It was a Friday when Kim Gyung-sook started to feel a little bad.
She had received a dose of the Pfizer vaccine two weeks earlier, but decided to be cautious and get tested for COVID-19.
“I had not been around anyone who tested positive, but I was not feeling well,” he told ABC.
Reality arrived on Saturday. The test came back positive. She had done the right thing by taking the test, but the confirmation was a major disruption in her life.
She was ordered to isolate herself in her apartment away from her family until she could be transferred to a government-run facility.
In South Korea, anyone who tests positive for COVID-19 is taken from their home. If they are severely affected, they are sent to the hospital.
But if they have mild symptoms or no symptoms, like Ms. Kim, they are taken to what the government calls residential treatment facilities.
Ms. Kim packed a small collection of belongings for the stay: clothing, toiletries, and her laptop. She was picked up by a government minibus, with the driver separated from her and the other positive passengers.
They took her for about an hour and a half to a complex that generally serves as a youth training center. It had been repurposed to house COVID-19 patients.
Although she was brought to the facility as soon as space was available, it appears that it was not fast enough. His two young daughters tested positive for the disease two days later. Her husband was negative.
His daughters were sent to the same center.
“At first I had shared a room with another patient. But when my two daughters arrived, we moved into what they call the family room,” Ms. Kim said.
The family room is quite spartan. It is just a room with a separate bathroom. It is usually used as a locker room, so the lockers line the walls.
While on the premises, Ms. Kim and her two daughters had to enter medical records twice a day into a specially designed application.
Using the equipment provided, patients upload their temperatures, blood pressure, heart rate, and oxygen saturation. The data is monitored by medical personnel on site in case someone’s condition deteriorates.
It’s a pretty bland existence. They receive three meals a day and snacks. There is also good quality Wi-Fi, which means that girls can continue to attend classes remotely during their stay. The full cost is covered by the government.
“This facility feels so stuffy and frustrating, but I think it’s the best option for the government,” Ms. Kim said.
South Korea burned by previous outbreaks
South Korea was one of the first countries to feel the force of the pandemic after the virus was first discovered in China in 2019.
The country of some 50 million people had experienced the trauma of dealing with a coronavirus outbreak.
In 2015, the very dangerous Middle East Respiratory Syndrome (MERS) entered the country and killed 38 people. Korean health professionals were aware of the risk of the new virus circulating.
Following a major COVID-19 outbreak in the central city of Daegu linked to a fringe Christian church, authorities called early on to send all positive cases to hospital for isolation in an attempt to reduce the risk of transmission.
But the public health system was “overwhelmed” and not coping, according to Lee Hoon-sang of Yonsei University.
To ease the pressure on the hospital system, the government began reusing different facilities to house those with mild or no symptoms. University dormitories, hotels and training facilities were reconfigured for this purpose.
Dr Lee said this makes it easier to ensure that people comply with quarantine orders than it would be if they had been in their own homes.
“[In government-run facilities] they can be monitored very closely. So if they have any kind of serious symptoms then they can be rushed to the hospital pretty quickly, “he said.
South Korea has not applied widespread lockdowns like many parts of Australia. Instead, there are restrictions on some exchanges and high compliance with the masking mandates.
Currently more than 2,000 new cases are registered every day. But at that level of transmission, Dr. Lee says the isolation system is beginning to feel the strain.
The Australian setting
Australia prides itself on its strict quarantine standards for returning international travelers, even those who tested negative and were double vaccinated.
But it is a different story for positive cases in the community. In most cases, you are asked to self-quarantine at home.
Epidemiologist Alexandra Martiniuk from the University of Sydney says that quarantine outside the home is “the gold standard” in terms of reducing transmission, while quarantine at home has been associated with a high rate of family transmission.
“I know of families where it passes from one person to another … and they all end up in quarantine for six, seven or eight weeks,” said Professor Martiniuk.
But now there is a debate as to whether Australia should even target zero transmission of COVID-19.
“Some people believe that when vaccines become very, very high in a total population, we will not quarantine or isolate positive cases, because it will only need to circulate,” Professor Martiniuk said.
Could Korea’s COVID quarantine model work in Australia?
Michael Toole, one of Australia’s leading public health experts, has closely followed the course of the disease in South Korea and believes Australia could learn from it.
He is particularly keen for the ‘COVID zero’ states of Queensland, Western Australia, South Australia and Tasmania to follow Korea’s lead and isolate positive cases away from home.
Dr. Toole says that given the reproductive rate of the Delta strain, positive cases should be isolated as quickly as possible.
“The average number of people that an infected person infects if they are not vaccinated is about five. Therefore, it is double the starting strain from last year,” he said.
“If someone gets infected and enters your home, almost everyone in the family will be infected and it can affect other people.”
Dr. Toole says that while the Korean model is logistically challenging and would require an investment of resources, it can be done, especially when the number of cases is low.
There is a high cost to removing someone from their usual home and isolating them elsewhere, both in terms of money and agitation for the individual, but Dr. Toole believes it could still work.
“Australians have quite complied with most of the restrictions. Of course, not all, but most of the people,” he said.
“I think that if they understood that this was protecting their family from getting infected and possibly seriously ill, they would accept it, as long as it is explained in a very detailed way.”
Dr Toole also said Australia’s focus on international travelers as a risk was starting to look out of date.
“The balance between those two requirements – keeping the virus out of the country, which is a little late now, and avoiding further spread when we already have outbreaks – that risk-benefit balance may have shifted now,” he said.
“In terms of community-wide transmission, it may make more sense to use those facilities for people who we know are infected.
“And for those travelers who arrive who are fully vaccinated and test negative on arrival, they could go into home quarantine.”
Australians are understandably expecting fewer restrictions as vaccination rates continue to rise, but Dr Toole says there is still a need to keep the number of cases as low as possible.
“You have to reduce the numbers. We have seen in other countries that have opened restrictions while still reporting a large number of cases, [they] They have had peaks, like Israel and the UK, parts of the US, and Singapore.
“They have experienced lower hospitalization rates, but still, particularly in England and Wales, hospitals are under a lot of pressure.”
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