[Q&A] Experts Discuss 'Gwahak Bangyeok'... Is Reintroduction of Social Distancing Possible?

[Image source=Yonhap News]

[Asia Economy Reporter Kim Young-won] Despite the recent increase in COVID-19 cases, health authorities have been emphasizing 'voluntary quarantine' only, leading to criticism that 'scientific quarantine' has been lost. As breakthrough infections and reinfections among fully vaccinated individuals have increased, doubts about the effectiveness and safety of the expanded fourth dose have also grown. On the 28th, the Korea Disease Control and Prevention Agency held a session answering public questions about the COVID-19 situation with Professor Kim Nam-joong of Seoul National University’s Department of Infectious Diseases and Professor Jung Jae-hoon of Gachon University College of Medicine’s Department of Preventive Medicine.

What does the government mean by 'scientific quarantine'?

(Kim Nam-joong) Scientific quarantine aims to minimize damage as much as possible by gathering scientific evidence available in the current situation. The current goal of quarantine is to minimize the number of critically ill patients and deaths. In this process, understanding the characteristics of variants and having vaccines and treatments allows for rational policy decisions considering all these factors, which I consider scientific quarantine measures.

However, scientific quarantine measures are not easy. For example, when a variant like BA.5 appears, it is necessary to understand its characteristics well, which always takes time. Nevertheless, quarantine policies must be decided. COVID-19 is the ultimate case of uncertainty management, and decisions cannot be postponed due to lack of data. Responding based on the best available scientific evidence is what I consider a scientific response.

Can 'voluntary quarantine' also be considered scientific quarantine?

(Jung Jae-hoon) So far, quarantine policies are the result of two and a half years of experience and sacrifice. During the Omicron surge in March, South Korea underwent a paradigm shift in quarantine policy. Before Omicron, policies aimed to suppress spread and reduce the overall number of infections, but after Omicron, it became practically impossible to stop the spread. Since then, quarantine has been applied in a way that tolerates some spread while reducing the scale of damage.

Widespread and uniform social distancing can have effects but also causes significant social and economic damage. Considering both, deciding future policy directions in a way that minimizes harm to the public is supported by various scientific agreements and consensus. The state's responsibility is not only to enforce uniform social distancing but also to secure medical and quarantine response capabilities in advance and communicate them to the public.

Especially before a resurgence, preparations such as encouraging the fourth dose, securing oral antiviral drugs, and flexible hospital bed management have been underway to some extent since the end of the Omicron surge. So, while not implementing social distancing means 'voluntary' in that sense, the state is fulfilling its responsibilities regarding other quarantine and medical response capabilities.

Is there a possibility of reintroducing social distancing?

(Jung Jae-hoon) Social distancing is effective, but its impact varies depending on timing, duration, and variant type. During the Delta variant wave, strong social distancing could suppress the outbreak. However, from Omicron onward, social distancing had limited effect in significantly reducing the scale or delaying the peak of the outbreak. We now need to consider whether the severe losses to small business owners, self-employed individuals, and children's academic setbacks are worth the limited benefits. We are at a point where the cost of social distancing outweighs its benefits. Other measures to suppress spread include mask-wearing and mandatory isolation of infected individuals.

(Kim Nam-joong) Strong distancing includes bans on gatherings, restrictions on restaurant operations, and suspension of in-person education. The current quarantine policy aims to minimize critically ill patients and deaths, which mostly occur among the elderly. However, social distancing mainly affects younger age groups. Therefore, the harm may outweigh the benefits. Although unlikely, if a new variant with severity equal to or greater than Delta emerges and spreads rapidly, strong social distancing may be reintroduced to achieve the goal of minimizing critically ill patients and deaths. Because the situation is variable, experts analyze it and provide appropriate opinions accordingly.

Please explain the safety of vaccines, including the fourth dose.

(Jung Jae-hoon) COVID-19 vaccines are among the most widely administered vaccines worldwide. Adverse reactions are evaluated under very strict global standards. According to global research, there have been no reports so far indicating that adverse reactions increase with the fourth dose compared to the first to third doses.

Also, vaccine adverse reactions such as myocarditis are known to occur more frequently in younger age groups than in the elderly. The current fourth dose recommendation targets, especially those aged 50 and above, have a low frequency of adverse reactions. People aged 50 and above also gain relatively greater benefits from vaccination. Therefore, considering the benefits and safety, vaccination is recommended. Currently, the overall adverse reaction reporting rate after the fourth dose is 0.06% during vaccination, which is lower than that of the primary and third doses.

With the improved vaccines soon to be introduced, is it necessary to get vaccinated now?

(Kim Nam-joong) Of course, if improved vaccines targeting BA.4 or BA.5 become available, they are expected to be more effective. However, no country is currently using improved vaccines for BA.4 or BA.5. Development is expected to be completed and available around October, but we still need to wait. We cannot wait for improved vaccines to respond to the current situation. The vaccines currently in use contribute to reducing severity and fatality, especially among high-risk groups like the elderly. Therefore, it is more reasonable to administer the fourth dose to eligible individuals now rather than waiting for improved vaccines and not getting vaccinated.

What is the situation of the outbreak overseas?

(Jung Jae-hoon) Until the Omicron surge, there was a time lag of over a month between Korea and other countries. However, as most countries worldwide have returned to normal life and international exchanges have resumed, the global outbreak trend and Korea’s trend are now almost identical. There is currently a time lag of about 1-2 weeks, and some major developed countries appear to have already reached their peak. This supports predictions that Korea will reach its peak within the next 1-2 weeks.

Because BA.2.75 was a concern, many experts have been monitoring its spread, but its spread appears slower than expected. Therefore, I personally speculate that BA.2.75 will have a limited impact on the scale of this outbreak.

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