"Including Patients in Their 50s with Underlying Conditions in Home Treatment... Confusion Grows Amid Fluctuating Policies"

Ahead of the transition to the home treatment system, on the 9th, staff at the home treatment team set up in a district office in Seoul are sorting health kits and treatment medicines to be delivered to home treatment patients. Photo by Jinhyung Kang aymsdream@

As the quarantine authorities prepare to implement a new home treatment system for COVID-19 confirmed cases, they initially excluded patients in their 50s with underlying conditions from the 'intensive management group' but reinstated them within a day. This flip-flopping on even the most basic patient classification criteria right before the new system's launch has drawn criticism for causing confusion among local governments and medical sites.

The Ministry of Health and Welfare announced around 11 p.m. on the 9th through a press release that "the criteria for the home treatment intensive management group have been finalized as 'those aged 60 or older or patients eligible for oral antiviral treatment (Paxlovid) whom local governments deem require intensive management.'"

On the 7th, the quarantine authorities had defined the intensive management group?patients whose health status must be checked twice daily by medical institutions?as "those aged 60 or older and those eligible for oral antiviral prescriptions (high-risk patients aged 50 or older with underlying conditions or immunocompromised)." However, on the morning of the 9th, this was changed to "those aged 60 or older and those already prescribed oral antiviral drugs whom local government heads judge to require intensive management." This meant that confirmed cases in their 50s with underlying conditions or immunocompromised status who were not prescribed the oral antiviral Paxlovid were excluded from health monitoring.

Underlying conditions include diabetes, hypertension, cardiovascular disease, chronic kidney disease, chronic pulmonary disease (including asthma), cancer, and overweight (BMI 25 or higher). Choi Jong-gyun, head of the home treatment team at the Central Disaster and Safety Countermeasure Headquarters, explained, "During the basic epidemiological investigation and patient classification, patients with diabetes or severe cardiovascular diseases are transferred to hospitals or residential treatment centers. For those prescribed oral antiviral drugs, additional monitoring may be necessary due to possible side effects, so they are designated as the intensive management group."

However, Paxlovid has 28 drug components that should not be taken concurrently, including the painkiller pethidine, angina treatment ranolazine, and the anxiety/depression remedy St. John's Wort. As a result, some patients with underlying conditions are not prescribed Paxlovid. When such patients in their 50s with underlying conditions or immunocompromised status have never been prescribed Paxlovid due to contraindicated medications, they are classified into the general management group and do not receive monitoring. In response to these concerns, the authorities reverted to the original criteria.

The Ministry of Health and Welfare urgently issued a statement just an hour before the new home treatment system's launch, stating, "After hearing opinions from the field, the criteria for the intensive management group have been corrected to 'patients eligible for oral antiviral treatment whom local governments deem require intensive management.'"

Starting from the 10th, the quarantine authorities will provide home treatment kits?including self-test kits, antipyretics, thermometers, pulse oximeters, and disinfectants?only to the intensive management group, with twice-daily telephone monitoring. Asymptomatic and mild cases in the general management group will manage their health with antipyretics on their own and can call local clinics or 24-hour home treatment medical consultation centers for telemedicine if they feel unwell.

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