If Cold Patients Also Flock, Testing Surges... Possible In-Hospital Transmission

Infectious Disease Expert Diagnosis

Expansion of Physician Discretion Positive but
Field Paralysis When Everyone is Tested
Concerns Over Delays in Actual Patient Diagnosis

On the 7th, as the spread of the novel coronavirus infection continues, a visitor at the National Medical Center screening clinic in Jung-gu, Seoul, is being guided by medical staff to enter the hospital. Photo by Kim Hyun-min kimhyun81@

[Asia Economy Reporters Choi Dae-yeol, Kim Heung-soon] "The novel coronavirus infection (Wuhan pneumonia) is difficult to distinguish from the common cold. It coincides with the cold season, making diagnosis and differentiation challenging." (Baek Kyung-ran, President of the Korean Society of Infectious Diseases)

"There is a high possibility that patients unrelated epidemiologically will increase. We expect considerable confusion." (Choi Won-seok, Professor of Infectious Diseases, Korea University Ansan Hospital)

Domestic infectious disease experts expressed concerns about potential confusion at frontline medical sites as the criteria for novel coronavirus testing expanded from the 7th. The guidelines changed to allow virus testing for those who have traveled to places with many confirmed cases, even if not China. At a Korean Society of Infectious Diseases meeting held the previous day, domestic infectious disease experts raised such concerns while anticipating that the situation in China will continue to worsen for the time being.

Concerns Over Hospital Confusion Due to Surge in Testing Demand
Possibility of Contact with Infected Persons at Clinics... Experts Recommend "Self-Quarantine if Mild"

From this day, the case definition for novel coronavirus changed so that patients who have traveled to countries with community spread of the virus within the past two weeks and show symptoms such as fever or cough can receive virus testing. Although no specific countries are named, Thailand, Singapore, and Hong Kong, where many cases have recently emerged, are mentioned. This implies a high likelihood of a surge in testing demand.

Testing for novel coronavirus infection is now possible not only at the Korea Centers for Disease Control and Prevention and 18 provincial health and environment research institutes nationwide but also at about 50 private hospitals. Regarding this, Professor Choi said, "(With patients crowding) there is a risk of missing actual patients or delayed diagnosis, and the screening clinics may become congested, increasing the risk of transmission among patients." Professor Son Jang-wook of Korea University Anam Hospital's Infectious Diseases Department said, "While physician discretion is positive, over-testing is inevitable," adding, "If everyone is tested, the diagnostic field could become paralyzed."

Baek Kyung-ran, Chairperson of the Korean Society of Infectious Diseases (Professor of Infectious Diseases, Samsung Seoul Hospital, left), and Kim Tae-hyung, Professor of Infectious Diseases at Soonchunhyang University Seoul Hospital, are holding a meeting in the conference room of the Infectious Diseases Society on the 6th.

Hospital-acquired infections are also a concern. During the 2015 Middle East Respiratory Syndrome (MERS) outbreak, the 'super-spreader' routes were hospital settings such as emergency rooms. Hospitals have many immunocompromised individuals, making them vulnerable to infection. The mild initial symptoms of the novel coronavirus, which are difficult to distinguish from a common cold, are also factors that could increase the possibility of infection within clinics. President Baek said, "If the patient's symptoms are mild, we do not recommend visiting screening clinics for testing," adding, "In mild cases, it is appropriate to self-quarantine and get tested only if symptoms worsen." Kim Seong-ran, President of the Korean Infection Control Nurses Association, said, "There is great anxiety that infected and non-infected people might come into contact and spread infection at clinics."

Possibility of 'April Peak' but More Observation Needed

President Baek referred to the 'April peak theory' based on research results from a team led by Professor Gabriel Leung at the University of Hong Kong Medical School. According to their estimates, one confirmed novel coronavirus patient infects 2 to 3 people around them, and if this rate continues, the number of infected individuals doubles every 6.4 days. Professor Leung predicted, "If transmissibility does not weaken, the peak will be reached in April." President Baek supported this inference by comparing confirmed cases and death numbers in Wuhan, China.

He said, "Usually, when plotting patient and death trends, the numbers rise rapidly, reach a peak, level off, and then the slope declines," adding, "(For the novel coronavirus) the trend has not yet bent." He emphasized, "Considering expert predictions and graphs, infections still appear to be increasing."

On the 7th, as concerns over the global spread of the novel coronavirus rise, the GS Home Shopping building in Yeongdeungpo-gu, Seoul, where the 20th confirmed patient worked, is being restricted from entry./Photo by Kang Jin-hyung aymsdream@

Experts judged that although there is concern about domestic community transmission with increasing second- and third-generation infections, it is still too early to conclude definitively. Professor Heo Jung-yeon of Ajou University Hospital's Infectious Diseases Department said, "There is sufficient possibility of community transmission domestically, but the pattern will vary depending on behavior," noting, "It could be very limited or widespread." Professor Kim Nam-joong of Seoul National University College of Medicine's Department of Internal Medicine estimated, "Second- and third-generation infections are naturally expected in China, and there are one or two cases in Korea unrelated to Wuhan, with more likely to come."

"Little Evidence for Asymptomatic Infection"

Fear surrounding the novel coronavirus has increased due to the possibility of infection from asymptomatic patients. Generally, it is common knowledge that even if infected with a virus, if symptoms are absent or viral replication has not progressed, the chance of transmission to others is low. However, some cases of infection from contact with asymptomatic patients have been reported for the novel coronavirus.

President Baek said, "There are concerns about transmission during asymptomatic stages, but in reality, patients start with symptoms so mild that they do not recognize being ill, and virus shedding begins then, leading to infectivity," adding, "The initially reported asymptomatic infection case in Germany was later found not to be so." Professor Kim Tae-hyung of Soonchunhyang University Seoul Hospital said, "In Wuhan, where many patients exist, transmission was not asymptomatic but occurred through contact with confirmed cases."

On the 7th, as the spread of the novel coronavirus infection continues, medical staff are entering the screening clinic at the National Medical Center in Jung-gu, Seoul. Photo by Kim Hyun-min kimhyun81@

This content was produced with the assistance of AI translation services.