of 230 countries and dependencies. The country’s population is aging rapidly, and it will soon climb to the top of the ranks. To deal effectively with the pandemic, public health officials should focus on protecting older people and other vulnerable populations.

In the end, the key to developing a response to the pandemic in South Korea is public trust in government. Do people trust the government to manage a strict New Zealand-style shutdown and address the ensuing economic dislocation? If so, then that is the best choice. If not, then the government should strengthen social distancing by focusing on the spatial and demographic conditions that fuel the spread of COVID-19. 


Robert J. Fouser
Robert J. Fouser, a former associate professor of Korean-language education at Seoul National University, writes on Korea from Pawtucket, Rhode Island. He can be reached at robertjfouser@gmail.com -- Ed.
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