“‘With Corona’ speed control failed… Hesitating in ’emergency stop’, the worst situation is self-inflicted”

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Lee Jae-gap, a professor of infectious diseases at Hallym University Gangnam Sacred Heart Hospital, is called a ‘virus fighter’. He suffered from SARS (severe acute respiratory syndrome) in 2003, the fourth year of his major, and the ‘New Infectious Disease Response Task Force’ organized by the Korean Medical Association to fight H1N1 flu (Swine Influenza A) in 2009 and MERS (Middle East Respiratory Syndrome) in 2015. worked in the ‘team’. He was also dispatched as an emergency relief chief to West Africa, where Ebola was raging. It seems that the fight against COVID-19 was difficult for him as well. He wrote in an article published in August of last year: “I was reminded of a movie in which Jim Carrey appeared. I hope it’s such a huge hidden camera, not ‘real’. This situation came so absurd to me as an infectious disease specialist, I hoped it would be a trick that disappears like a lie when I wake up one day.” The time he said, ‘I can’t help but get tired, but I can’t get tired’ has been going on for a year and four months since then. He is still fighting the virus. I met him, who is also a member of the ‘Corona 19 Daily Recovery Support Committee,’ and heard his thoughts on why the government’s ‘step-by-step recovery’ (with Corona) faced a crisis. The interview was held on the 15th at Gangnam Sacred Heart Hospital in Yeongdeungpo-gu, Seoul.

at Hallym University Gangnam Sacred Heart Hospital in Yeongdeungpo-gu, Seoul on the 15th. By Kim Kyung-ho, Senior Correspondent, [email protected]” alt=”Lee Jae-gap, professor of infectious diseases at Hallym University Gangnam Sacred Heart Hospital, is interviewing at Hallym University Gangnam Sacred Heart Hospital in Yeongdeungpo-gu, Seoul on the 15th. By Kim Kyung-ho, Senior Correspondent, [email protected]” />

Jae-gap Lee, a professor of infectious diseases at Hallym University Gangnam Sacred Heart Hospital, is interviewed at Hallym University Gangnam Sacred Heart Hospital in Yeongdeungpo-gu, Seoul on the 15th. By Kim Kyung-ho, Senior Correspondent, [email protected]

―The past two years must have been days like a war. “Even these days, sometimes I wake up in the morning feeling like I just woke up from a dream. The past two years have been a dream, and it feels like going back to a certain day in 2019 and living a normal life. That’s why I miss life before Corona so much. I still can’t believe how this movie-like thing happened.” ―If you look at the exposure to the media these days, it seems that 24 hours a day is not enough. What are you doing in relation to COVID-19? “In our hospital, there are 8 intensive care beds for COVID-19 and 5 general beds. We are also managing about 400 home-treated patients. Since I am the head of the Department of Infectious Diseases, it can be said that I am responsible for all the treatment for COVID-19. As for outside activities, he often advises governments such as the Korea Centers for Disease Control and Prevention and the Ministry of Health and Welfare. I am also a member of the Daily Recovery Support Committee. We also provide advice on infection control in small and medium-sized hospitals such as nursing homes.” ―The government seems to be announcing measures to strengthen quarantine soon. There were many reviews that it was too late, how do you see it? “The government’s response was delayed one step at a time. The ‘special quarantine measures follow-up measures’ implemented from the 6th of this month (limited to 6 people in the metropolitan area and 8 people in the non-metropolitan area) should have come out by the end of November at the latest. Then things wouldn’t have gotten this bad. It is also unfortunate that the business hours restrictions were not included in the follow-up measures.” ―How serious is the current medical situation? “It is almost at its limit. In addition to waiting for a critically ill patient brought to the emergency room because there is no room, I heard that a home treatment patient suddenly deteriorated and there was no room for the emergency room, so he waited in the ambulance for over a day. The patient needs to go to the intensive care unit right away. The pressure I feel in the medical field is much greater than last December (the third wave).” ―Why is the government’s response so delayed one step at a time? “In order to tighten the quarantine, we need to come up with measures to compensate the loss of the self-employed and small business owners, but it must be because we can’t promise that with certainty. This is because the Ministry of Strategy and Finance has continued to show a passive attitude toward compensation for losses. In the past, there have been times when we have been criticized for preemptively strengthening quarantine measures, but only increasing damage to the livelihood of the people by overreacting.” ―When discussing ‘step-by-step recovery of daily life’ (with Corona), did the experts anticipate such a situation? “Everyone predicted that the epidemic would worsen and there would be problems with the medical system if the extent of quarantine mitigation was not well controlled. In the case of Singapore, the number of confirmed cases has risen sharply even though there has not been much relief. So even within the Daily Recovery Support Committee, there was a position that the quarantine and medical parts should not be eased abruptly, but the demand for easing in the economic part was too strong. We tried to prevent rapid relief as much as possible, but it was not an easy situation. That’s why we made a safety plate called ’emergency plan’ at our request.” ―Are you saying that the problem was that the extent of quarantine relief was too large in the first stage? “That’s right. Besides, the government has already increased the number of private gatherings before the gradual recovery of daily life, that is, after Chuseok. He gave a strong sign of easing the quarantine. So the fashion scale was already growing. In such a situation, a gradual recovery of daily life began, and the extent of easing of quarantine was large. And in the past, when the epidemic was expected to strengthen the quarantine, the amount of movement of people started to decrease first, but recently, the pattern has changed. Signs for mitigating quarantine are accepted quickly, while signs for strengthening are accepted later. That’s how tired you are. Because of quarantine fatigue.”

In the intensive care unit of a hospital in the metropolitan area, medical staff are taking care of a patient with severe COVID-19.  By Kim Myung-jin, staff reporter littleprince@hani.co.kr

In the intensive care unit of a hospital in the metropolitan area, medical staff are taking care of a patient with severe COVID-19. By Kim Myung-jin, staff reporter [email protected]

―The biggest problem this time is the shortage of beds for critically ill patients. What is the reason for the shortage of beds so quickly? “It was not that the government was not concerned about securing hospital beds. We anticipate that the number of patients will increase when we go into a step-by-step recovery, and we have a plan to secure a bed. However, as the vaccine’s effectiveness in preventing infection and aggravation fell faster than expected, the number of critically ill patients increased faster than expected. We made a plan to secure beds based on the severity of the disease during the period (September to October) when the vaccination effect of the elderly was sufficient. As a result, the speed of securing beds did not keep pace with the rate of increase in critically ill patients.” ―The problem of shortage of beds is serious, but the rate of expansion is too slow. “Currently, most intensive care units with sufficient capacity to see patients with severe COVID-19 are located in tertiary general hospitals or university hospitals. However, the intensive care unit of such hospitals was a place where there were not enough seats since there were many patients before Corona. Getting out of bed is not easy. It is also necessary to take into account that there may be problems in the treatment of general intensive care patients. A balance between corona treatment and general intensive care is necessary. That is why it is necessary to control the scale of the epidemic at an appropriate level so that the number of critically ill patients does not increase rapidly. Unlike other countries, the reason why there were almost no ‘excess deaths’ during the corona epidemic in Korea is because the epidemic has been well controlled and balanced.” ―Some people pointed out that the shortage of medical personnel was a problem. How do you view it? “It is true that in Korea, manpower is very tight. In the United States, one nurse usually sees one critically ill, but we see two or three, or up to four at most. It is a system that is maintained by reducing labor costs. In this situation, even if the number of beds for critically ill patients with COVID-19 is increased, the manpower will not be able to withstand it. I don’t know if I usually see 2 people rather than 1, but I’m already seeing 2-4 people, so I can’t ask you to see more.” ―There are many voices complaining of anxiety and discomfort about the home treatment, which the government has been taking as a principle for some time. “Home treatment is inevitable for a step-by-step recovery. It can also be seen as a kind of normalization of the medical system. In the past, Korea has maintained a system that finds patients one by one and treats them at hospitals or living treatment centers, which is rare in the world. Most people wait at home and go to the hospital when they become unbearable. There are few countries where medical staff check the condition of home patients like ours. Of course, it is understandable that you feel anxious when you are constantly being hospitalized and then suddenly ask for home treatment, but now is the time to change that. It is a disappointing part that we started as if we were being pushed because the number of confirmed cases was soaring without sufficient preparation.” ―There seems to be an evaluation that the policy of implementing the youth quarantine pass only stimulated public opinion against vaccination. “Even if schools are to reopen next year, we need to increase the youth vaccination rate. Of course, it would be best to encourage vaccination by going through the process of explaining and persuading them in advance. Recently, the number of confirmed youths has increased rapidly, so there is an aspect that the introduction policy was urgently announced, but I think it was inevitable. However, it is truly unfortunate that the ‘anti-white papers’ (anti-vaccine opponents) gave an opportunity to raise their voices by riding on the public opinion against some parents.” ―I heard that you get a lot of complaints about recommending vaccination. “Yes. There were also emails protesting, and a one-man protest was held near my house a while ago. It became the achievement of the ‘anti-white papers’.” (Laughs)

On the afternoon of the 19th, citizens who visited the temporary screening test center for COVID-19 prepared in the 2nd parking lot of Jamsil Sports Complex in Songpa-gu, Seoul are lining up for the test.  yunhap news

On the afternoon of the 19th, citizens who visited the temporary screening test center for COVID-19 prepared in the 2nd parking lot of Jamsil Sports Complex in Songpa-gu, Seoul are lining up for the test. yunhap news

―These days, there is a saying that ‘the era of constant infectious diseases’, but what do you think needs to be changed in order to have a sustainable medical system even in the face of epidemics? “First of all, the intensive care unit needs to be converted to a single-bed structure. If the intensive care unit is a single room, the general intensive care unit can be flexibly converted into a bed for patients with infectious diseases in a crisis situation. For example, if there are 10 single-bed intensive care units, they are usually used for general patients, but when an infectious disease such as Corona 19 spreads, some of them can be immediately converted to dedicated beds. In the United States, all intensive care units are single beds. In a structure where more than 10 people are lying in an intensive care unit like Korea, even if only one patient with an infectious disease is to be received, all other critically ill patients must be evacuated to empty the room. Securing hospital beds will inevitably be delayed. In addition, we must ensure that patients with infectious diseases can be safely treated through outpatient treatment in hospitals. Then, even in infectious disease situations, patients can be seen within the daily medical system. Of course, this is possible with a significant investment.” ―I understand that you have emphasized the need for a social safety net several times over the years. “If a social safety net is in place on a regular basis, it can prevent the vulnerable from falling into the abyss in disaster situations. And this is essential for sustainable quarantine. At least you don’t have to worry about making a living, so why not comply with the government’s quarantine regulations? When you are sick, you need to be able to rest to control the spread of infectious diseases. ―You seem to have a lot to say about the media reports related to COVID-19. “I would like the media to report with the direction and principle of ‘overcoming the crisis’ in a disaster situation. The attitude of publishing interesting and provocative articles that may cause misunderstanding of the public or even contesting the opinions of experts is very worrying. In particular, I think we should refrain from inducing anxiety by even publishing unsubstantiated claims about vaccination.” ―Finally, I think you will get a lot of questions like this in private. How long will the Corona 19 epidemic last? “Actually, until the delta mutation came out, I expected that it would be a little more stable by the end of this year. Of course, I expected it to be a few more years before the end of it. But when Delta came out, I thought, ‘This isn’t really easy, it’s going to last a long time’. After that, I thought, ‘How can we block Delta well, maybe another mutation stronger than this will come out’, but recently Omicron came out again. So now I’m thinking that I shouldn’t say that I can go back to the past at some point. Whether it will be two years or three years, we do not know, but for a while we have no choice but to live with Corona. I think the time has come for us to think that we should change our lives, not restore our daily lives.” Jong-gyu Lee Editorial member [email protected]



Reference-www.hani.co.kr

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