Fighting coronavirus: How South Korea got it right and Italy wrong

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Fighting coronavirus: How South Korea got it right and Italy wrong
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The story of two outbreaks illustrates a coming problem for the rest of the world.

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.

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.”

Seoul says it is building on lessons learned from an outbreak of Middle East Respiratory Syndrome in 2015 and working to make as much information available as possible to the public. It has embarked on a massive testing programme, including people who have very mild illness, or perhaps don’t even have symptoms, but who may be able to infect others.

The rate of newly confirmed cases has dropped since a peak in mid-February, but the system’s greatest test may still be ahead as authorities try to track and contain new clusters. South Korea does not have enough protective masks - it has started rationing them - and it is trying to hire more trained staff to process tests and map cases.

Italy’s epidemic kicked off last month. A local man with flu symptoms was diagnosed after he had told medical staff he had not been to China and discharged himself, said Massimo Lombardo, head of local hospital services in Lodi. On the other hand, the more you test the more you find, so testing in large numbers can put hospital systems under strain, said Massimo Antonelli, director of intensive care at the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome. Testing involves elaborate medical processes and follow-up. “The problem is actively searching for cases,” he said. “It means simply the numbers are big.

“Doctors and nurses are at the limit,” said a nurse from the hospital where Mattia was taken in. “If you have to manage people under artificial respiration you have to be watching them constantly, you can’t look after the new cases that come in.” The region has already asked nursing institutes to allow students to bring forward their graduation to get more nurses into the system early. Pools of intensive care specialists and anaesthetists are to be set up, including staff from outside the worst affected regions.

Like the patient named Mattia in Italy, the woman had no known links to Wuhan, the Chinese province where the disease was first identified. And as in Italy, the doctors’ decision to recommend a test went against guidelines at the time to test people who had been to China or been in contact with a confirmed case, said Korea Medical Association’s Choi Jaewook.

A total of 117 institutions in South Korea have equipment to conduct the tests, according to the Korea Centers for Disease Control and Prevention . The numbers fluctuate daily, but an average of 12,000 is possible, and maximum capacity is 20,000 tests a day.

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