South Korea's tens of thousands of elderly deaths continue to sound the alarm for all countries in epidemic prevention.
Written by | Ling Jun
Source | "Medical Community" public account
On March 29, the World Health Organization released the "Latest News of the Weekly Epidemiology of COVID-19". From 21 to 27 March, new COVID-19 cases worldwide fell by 14% compared to the previous week.
The most interesting of all countries is South Korea. South Korea's population is just over 50 million, but last week the number of new COVID-19 cases reached 2.44 million, the highest number of all countries, in addition to 2471 deaths.
On the one hand, there is a shortage of crematoriums for COVID-19 deaths in South Korea. On the other hand, epidemic prevention measures are being relaxed, and the number of air tickets for "overseas tourism" has also risen sharply year-on-year.
In stark contrast, what is happening in South Korea?
"Fear" is being eliminated and "retaliatory travel" is on the rise
Before the Arrival of the Omikejong mutation, South Korea had been a global "superior student in epidemic prevention", and the number of infected people remained low, with few deaths. Until December last year, the number of new CONFIRMed cases soared, and the South Korean government also urgently stopped the "coexistence with the new crown" epidemic prevention model that resumed normal life in stages.
But this still did not stop the Omikejong mutation, which increased by nearly 100 times in the average daily diagnosis within 3 months. Woo Joo Kim, a professor of infectious diseases at Korea University's Guro Hospital in South Korea, told CNN that the government subsequently eased restrictions again in the weeks leading up to the March elections to address the economic losses suffered by small business owners.
Faced with small businesses and self-employed households struggling to survive the pandemic, the South Korean government has largely relaxed its close contact tracing and social distancing programs, and since this month, a series of strict epidemic prevention measures have been lifted, including entering public places that no longer require vaccine passes; most of the inbound personnel who have been vaccinated throughout the vaccine do not need to be quarantined; and the restriction on private gatherings has risen from 8 to 10 people since April 4.
This round of epidemic peak has not yet allowed the South Korean government to consider re-tightening epidemic prevention. According to the British newspaper The Guardian, public opinion in South Korea seems to support these relaxation measures.
A survey released last week by the Graduate School of Public Health at The National University of Korea showed that the proportion of South Koreans who believe they might be infected with the new coronavirus has reached 28% for the first time since January 2020, but the number of people who are worried about its health impact is the lowest in two years, about 48%.
The head of the research team said that this shows that people's understanding of the dangers of the virus has clearly changed.
At present, South Korea's full vaccination rate is nearly 87%, 63% of people have received booster injections, relying on the immune barrier established by vaccines, South Korea's young people seem to no longer fear the new crown virus. In mid-February, the South Korean government also decided to further approve the Pfizer mRNA vaccine for children aged 5-11 years to provide better immune protection.
According to the Korea Disease Control and Prevention Agency (KDCA), as of 00:00 on March 31, the number of COVID-19 infections under the age of 60 in South Korea totaled nearly 11 million, the number of deaths was only about 1,000, and the infection case fatality rate was less than 1 in 10,000. Among middle-aged people aged 30-39, only 83 of the nearly 2 million infected people died.
The low case fatality rate is the biggest basis for South Korea's deregulation at this stage. South Korea's Ministry of Health official Son Young-rae publicly revealed on March 16 that an analysis of 141,000 cases of Omilon infections in 2021 showed that none of the people under the age of 60 who received the vaccine booster test died, and believed that the new crown virus could be treated like seasonal influenza.
Many people seem to have been impatient. "Reuters" reported that from the 11th to the 27th of this month, the overseas air ticket sales of the e-commerce division of SK Telecom Co Ltd, south Korea's largest mobile operator, increased by more than 8 times compared with last year.
Reuters said the term "retaliatory travel" had been circulated on South Korean social media. The travel arm of South Korean online retail giant Interpark Corp similarly reported that flight bookings in Oceania increased by 324% between March 11 and 22, Southeast Asia by 268%, and Europe by 262% compared to the same period in 2021.
South Korea is essentially pursuing a natural immunization strategy, although restrictions on groups, including a maximum number of people in gatherings and a curfew in shops, have not been completely lifted, the Korea Herald said, and it is expected to be fast.
Professor Woo Joo Kim concluded in an interview, "We should not completely abandon or oppose the epidemic prevention measures and their implementation, but we also do not need to be afraid or panic about the number of new cases as in the past." ”
The surge in the number of infections or offset the decline in the virulence of the virus
Public fear of the virus may be waning, but pressure on the health care system remains.
"The total number of COVID-19 infections and deaths should be reduced to 35,000 and 35 per day to be considered similar to influenza." Kim Tak, a professor of infectious diseases at Bucheon Hospital at Suncheon University in South Korea, said on March 1. According to the South Korean Ministry of Health, on March 31, there were about 280,000 new infections and 360 deaths in South Korea.
The corresponding data are about 10 times higher, suggesting that the threat reduced by the reduced toxicity of the Opichron variant is also being offset by a large number of infections.
On March 23, Health Ministry official Son Young-rae said publicly that the number of confirmed cases continues to increase significantly, but severity, mortality, and the responsiveness of the health care system suggest that the outbreak is manageable.
But even if it has not caused a serious "medical run", many Korean hospitals have already admitted mildly ill COVID-19 patients in ordinary wards. With the surge in cases, it is no longer realistic to transfer all infected people to isolation wards. According to the South Korean government's regulations, people with mild and asymptomatic infections can also choose to receive treatment at home to reduce the pressure on medical institutions, but they need to be quarantined with cohabitants for at least 7 days.
According to the "CCTV Financial Channel", fire protection, medical and other social necessities have also been diagnosed one after another, many firefighters have changed from "three shifts" to "two shifts", hospital emergency room closures, surgery postponement incidents occur from time to time.
Intensive care beds are not yet fully loaded, but occupancy rates have risen from 59% two weeks ago to about 64% this week, so many experts have warned.
At the same time, South Korea's "JoongAng Daily" reported that there is a shortage of cough medicines and fever drugs for mild patients. On March 21, KDCA official Jeong Eun-kyeong said at a news conference that Pfizer's inventory of the new crown drug Paxlovid was only enough for another two weeks.
In response to related concerns, on the one hand, the relevant departments in South Korea have begun to negotiate with pharmaceutical manufacturers. On March 23, the Korean Food and Drug Safety Department further said that it decided to approve the emergency use authorization of merck's new crown oral drug "Lagevrio" capsules. As of March 28, KDCA revealed that Pfizer and Merck's two COVID-19 drugs can cover 962,000 and 242,000 people, respectively.
At the same time, Yonhap News Agency reported that since Wednesday, South Korea has begun to accept medical service applications in "small" clinics, and it is expected that more and more primary medical institutions will provide face-to-face treatment for new crown patients. The KDCA said the move aims to better support patients at home and shift to a new medical response system to deal with long-term epidemics.
Nearly 9,000 clinics and hospitals in South Korea can provide medical services by telephone, and the government has designated 279 clinics across the country to provide medical support for home COVID-19 patients.
If trying to coexist with COVID-19, "the government must consider further expanding and improving the existing health care system in the medium and long term." Professor Kim Tak previously said.
The elderly population is the key to the second half of the epidemic
In stark contrast to "overseas tourism", the crematorium in South Korea for the disposal of elderly COVID-19 deaths has become tense.
A number of experts have previously told the "medical community" that the "threat" of new mutants to young people is getting smaller and smaller, and the "decisive victory" battlefield is among the elderly. Similar to Hong Kong, South Korea's age distribution of deaths also validates this view.
According to South Korea's latest outbreak data, people over the age of 60 account for less than 15% of all COVID-19 infections, but nearly 94% of deaths. The infection mortality rate is 0.68% in the elderly aged 70-79 years and as high as 2.67% in the age of 80 years.
On Monday, South Korea's Ministry of Health instructed 60 crematoriums across the country to extend working hours. Previously, South Korean authorities had increased the total daily cremation capacity from about 1,000 people per day to 1,400 people. But Health Ministry official Son Young-rae said there was still a large backlog of bodies in the densely populated Seoul area and said the government would temporarily allow crematoriums in each city to accept bookings to come to other areas.
The COVID-19 vaccination rate for the elderly in South Korea is not low, with more than 90% of people over the age of 60. The South Korean government has not released specific details of vaccinations for elderly people who have died of the epidemic, but Park Hyang, director of the Department of Epidemic Prevention and Response Management of the Ministry of Health, said at a briefing in mid-March that people aged 60 and over who are not vaccinated are ten times more likely to die from the epidemic than those who have received the booster needle.
The typical age dependence of the new crown virus suggests that the health of the elderly is particularly worrying once the number of infections surges. In Japan, the Tokyo Metropolitan Government announced 158 deaths between January 1 and February 15, 2022, accounting for about 90% of the people over the age of 60 by age.
It's not just a matter of vaccinations. The older you get, the worse your immunity becomes, and the more likely you are to have other underlying diseases.
A specific analysis of 158 deaths in Tokyo revealed that at least 117 people had some sort of underlying health problem, including 39 deaths with recorded hypertension, 21 with diabetes, 19 with cancer, and 6 with dyslipidemia...
The South Korean government is also currently trying to promote the treatment and testing of the elderly through a series of initiatives, especially in nursing homes and nursing homes. Park Hyang said that if people aged 65 and older in nursing homes are infected with the virus, priority will be given to having them treated in specialized medical centers, even if it is only mild.
At the same time, plans to give the elderly a fourth dose of the vaccine are also advancing. Son Young-rae said, "This may be the last major crisis we have to deal with COVID-19, and if we overcome it, we will be closer to returning to normal life." ”
However, no matter what the final results, the tens of thousands of elderly deaths in South Korea are indisputable facts, and they continue to sound the alarm for countries in the layout of epidemic prevention.
On March 29, Weibo Big V - Virus and Infectious Disease Scientist @ Ziling expressed his opinion on Weibo in listening to the song, saying that the characteristics of the Aomi Kerong mutant strain have undergone a fundamental change, compared with the original strain, the case fatality rate has dropped by dozens of times, the spread force (R0 value) has increased exponentially, and the cost of strict "blockade" measures will become higher and higher, and the role it can play will become more and more limited.
"The fight against the epidemic that ignores the nature of the virus itself is blind." He wrote.
Since the development of the epidemic, most of the epidemic prevention measures have been weighed in the "lesser of the two harms". Recently, the situation in countries including Hong Kong, South Korea and other countries has once again reminded that the key protection of the elderly group is one of the keys in the second half of the epidemic.
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