Biosecurity

When to reopen the economy during the coronavirus pandemic? South Korea’s got a plan and the numbers to back it up

By HyunJung Kim, May 7, 2020

In a sort of natural experiment, South Korea and the United States have showcased two divergent approaches to dealing with the novel coronavirus pandemic. Both countries detected their first cases of COVID-19 on the same January day, but South Korea has since responded to the outbreak far more effectively and has used testing, contact tracing, and isolation to bring the epidemic to heel, reporting just a trickle of new cases on most recent days. Now both nations are once again facing a common challenge: how and when to reopen economic and social life. This time, however, they’re standing at very different starting points.

In announcing a phased approach to reopening the country, US President Donald Trump on April 16 said, “based on the latest data, our team of experts now agrees that we can begin the next front in our war which we are calling opening up America again.” Since then states have raced ahead to do just that. But where on May 5, South Korea reported just three new COVID-19 cases, the US government logged more than 19,000 new cases—this discrepancy in a country with a population just six times larger than South Korea’s.

Seoul seems to have an evidence-based approach to reopening, Washington, meanwhile, is just playing lip service to the idea of being guided by data.

A recent statehouse protest in Ohio, one of several such rallies in which demonstrators have been demanding that the stay-at-home orders that state governments have implemented to stop the spread of the novel coronavirus be lifted. Credit: M. CC BY-SA 4.0.

In many parts of United States, the data doesn’t paint a clear picture of a waning epidemic. The governor of Oklahoma, for instance, cited his state’s relatively low rate of infection in defending his decision to allow businesses to begin reopening in a limited fashion, even though new cases and deaths reported by the state on May 5 rose at higher rates than in the country as a whole.

Even the statistics that show the number of new cases rising are probably not capturing the full extent of COVID-19 infection in the United States, with the percentage of the population getting tested in most states languishing below the  2- to-2.6-percent threshold the federal government has cited as a criteria for reopening. The lack of testing supplies, like swabs and reagents, pose a critical obstacle in the United States and render an accurate count of infections nearly impossible.

While South Koreans haven’t been living under the same stringent shelter-in-place orders that many Americans have since March, the government in Seoul did implement social distancing guidelines that month. They were recommendations and were a far cry from the so-called lockdowns that authorities put in place in the United States. The guidelines expired on May 5. In their place, Seoul implemented what it calls “everyday life quarantine” guidelines, a draft of which detailed relaxed preventative hygiene and social distancing measures that would allow people to engage in a certain level of economic and social activities, so long as they kept arms-length apart, washed hands regularly, and took other precautions.

The South Korean government carried out science-based epidemic control and prevention actions before trying to enter the recovery phase it’s in now, and due to that response, the epidemic situation of South Korea really is improving and stabilizing. From May 1 to May 5, the country reported between three to 13 new cases of COVID-19 each day, according to the Korea Center for Disease Control and Prevention. And as of May 5, the country of close to 52 million people has had fewer than 11,000 cases and just 254 deaths since January. Compare those numbers to the United States, which has a population of 328 million people and, as of May 5, had reported close to 1.2 million cases and almost 70,000 deaths, according to the US Centers for Disease Control and Prevention.

The South Korean government’s approach to COVID-19, based on massive diagnostic testing, has successfully employed the so-called 3T practices–testing, tracing and treatment–to help continue decreasing the number of newly reported COVID-19 cases in South Korea. As of May 5, there have been 640,000 tests conducted in the country. Nearly 20,000 people were tested per day in the peak period (early March), and as of early May, 3,000 to 5,000 tests were still being conducted daily, even though the number of daily cases had fallen into single-digit territory.

Cheaper medical expenses increase the accessibility of the 3T practices for South Koreans, a fact which has helped authorities gather accurate epidemic information by large-scale testing. South Korea’s state-run health insurance system is charging patients only $35 for coronavirus treatment bills of $10,000. It’s more difficult to assess how much patients will be charged for similar treatment in the United States, as insurance plans will handle costs differently. Under the types of plans typical at large employers, patients could face considerable expenses before insurance coverage kicks in.

Thanks to effective disease control and prevention practices, South Korea even held the world’s first national election during the pandemic. Although turnout was 66 percent, the highest voting rate since 1992, there has been no notable sign of another surge in COVID-19 cases.

The new “everyday life quarantine” policies represent another loosening of restrictions in Korea. In March, the government’s so-called aggressive social distancing policy encouraged people to distance themselves from others in public spaces, wear masks, sanitize hands, and refrain from social gatherings such as religious services, entertainment spots, or indoor sports activities. Although the government decided to extend the aggressive social distancing campaign until April 15 due to imported cases and continued flareups, it then eased restrictions to allow places like cram schools and religious venues to reopen.

Based on the large volume of epidemiological data that South Korea has gathered, it is reasonable to assume that the country’s statistics are accurate and reliable enough to estimate the epidemic situation. The new everyday quarantine guidelines are the start to South Korea’s recovery phase, the start to repairing the damages caused by the pandemic and resuming a more normal life.

Although the peak of the epidemic in the United States may, as Trump has emphasized, already have passed, the country is still reporting tens of thousands of new cases and hundreds of new deaths a day. Even as governors announce plans to reopen local economies, many Americans tell pollsters they’re wary of fully plunging back into public life. It seems obvious that the American public remains skeptical about easing social distancing policies and stay-at-home orders given the uncertainty and opaqueness caused by the lack of testing capabilities.

As is the case in many other countries, the pandemic has hobbled the South Korean economy. Economic growth in the first quarter of 2020, shrank 1.4 percent, the most severe contraction since the 2008 financial crisis. The country may have fared better than other major economies, however. (The United States contracted at an annual rate of 4.8 percent, for instance.) Because South Korea had a massive testing policy instead of a lockdown policy, the economic damage appears to have been less severe. President Moon Jae-in recently ordered a third round of economic stimulus, dubbed the “Korean-style New Deal,” to shield the economy from the ravages of the pandemic. This round also focuses on creating jobs and boosting economic growth and innovation for the post-coronavirus era, allocating $69 billion to saving key industries such as the aerospace, shipping, and car industries.

South Korea has now turned its attention to economic recovery, as has the United States. Only one of the countries, though, has arguably gotten close enough to the coronavirus finish line to make that pivot.

The decision for reopening the US economy should, in emulation of South Korea, be founded on scientific and empirical evidence, not political agendas.

As the coronavirus crisis shows, we need science now more than ever.

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View Comments

  • I think the economy should be opened very gradually only when tracking, testing and isolation can be completed on the same day. When the R ratio is under .8 and when there is surplus PPE for hospitals and care homes. Spikes will happen and could be monitored using data from calls to the emergency services that are Covid related.

  • The effective response of South Korea is because of the earlier SARS epidemic that taught the public and politicians what to do. In the real world, effective action is only possible after the first epidemic. It is politically impossible for any leader to effectively respond the first time because of political constraints.

    The classic example in the U.S. is the failure to shut down mass transit in New York City that resulted in massive acceleration of the pandemic in New York and the eastern half of the U.S. That is in contrast to the Chinese where shutting down mass transit was priority one.

  • Opening any economy has to be evidence based on the certain criteria being met. First, the R , rate of infection, must be a minimum of 0.8 with a downward trend. If R is 1 and goes up to 1.1 you could see a doubling in the rate of infections.

    Secondly, tracking, testing and isolation must be carried out quickly. If you can get this process completed in 24 hours that will push the R downwards. Closely monitor the R by capturing Covid related calls to the emergency services will give an indication of how effective this process is.

    Social distancing must be kept by individual States until R is under 0.8. Individual States can have a red, amber, green system where red represents R1 - 1+, Amber where R represents 0.5 - 0.8, and green when R is under 0.5. Keeping the public informed with solid advice is key. The advice must be firm like stay at home, protect health care, save lives, not keep save, try not to go out, stay alert. You need clear consistent government advice.

    Unless these criteria are met you cannot even think about opening the economy. Any spike in infections over R1.1 will see at least twice more cases and deaths, and if this pandemic continues into the winter, it will be hard to stop, particularly if it coincides with the flu season. Hospitals will be overwhelmed and push ordinary surgery further into the future, causing more non Covid deaths.

  • 70% of the 1.3M cases in the US are still active. The ratio between total cases and total closed cases is important. South Korea has closed 99.99% of its cases