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This year’s MERS crisis should be springboard for future

Kwak Sung-sun  Published 2018.10.03  10:19  Updated 2018.10.03 10:19

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- Epidemic crisis virtually ends as quarantine is lifted for close contacts
Experts evaluate the crisis as well-handled, stress need to revise quarantine guidelines

The Middle East Respiratory Syndrome crisis which returned to Korea for the first time in three years has virtually ended. The patient confirmed with the disease is completely cured, and the quarantine on the 21 people who had close contact with the man was lifted on Sept. 22.

This year’s crisis is evaluated to have been well handled compared to that of 2015, marking only one patient, zero deaths or infections among 21 close-contacted people.

Experts point out, however, that the government should take another step forward and find points to improve, just as the 2015 crisis brought forth the development of the national quarantine system. This year’s crisis should trigger the establishment of a more meticulous system, experts say.

MERS virtually ceased on Sept. 22
The Ministry of Health and Welfare and Korea Centers for Disease Control and Prevention (KCDC) lowered the alert level from “caution” to “attention” on Sept. 22, following the decision made at the crisis evaluation meeting held the previous day.

The 21 people who had close contact with the MERS-confirmed patient were released from the quarantine of 14 days -- the maximum incubation period of MERS --on Sept. 22 as the results of their second test conducted the previous day were negative. Monitoring of the 396 people who came into regular contact with the MERS patient also ended on the same day.

The government’s move showed that the MERS crisis virtually ceased, although the official end will be declared on Oct. 16, 28 days after the MERS patient is cleared with a final negative reading.

In 2015, a total of 186 patients were confirmed with MERS, 38 died, and 16,693 were quarantined. This year, the only confirmed patient was the one first discovered, and the number of people who had close contact with the patient stopped at 21 among whom none showed secondary infection. Experts evaluate that this year’s crisis was handled well.

2018 MERS crisis shows luck is as important as competence

Professor Kim Woo-joo from Korea University College of Medicine’s Infectious Diseases Department, who was in charge of the health-welfare ministry’s immediate response team, pointed out that what is the most important in handling MERS is shortening the time between the diagnosis of the disease and quarantine when a suspected patient enters the country, and that it only took a day this year.

“The number of people with close contact was minimal. There was one confirmed patient and 21 who had close contact with him but no secondary infections. There was no infection within the medical institutions, either. This is the final score of this year’s MERS crisis,” Kim said.

Kim added, however, luck is as important as competence, looking back on this year’s progress.

“In this year’s case, for example, we should think of what could have happened if the patient went to another hospital instead of Samsung Medical Center. Things could have been different if it had been somewhere else where the negative pressure rooms are not as well-equipped as in SMC,” Kim said.

Kim also noted that the one thing the medical community should not do right now is to get carried away with self-praise.

“There is no guarantee that next time will be as lucky as this time. We should thoroughly review this year’s crisis, improve things that need improvement and get rid of whatever may bring bad luck,” he said.

Quarantine guidelines should be revised

The single confirmed patient showed diarrhea symptoms at the time of entering Korea from the Middle East but was able to pass through the airport quarantine station as his fever was not high enough to be suspected as a MERS patient. This aroused criticisms that there is a loophole in the nation’s quarantine system and that the patient brought the disease into Korea on purpose.

“About 20 percent of the MERS patients show diarrhea symptoms although diarrhea is not included in the current list of symptoms to look for in suspected MERS patients. The list should be supplemented in this regard. Thermal reactions may not be demonstrated in some cases depending on body conditions,” Kim said.

“Some argue that the number of airport quarantine officers should be increased to solve the problem, but it would only result in alleviating the officers’ fatigue,” the professor said. “Tens of thousands of people use the airport every day in Korea. We should think about not only increasing the number of the quarantine officers but their capacity as well.”

Lee Jae-gab, director of PR at the Korean Society for Healthcare-associated Infection Control and Prevention (Hallym University Medical Center, Infectious Diseases Department), noted that foreign cases also show that reinforcing quarantine through a quarantine station is not cost effective.

“We need to create a system in which people can voluntarily report their conditions upon their arrival,” Lee said.

Suspected patients should be sorted out more precisely

Experts also point out that health authorities should sort out suspected patients more precisely. The officials should better manage long-term residents and focus on those entering from the Middle East more thoroughly.

Kim stressed the need to look through the long-term residents rather than travelers.

According to the analysis of the MERS patients dispersed to the world through the Middle East since 2015, no significant risk occurred when one stopped by Dubai. Instead, most of them were long-term residents who, for example, are doing business in the Middle East, Kim said.

“We need to classify long-term residents, including the medical workers working in the Middle East, patients on medical tourism from the region or those who do business there. There should be a system, in which such people can immediately report when they have a fever or show symptoms of diarrhea there.”

Experts also said the public should change their perception regarding countermeasures for infectious diseases. People ought to avoid stigmatizing the suspects of overseas contagious diseases, they said.

“It is okay to think that it is better to arrive at the hospital as soon as possible than to spend two to three hours at the airport quarantine station. In that case, it is possible that one thinks it is simply a nuisance to get caught at the airport. We need a system in which such disadvantages (of getting stigmatized) do not occur,” Lee said.

Suspected patients should not be stigmatized. In this year’s MERS crisis, for example, the driver of the limousine in which the confirmed patient was in is known to have been frightened, Lee stressed.

Professor Kim agreed, saying, “We should all realize that any one of us could be in the same situation. Stigmatizing only results in further hiding,” he added.

kss@docdocdoc.co.kr

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