Lives were saved by reserving beds for most acutely ill Covid-19 patients and putting less sick in dorms
A camping site in Sejong, South Korea, functioning on March 12 as a makeshift clinic for patients with mild Covid-19 symptoms. PHOTO: YONHAP NEWS/NEWSCOM/ZUMA PRESS
By Dasl Yoon
March 22, 2020 7:00 am ET
DAEGU, South Korea—During the darkest days of its coronavirus outbreak, South Korea didn’t have enough doctors and nurses to treat the sick, and patients were dying while waiting for hospital beds.
The country managed to turn the rapidly deteriorating situation around quickly, however, by devising a system to reserve hospital beds for those most in need and creating extra space with help from its biggest companies.
South Korea divided confirmed patients into four categories. Only the sickest and elderly went to hospitals. The young and asymptomatic went to dormitories, which were lent bySamsung Life Insurance Co., LG Display Co. and others, equipped with little more than beds, Wi-Fi and the occasional television.
The decision ensured that low-risk individuals remained quarantined under government watch. Thousands of South Korea’s virus patients have ridden out the past several weeks living in buildings where companies typically put up workers for off-site, multiday training.
With Covid-19 cases skyrocketing daily, health officials around the globe fear their countries lack enough hospital beds, respirators, supplies and staffing to meet demand. Few, if any, can. But South Korea, where new infections have recently tapered off, offers an example of how the intense pressure on hospital beds and equipment can be alleviated.
South Korea, despite roughly 8,900 confirmed patients, has reported only 104 deaths. Just five died while waiting for a hospital bed, and everyone with severe symptoms is now hospitalized. Not a single South Korean doctor or nurse has died.
“We were fighting a war with very little time on our hands,” said Min Pok-kee, who heads South Korea’s Covid-19 response team in the city of Daegu, the center of the country’s coronavirus outbreak. “If we had not secured these other facilities, our death rate would have resembled other countries’.”
The coronavirus pandemic hasn’t yet shown much stasis. In Italy, where deaths now outnumber those of China, where the outbreak began, hospitals are forced to choose which critically ill patients get admitted to intensive-care units. Some U.K. lawmakers are urging health officials to requisition beds from private hospitals. China addressed its bed shortage by building two makeshift hospitals in the hard-hit city of Wuhan.
And in the U.S., some large cities are contemplating converting entire hotels into hospitals, while the country’s largest hospital group warns of respirator shortages.
South Korea had a decided advantage over the U.S., with far more hospital beds per capita. The country has more than 12 hospital beds per 1,000 people, compared with the U.S., which has less than 3 per 1,000, according to the Organization for Economic Cooperation and Development.
Based on some modeling of virus spread, the U.S. could be about 100,000 ICU beds short, said Irwin Redlener, director of Columbia University’s National Center for Disaster Preparedness.
A country of 52 million people, South Korea also benefited from having a single-payer health-care system that ensured testing—and treatment—was free or low-cost. Wide screeningdetected the sick early on. The strategy succeeded at preventing a riptide of contagions forming outside the Daegu area. The pace of new infections has slowed.
Ambulances parked earlier this month in Daegu, South Korea, as they wait to transport patients with mild symptoms of the coronavirus.PHOTO: LEE MOO-RYUL/NEWSIS/ASSOCIATED PRESS
In late February, South Korea confronted an increasingly familiar problem as infections exploded across Daegu. The task: quickly secure 5,000 hospital beds, locate 1,000 more medical staff and keep supplies plentiful.
The most profound shift occurred on March 1 when the country’s Centers for Disease Control and Prevention stopped admitting every confirmed patient into a hospital. Instead, it divided everyone into four groups based on criteria set by South Korea’s largest physicians group: asymptomatic, mild, severe and critical.
Only the latter two categories went to the hospital. Patients running fevers more than 100 degrees, having difficulty breathing or aged 50 or above were deemed severe or critical, according to guidelines from the Korean Medical Association.
Workers setting up containers as a makeshift medical facility to accommodate Covid-19 patients on the grounds of a hospital in Daegu, South Korea, on Feb. 28.PHOTO: KIM HYUN-TAE/YONHAP NEWS/ASSOCIATED PRESS
The approach bore some similarities to that in Wuhan, the city at the center of the pandemic in China, where officials also split up at-risk people into four categories. The Chinese city relied on the Communist Party’s local residential committees to assess patients. In South Korea, doctors were the ones making the call.
The Seoul government’s classification showed about 80% of the cases were mild, a similar ratio to that in Wuhan. But the grouping exercise also highlighted who should take priority: Just one of every 10 individuals needed medical treatment at a fully equipped hospital, said Son Young-rae, a senior South Korean health ministry official.
“We could focus on hospitalizing severe patients in intensive care units with round-the-clock treatment, which lowers the death rate,” Mr. Son said.
The shift required some relatively healthy people already hospitalized to be discharged. In early March, roughly 3,000 people were moved to more than a dozen repurposed company dormitories that health officials labeled as “residential treatment facilities.” The buildings include those owned by Samsung Life and LG.
LG Display, in a statement, said it provided its facility to “share in the community’s difficulties.” Samsung Life declined to comment. Until the virus hit, the facilities were used by company staff during training retreats. The South Korea government pays for staffing and utilities, though not rent.
Some of the makeshift medical facilities were hours away from Daegu. In one instance, a bus was chartered and left fully packed with infected patients.
The nonhospital venues dramatically reduced staffing shortages that looked bleak in the first week. Only about 10 medical staff are required for a 200-patient facility. Those whose condition worsens are transferred immediately to a nearby hospital.
To counter a shortage of medical staff, South Korea’s health officials and medical groups called for volunteers. Eventually more than 1,000 people raised their hands.
The bed shortage has also dissipated. As recently as March 8, more than 2,200 confirmed patients—or roughly 40% of Daegu’s total cases—awaited a hospital bed of any kind. Two weeks later, that number has dwindled to just 124, all of which are mild or asymptomatic cases.
Having learned from Daegu’s experience, all districts in South Korea have been ordered to secure residential facilities before cases rise, said Mr. Son, the health ministry official.
With the nation’s infections moderating, hospitals say they have enough government-provided protective suits, goggles and masks to last seven to 10 days, though initially supplies had been depleted. Doctors still may wear a single mask all day rather than switch out after the recommended eight hours. Volunteer nurses often wear protective suits longer than the recommended two hours. “Manageable but not ideal,” a Korean Medical Association spokesman said.
Life inside the residential-treatment facilities can be calm. Kim Jin-sun, a 27-year-old nurse, volunteered earlier this month at the Samsung Life Insurance facility that holds around 170 relatively healthy coronavirus patients. She works 16-hour shifts. Small talk is scant as she monitors patients and hands out medicine.
One male patient, fearful of spreading infection, hides his face behind the door every time she shows up. He typically utters the same few words: “Thank you, thank you.”
https://www.wsj.com/amp/articles/how-south-korea-solved-its-acute-hospital-bed-shortage-11584874801
@60 in case you haven’t seen this or are interested.
A camping site in Sejong, South Korea, functioning on March 12 as a makeshift clinic for patients with mild Covid-19 symptoms. PHOTO: YONHAP NEWS/NEWSCOM/ZUMA PRESS
By Dasl Yoon
March 22, 2020 7:00 am ET
DAEGU, South Korea—During the darkest days of its coronavirus outbreak, South Korea didn’t have enough doctors and nurses to treat the sick, and patients were dying while waiting for hospital beds.
The country managed to turn the rapidly deteriorating situation around quickly, however, by devising a system to reserve hospital beds for those most in need and creating extra space with help from its biggest companies.
South Korea divided confirmed patients into four categories. Only the sickest and elderly went to hospitals. The young and asymptomatic went to dormitories, which were lent bySamsung Life Insurance Co., LG Display Co. and others, equipped with little more than beds, Wi-Fi and the occasional television.
The decision ensured that low-risk individuals remained quarantined under government watch. Thousands of South Korea’s virus patients have ridden out the past several weeks living in buildings where companies typically put up workers for off-site, multiday training.
With Covid-19 cases skyrocketing daily, health officials around the globe fear their countries lack enough hospital beds, respirators, supplies and staffing to meet demand. Few, if any, can. But South Korea, where new infections have recently tapered off, offers an example of how the intense pressure on hospital beds and equipment can be alleviated.
South Korea, despite roughly 8,900 confirmed patients, has reported only 104 deaths. Just five died while waiting for a hospital bed, and everyone with severe symptoms is now hospitalized. Not a single South Korean doctor or nurse has died.
“We were fighting a war with very little time on our hands,” said Min Pok-kee, who heads South Korea’s Covid-19 response team in the city of Daegu, the center of the country’s coronavirus outbreak. “If we had not secured these other facilities, our death rate would have resembled other countries’.”
The coronavirus pandemic hasn’t yet shown much stasis. In Italy, where deaths now outnumber those of China, where the outbreak began, hospitals are forced to choose which critically ill patients get admitted to intensive-care units. Some U.K. lawmakers are urging health officials to requisition beds from private hospitals. China addressed its bed shortage by building two makeshift hospitals in the hard-hit city of Wuhan.
And in the U.S., some large cities are contemplating converting entire hotels into hospitals, while the country’s largest hospital group warns of respirator shortages.
South Korea had a decided advantage over the U.S., with far more hospital beds per capita. The country has more than 12 hospital beds per 1,000 people, compared with the U.S., which has less than 3 per 1,000, according to the Organization for Economic Cooperation and Development.
Based on some modeling of virus spread, the U.S. could be about 100,000 ICU beds short, said Irwin Redlener, director of Columbia University’s National Center for Disaster Preparedness.
A country of 52 million people, South Korea also benefited from having a single-payer health-care system that ensured testing—and treatment—was free or low-cost. Wide screeningdetected the sick early on. The strategy succeeded at preventing a riptide of contagions forming outside the Daegu area. The pace of new infections has slowed.
Ambulances parked earlier this month in Daegu, South Korea, as they wait to transport patients with mild symptoms of the coronavirus.PHOTO: LEE MOO-RYUL/NEWSIS/ASSOCIATED PRESS
In late February, South Korea confronted an increasingly familiar problem as infections exploded across Daegu. The task: quickly secure 5,000 hospital beds, locate 1,000 more medical staff and keep supplies plentiful.
The most profound shift occurred on March 1 when the country’s Centers for Disease Control and Prevention stopped admitting every confirmed patient into a hospital. Instead, it divided everyone into four groups based on criteria set by South Korea’s largest physicians group: asymptomatic, mild, severe and critical.
Only the latter two categories went to the hospital. Patients running fevers more than 100 degrees, having difficulty breathing or aged 50 or above were deemed severe or critical, according to guidelines from the Korean Medical Association.
Workers setting up containers as a makeshift medical facility to accommodate Covid-19 patients on the grounds of a hospital in Daegu, South Korea, on Feb. 28.PHOTO: KIM HYUN-TAE/YONHAP NEWS/ASSOCIATED PRESS
The approach bore some similarities to that in Wuhan, the city at the center of the pandemic in China, where officials also split up at-risk people into four categories. The Chinese city relied on the Communist Party’s local residential committees to assess patients. In South Korea, doctors were the ones making the call.
The Seoul government’s classification showed about 80% of the cases were mild, a similar ratio to that in Wuhan. But the grouping exercise also highlighted who should take priority: Just one of every 10 individuals needed medical treatment at a fully equipped hospital, said Son Young-rae, a senior South Korean health ministry official.
“We could focus on hospitalizing severe patients in intensive care units with round-the-clock treatment, which lowers the death rate,” Mr. Son said.
The shift required some relatively healthy people already hospitalized to be discharged. In early March, roughly 3,000 people were moved to more than a dozen repurposed company dormitories that health officials labeled as “residential treatment facilities.” The buildings include those owned by Samsung Life and LG.
LG Display, in a statement, said it provided its facility to “share in the community’s difficulties.” Samsung Life declined to comment. Until the virus hit, the facilities were used by company staff during training retreats. The South Korea government pays for staffing and utilities, though not rent.
Some of the makeshift medical facilities were hours away from Daegu. In one instance, a bus was chartered and left fully packed with infected patients.
The nonhospital venues dramatically reduced staffing shortages that looked bleak in the first week. Only about 10 medical staff are required for a 200-patient facility. Those whose condition worsens are transferred immediately to a nearby hospital.
To counter a shortage of medical staff, South Korea’s health officials and medical groups called for volunteers. Eventually more than 1,000 people raised their hands.
The bed shortage has also dissipated. As recently as March 8, more than 2,200 confirmed patients—or roughly 40% of Daegu’s total cases—awaited a hospital bed of any kind. Two weeks later, that number has dwindled to just 124, all of which are mild or asymptomatic cases.
Having learned from Daegu’s experience, all districts in South Korea have been ordered to secure residential facilities before cases rise, said Mr. Son, the health ministry official.
With the nation’s infections moderating, hospitals say they have enough government-provided protective suits, goggles and masks to last seven to 10 days, though initially supplies had been depleted. Doctors still may wear a single mask all day rather than switch out after the recommended eight hours. Volunteer nurses often wear protective suits longer than the recommended two hours. “Manageable but not ideal,” a Korean Medical Association spokesman said.
Life inside the residential-treatment facilities can be calm. Kim Jin-sun, a 27-year-old nurse, volunteered earlier this month at the Samsung Life Insurance facility that holds around 170 relatively healthy coronavirus patients. She works 16-hour shifts. Small talk is scant as she monitors patients and hands out medicine.
One male patient, fearful of spreading infection, hides his face behind the door every time she shows up. He typically utters the same few words: “Thank you, thank you.”
https://www.wsj.com/amp/articles/how-south-korea-solved-its-acute-hospital-bed-shortage-11584874801
@60 in case you haven’t seen this or are interested.
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