Mystery of Infection Routes for Cases 29 and 30... Growing Concern in the Community

Concerns Over Full-Scale Community Transmission... Causality Unclear
Delayed Treatment May Worsen Symptoms

On the 16th, the Regional Medical Emergency Center at Korea University Hospital in Seongbuk-gu, Seoul, where the 29th COVID-19 patient visited, is conducting disinfection after implementing access control measures. Photo by Jinhyung Kang aymsdream@

[Asia Economy Reporters Choi Dae-yeol and Kim Heung-soon] Concerns are growing that community transmission of the novel coronavirus infection (COVID-19) in South Korea may be intensifying as patients with unidentified sources of infection have emerged among the newly confirmed cases. The specific infection routes of the 29th (born 1938, Korean male) and 30th (born 1952, Korean female) patients, a married couple who tested positive on the 16th, had not been identified as of the morning of the 18th, two days later. Community transmission refers to cases where patients arise among the public who are not included in the quarantine authorities' management system. Such individuals may unknowingly spread the virus to many others while going about their daily lives, and because treatment may start late, the likelihood of symptom worsening is high. Due to the extensive scope of epidemiological investigations by the authorities, causal relationships may remain unclear.

◆ Infection without overseas travel history= The Central Disease Control Headquarters had identified a total of 114 contacts of the 29th patient as of that morning. At Korea University Anam Hospital, where the COVID-19 positive diagnosis was made, a total of 76 people (45 medical staff and employees, 31 patients) were confirmed positive. Additionally, the patient had contact with 37 people at a hospital in Jongno-gu, Seoul (Gangbuk Seoul Surgical Clinic and Shin Jung-ho Internal Medicine Clinic) and a pharmacy (Bom Pharmacy), which he had visited since 2016 for treatment of other illnesses. The remaining one contact was his wife, who was classified as the 30th confirmed patient. The authorities determined that the 29th patient had symptoms such as cough and sputum starting from the 5th, designating that day as the symptom onset date. According to relevant regulations, the patient's movements and contacts are being traced from the day before, the 4th, to the present. However, no individuals linked to COVID-19 have been identified among the places visited or contacts during this period.

Therefore, the epidemiological investigation scope was expanded to include movements up to two weeks prior to symptom onset. Director Jeong Eun-kyung of the Korea Centers for Disease Control and Prevention stated, "Neither the 29th nor the 30th patient has a history of overseas travel, and no family members with overseas travel history or symptoms have been identified. We are investigating whether any contacts have traveled abroad or show symptoms by additionally confirming movements over approximately two weeks." She added, "Investigations are ongoing considering various possibilities regarding the infection source and route of the 29th and 30th patients, such as whether it was a common exposure or if the wife was infected by the husband." The 31st patient (born 1959, Korean female), who tested positive in Daegu on the same day, also reported no overseas travel history, necessitating further investigation.

◆ "Not the first community infection yet"= If the infection sources of the 29th and 30th patients remain unidentified, these cases would represent the first community transmission instances in South Korea. Neighboring countries such as Japan and Hong Kong have reported community transmission cases where infection sources or transmission routes could not be identified, with some resulting in fatalities. South Korean health authorities have repeatedly emphasized the need to prepare for possible community spread, but they have not yet concluded that the 29th and 30th patients represent such cases.

Director Jeong emphasized, "Tracking the movements of these two individuals over about two weeks takes some time, but we are not completely unable to estimate the infection source. We are investigating several possibilities." She added, "Currently, one rapid response team is conducting the epidemiological investigation, and if the scope expands, additional epidemiologists will be deployed. The investigation is being conducted jointly with local governments, including epidemiologists from Seoul and public health center officials, working as a team."

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