Doctors split over using daily cases as social distancing criteria

The health authorities are soon to revise the criteria for social distancing rules, currently set as the number of new daily Covid-19 cases.

However, healthcare experts expressed different opinions on whether the government should decide distancing levels depending on the number of Covid-19 patients.

Some doctors said setting social distancing based on new Covid-19 cases alone was like giving a unanimous punishment on the public to share the social burden. In contrast, others said failing to curb the number of patients will lead to infections in high-risk facilities such as nursing homes.

The Ministry of Health and Welfare held a public debate on revising the social distancing system on Tuesday.

Kwon Soon-man, president of the Korean Academy of Health Policy and Management, said a stricter curbing could reduce the number of Covid-19 patients but worsen people’s health in the long term.

Instead of a single policy on all Koreans, the nation needs a differentiated response measure by each local government, Kwon said.

He said the government needs to expand the social safety net by introducing paid sick leave and health insurance sick benefits. He went on to say that social distancing rules should be based on the number of serious Covid-19 patients and the healthcare system’s capacity, not on the number of Covid-19 cases.

Social distancing requires logical and scientific evidence, but the current ban on the business operation after 9 p.m. and the prohibition of the gathering of more than four people were unreasonable, Kwon noted.

Professor Kim Yoon of Seoul National University College of Medicine also said the government should do away with a group punishment-like social distancing that aims to reduce infection cases only.

Experts discuss how to revise the social distancing system at a public debate organized by the Ministry of Health and Welfare Tuesday.

Forcing other facilities to close the business due to a cluster outbreak, caused by some facilities that did not comply with quarantine rules, is an unscientific group punishment, Kim said.

“The government should fulfill its responsibilities first, and then demand the public to share the pain,” he said. “We need to expand local governments’ quarantine personnel, secure Covid-19 treatment beds and manpower, improve emergency center treatment systems, and enhance infection control in nursing hospitals and facilities.”

When the first outbreak occurred in Daegu and Gyeongsang Province last year, people said hospital beds were in shortage in the region. However, Daegu did not have a shortage of beds. Still, the government was unprepared to mobilize beds and workforce for such a massive outbreak, Kim noted.

“If the government had invested hundreds of billions of won in mobilizing 10 percent of beds for non-urgent patients, it could have reduced socioeconomic damages incurred by social distancing,” he added.

The social distancing for the past year is estimated to have incurred about 40 to 50 trillion won in damages. If the government had invested only one-hundredth of the cost, it could have eased social distancing and reduced damages, Kim said.

On the other hand, Professor Choi Won-seok of the Infectious Disease Department at Korea University College of Medicine said unless the government reduces Covid-19 cases, it cannot prevent infections at high-risk facilities, including nursing homes.

“If we can prevent Covid-19 patients from entering high-risk facilities in a cluster infection situation, there will be no problem. But we have to think about whether this is possible,” Choi said. “Nursing hospitals took pre-emptive measures to restrict visits to patients and regularly test employees, but Covid-19 cases still occurred.”

He noted that as Korean hospitals usually put multiple patients in a single room, it is almost impossible to practice distancing within hospitals. “A cluster infection occurs not because high-risk facilities fail to control infections but because cases from a community infection enter the facility,” he said.

Choi was also negative about mobilizing some hospital beds of private institutions to treat more Covid-19 patients.

It was unfortunate that Korea cannot increase its healthcare capacity in the third outbreak of Covid-19. Still, the government should not order private hospitals to open more beds for Covid-19 response, he said. Tertiary hospitals are giving 1 percent of their intensive care units (ICU) for Covid-19 patients. This means that a tertiary hospital has to give up one-fourth of ICU beds, he added.

Son Young-rate, the spokesperson for the Ministry of Health and Welfare who doubles as head of the Central Disaster Management Headquarters' social strategy team, refuted some professors’ claim that social distancing should be based on the enhancement of the healthcare system.

Strengthening healthcare capacity aims to increase the ability to withstand Covid-19 cases, not to reduce the number of cases, he said.

“Enhancing the healthcare system is very important, and it can reduce the fatality rate, but it has little to do with reducing the number of cases to adjust the distancing system,” Son said. “It will increase the force to endure the situation for a long time, but it will not be relevant to efforts of slowing the outbreak and reducing transmissions.”