Response to COVID-19 in South Korea and implications for lifting stringent interventions

BMC Medicine

Sangeeta Bhatia¹  Edward Knock¹  Sabine L. van Elsland¹  Nicholas F. Brazeau¹  H. Juliette T. Unwin¹  Janetta Skarp¹  Robert Verity¹  Caroline E. Walters¹  Laura V. Cooper¹  Amy Dighe¹  Marc Baguelin¹  Zulma Cucunuba¹  Natsuko Imai¹  David J. Haw¹  Charles Whittaker¹  Azra C. Ghani¹  Kylie E. C. Ainslie¹  Wes Hinsley¹  Hayley A. Thompson¹  Daniel J. Laydon¹  Margarita Pons-Salort¹  Neil M. Ferguson¹  Gemma Nedjati-Gilani¹  Lorenzo Cattarino¹  William D. Green¹  Thomas Mellan¹  Helen Coupland¹  Steven Riley¹  Swapnil Mishra¹  Gina Cuomo-Dannenburg¹  Samir Bhatt¹  Ilaria Dorigatti¹  Oliver D. Eales¹  Katy A. M. Gaythorpe¹  Michaela A. C. Vollmer¹  Lilith K. Whittles¹  Richard G. FitzJohn¹  Oliver J. Watson²  Christl A. Donnelly³  Pierre Nouvellet⁴  Adhiratha Boonyasiri⁵ 

[1] MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), Imperial College London, London, UK;MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), Imperial College London, London, UK;Department of Laboratory Medicine and Pathology, Brown University, Providence, RI, USA;MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), Imperial College London, London, UK;Department of Statistics, University of Oxford, Oxford, UK;MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), Imperial College London, London, UK;School of Life Sciences, University of Sussex, Brighton, UK;NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK;

关键词: COVID-19;    South Korea;    Public health interventions;    Reproduction number;    Contact tracing;   

DOI  :  10.1186/s12916-020-01791-8

来源: Springer

【 摘 要 】

BackgroundAfter experiencing a sharp growth in COVID-19 cases early in the pandemic, South Korea rapidly controlled transmission while implementing less stringent national social distancing measures than countries in Europe and the USA. This has led to substantial interest in their “test, trace, isolate” strategy. However, it is important to understand the epidemiological peculiarities of South Korea’s outbreak and characterise their response before attempting to emulate these measures elsewhere.MethodsWe systematically extracted numbers of suspected cases tested, PCR-confirmed cases, deaths, isolated confirmed cases, and numbers of confirmed cases with an identified epidemiological link from publicly available data. We estimated the time-varying reproduction number, Rt, using an established Bayesian framework, and reviewed the package of interventions implemented by South Korea using our extracted data, plus published literature and government sources.ResultsWe estimated that after the initial rapid growth in cases, Rt dropped below one in early April before increasing to a maximum of 1.94 (95%CrI, 1.64–2.27) in May following outbreaks in Seoul Metropolitan Region. By mid-June, Rt was back below one where it remained until the end of our study (July 13th). Despite less stringent “lockdown” measures, strong social distancing measures were implemented in high-incidence areas and studies measured a considerable national decrease in movement in late February. Testing the capacity was swiftly increased, and protocols were in place to isolate suspected and confirmed cases quickly; however, we could not estimate the delay to isolation using our data. Accounting for just 10% of cases, individual case-based contact tracing picked up a relatively minor proportion of total cases, with cluster investigations accounting for 66%.ConclusionsWhilst early adoption of testing and contact tracing is likely to be important for South Korea’s successful outbreak control, other factors including regional implementation of strong social distancing measures likely also contributed. The high volume of testing and the low number of deaths suggest that South Korea experienced a small epidemic relative to other countries. Caution is needed in attempting to replicate the South Korean response in populations with larger more geographically widespread epidemics where finding, testing, and isolating cases that are linked to clusters may be more difficult.

【 授权许可】

CC BY