The government said it will not convert entire hospitals into infectious disease–only facilities or immediately resort to social distancing even if the next pandemic arrives. It acknowledged the effectiveness of past disease control but judged that the medical gaps and the social and economic damage during the process were significant.
The Korea Disease Control and Prevention Agency on the 10th announced a plan to upgrade the infectious disease crisis management system. It aims to overhaul the response approach to build a system that maintains medical and social functions while responding to crises.
Im Seung-gwan, commissioner of the Korea Disease Control and Prevention Agency, said, "Infectious disease crises will inevitably return," and added, "In the next crisis, we will build a system that protects not only people's lives but also daily life and social functions."
◇ Response by infectious disease type: separate "eradication" and "coexistence"
From now on, responses will be tailored by disease type. For diseases such as MERS and Ebola, which have low transmissibility but high fatality, the goal is early containment and domestic eradication. In contrast, for diseases like COVID-19 that spread easily and are likely to become prolonged, the response system will shift at a certain point to one premised on coexistence.
The crisis alert system will also change. Alerts will be issued after weighing not only case counts but also transmissibility, severity, medical response capacity, and social acceptability. Currently, the pan-government response activates at the highest level, "serious," but going forward, the Central Disease Control Headquarters of the agency will oversee the response up to the "alert" level.
Surveillance will be reinforced. Among new overseas infectious diseases, those with a high risk of entering Korea will be selected for targeted management, and a system that uses cremation data to identify death trends and excess mortality in real time will be introduced. In the early stages of an outbreak, pathogen, epidemiological, and clinical information will be integrated to quickly grasp disease characteristics.
◇ Maintain routine care instead of emptying entire hospitals
The core of this overhaul is the medical response system. During COVID-19, converting entire hospitals into infectious disease–designated hospitals repeatedly halted or reduced care for general patients. The agency said it will move away from a model that sacrifices the general medical system and build a sustainable response system.
To that end, a new four-tier medical system will be established, from central and regional infectious disease specialized hospitals to neighborhood infectious disease treatment hospitals. In the early phase of an outbreak, specialized hospitals will take severe cases, and if the outbreak persists, local hospitals and clinics will share mild cases.
"Convertible beds," which keep routine care during normal times and switch only certain wards to infectious disease response during crises, will also be expanded. Instead of emptying entire hospitals, both routine and infectious disease care will be maintained.
Dedicated beds will also be operated for special patients such as pediatric and maternity cases. In 70 intermediate medical service areas nationwide, regional infectious disease centers will be designated to prevent patients from concentrating in specific areas. A medical resource information system will be built to track medical staff, beds, and equipment in real time.
◇ Develop vaccines within 100 days and treatments within 200 days
The vaccine framework will also be revised. The agency assessed that during COVID-19, roles between ministries were unclear during vaccine introduction, and controversy over adverse events led to vaccine hesitancy. Going forward, vaccines will be secured faster through partnerships with drugmakers and international organizations.
In a crisis, a pan-government consultative body will be activated to streamline vaccine introduction procedures. A public-private expert verification system will also operate to check safety and effectiveness even under rapid introduction.
Monitoring of adverse events will be strengthened. Surveys and big data analysis will be added to the existing reporting system to detect risk signals early, and the compensation system for harm will be improved. A response system for false or manipulated information about vaccines will also be established.
In research and development, the goal is to develop vaccines within 100 days and treatments within 200 days when a new pandemic occurs. An infectious disease clinical research and analysis center will be established to oversee public clinical trials and clinical data analysis, and an infectious disease research network will be built.
Korea will also pursue domestic production of a COVID-19 mRNA Vaccine by 2028. A "vaccine library" to pre-secure prototype vaccines for high-risk pathogens and a national therapeutic library will be built. Development of the "K-AI PPX," a Korea-style pandemic preparedness engine using artificial intelligence (AI), will also be pursued.
◇ Why change now: $22 trillion spent on COVID-19, and super-aging as a variable
The government's push for a sweeping overhaul stems not only from lessons from COVID-19 but also from a changed environment.
According to the agency, expenses投入 for the COVID-19 response from 2020 to 2022 exceeded 22.6 trillion won, including 14 trillion won from government finances and 8.6 trillion won from the National Health Insurance. The social cost, including reduced productivity, is estimated at 36 trillion won annually. This is why the agency decided to consider ways to secure separate funding for infectious disease crisis response.
Entry into a super-aging society is also a factor. Last year, Korea's population aged 65 or older exceeded 20%. During COVID-19, the cumulative fatality rate for those 80 or older was 1.83%, a stark contrast with those 29 or younger. This means that even if an infectious disease of a similar scale reemerges, there could be more severe cases and deaths than in the past.
Public perception has also changed. A survey by the agency found that 57.6% said they would hesitate to get vaccinated even if the next pandemic arrives.