SGRA Kawaraban (Essay) in English
ChoiKyu-jin “Medical Blank and Human Rights” were made clear by COVID-19
◇At the beginning :
No countries have excellent plans against COVID-19 at this moment. In Sweden, they did “cluster immunities”. In Italy and U.K., there were a lot of dead because of the delay of measures at the beginning. We have a few effective measures through which we check suspected persons quickly and if they are proved to be infected, proper measures (grasping the numbers of patients and their isolations by administrations) would be taken and other people will keep “social distances”. It is an actuality now.
In such circumstances, we can say that the measures which Korea took are evaluated highly in the world. They are trying to follow the model of Korea, so-called “K-epidemic prevention”. For example, the world is taking notice of “drive through”, “walk through” and “diagnosis kits”. I am glad that Korea, which follows Japan as the member of the council of the WHO, can contribute to the world in the prevention of COVID-19.
It is true that “K-epidemic prevention” has succeeded. However, it is true also that there are opinions about problems behind Korean successes. I like to introduce such issues which exist in the back of Korean success. It is not my purpose to find fault with Korean way of preventions. I would be happy if you understand my real intention of bringing up the issues here the counter measures against the secondary wave of COVID-19 more perfectly than the first wave.
I would like to explain here about the most important issues like “medical blank” and “human rights” referring to two actual incidents. One is “the fatal accident of Mr. Chong Yuyob (17)” and “spread of COVID-19 at a night club at Itae-won in Seoul”.
◇Medical Blank in the fatal accident of Mr. Chong Yuyob(17)
Mr. Chong run high fever and went to a general hospital which is one in the area around seven o’clock in the evening. But he was refused any medical care before PCR checked and was asked to visit next day. He had to return home without any medical care as the PCR clinic had already closed at six o’clock.
He suffered from high fever all through the night. He visited the clinic to get PCR checked in the next morning and was X-rayed. However again, he had to return home because he had to wait for the result of PCR before hospitalization. In his home, he kept running high fever and had difficulties in breathing and his parent got touch with the Disease Headquarters (an organization under the Ministry of Health and Welfare) immediately. The headquarters got touch with the health center in the area, but the center needed PCR report from general hospital for further action. Meanwhile, time passed in vain. It was only after 4:30 PM when Mr. Chong went to the general hospital. His parent heard the result of X-ray and his condition was not good and was told to go to the Yong Nam University Hospital. Mr. Chong could not get proper medical care and passed away after two days.
Many people say that the death of Mr. Chong was unavoidable in such circumstances of the pandemic of COVID-19. If we get away with such case this time, it means we leave the similar cases which would have few hundred victims hereafter as “unavoidable accident”. Moreover, Mr. Chong had no basis diseases actually. During the time when we verify this accident seriously, we found many points which we cannot leave unavoidable.
It was the basic policy of general hospital, which is one in the area, that we cannot get any measures without results of PCR. It has revealed to be big faults of measures against COVID-19
If private hospitals had to follow Governmental regulations, they should have advised other facilities which can do PCR at earlier stage. There was a clinic within only five- minute walk actually which can check PCR that evening. In spite -of doctor’s view about Mr. Chong’s pneumonia next day, general hospital instructed him to wait at home before PCR. General hospital missed early chance of treatment and we can say it was the fault of hospital clearly. The Disease HQ and clinic both has just instructed parent to get touch with private hospitals. They did not mediate properly during the time when he waited for the result at home. It was a cause of accident this time that there was no control tower which know medical systems in the area accurately.
People can be hospitalized in Yong Nam University Hospital any time actually without the result of PCR. It means the accident could be prevented if either Disease Headquarter, health center or general hospital would have referred to Yong Nam Hospital. We cannot say Yong Nam Hospital had no fault. When they were informed from general hospital that the result of PCR is negative, they kept doubting of pneumonia by coronavirus and had checks thirteen times. Moreover, oxygen mask was off for thirty seconds. The reasons are under investigation now. But it may of medical staffs for infection treatment.
Some people say that it is the specialty of North Gyeonsang Province where big epidemics. 0ccures. But I think it is same with any other provinces. Korean societies should reconsider many points:
・We do not have any control tower which grasp the whole medical systems in the area.
・Where we can get instant PCR report quickly in the pandemic of COVID-19?
・Where do we get medical treatment in emergency before PCR check ? Many people agree that the Medical Control Head Quarter will be promoted to the Medical Control Agency. And, some people say that “Public Medical Agency” should be established in the circumstances which present Korean medical systems depend on private medical facilities.
Korea is the lowest among OECD Member Countries in terms of specific gravity of public health services. A specific gravity rate in terms of the number of sick beds is 10% and in terms of medical organizations is 5.7%. In North Gyeonsang Province where conservative political party is controlling, public medical service organizations were closed one after another and the gravity of public health services became lower than other provinces.
It is impossible to say that Mr. Chong’s death has no relations with unfortunate conjunction circumstances. We like bethink medical “blank” again.
◇Human Rights which can be seen through ”Spread of COVID-19 from Itaewon”
When the number of infected patients doubled digits gradually in early May, infection spread rapidly among visitors in Itaewon club. Dislike and discrimination against minority became serious after rapid spread of COVID-19. Human rights issue is big in Korea now.
The shadows of the issues on dislike and discrimination have been cast actually since the early stage of prevention of epidemics. Following to dislike and discrimination against Chinese, there was an attack on the specific religion “The New World” by the whole societies. The government has focused on measures for prevention of epidemics too much and has overlooked the issues. As a result, dislike and discrimination against minorities have occurred. As discrimination against specific groups is an obstacle for prevention of epidemics and connect to spread of coronavirus, everybody in the society have to work on and improve such phenomena.
According to report, many gay or (male) homosexual visited the club in Itaewon where there were clusters of infected people in early May. Media had attacked visitors in the club excessively as immodest sexual group and such dislike of feeling in the society was exaggerated. Moreover, the number of infected people has increased because some visitors to Itaewon did not get PCR. And dislike and discrimination against gay became more serious accordingly. In this case, complicated issue of discrimination is involved and we cannot debate simply saying they lack in ethical values. Some self-governing body check anonymously. But if people visit Itaewon, they are considered as gay and discriminated. This is question which will not be solved simply.
Once people get PCR check, they have to wait for result for one or two days at least even if they do not contact closely with infected person. They have to explain to their friends or workplaces for the reasons being stayed at home. In the atmosphere where media stirred up such dislike, it will be almost impossible for the people, who visited Itaewon, to inform work places about the report.
In the Korean society where there remains negative understanding against minority and such dislike and discrimination, it would affect the life. In case of a lecturer of “juku” (private-tutoring school) who goes to a university in Inchon area, he hid his actual occupation and what he hid his occupation caused to the situation that his colleagues and students were infected. Under such circumstances, Inchon city government filed criminal charge against him. He confessed afterward that he was afraid that his studies would affect and feared for further aspect of job. Would it be possible to say that he is responsible for spreading coronavirus? I think Korean society, media and politicians were responsible for the second and the third spread of infections. Korean society has discriminated minority. Media kept sending stereotyped messages that visitors to Itewon were minority and minority should be excluded from society. Politicians left also such messages unchecked and made ordinary people to be “liars”
Public health doctors (who work at health center not as military services) who worked at selected health centers and knew the importance of receiving checked quickly, had visited clubs at Itewon. But they hid such visits for four days and examined patients.
Even doctors who work at selected health center were afraid of discrimination rather than coronavirus.
As mentioned above, dislike and discrimination of the weak socially are big obstacles for prevention of epidemics. All world is prepared now for prolonged war against coronavirus. It will be simple to win the war. In case of suspicion of infections, it will be the only way for victory that we arrange everything in the circumstances to be able to get PCR check quickly. In order to improve present circumstances where we cannot receive PCR check voluntarily in discrimination, it is necessary to have positive intervention at national level.
It is true that infectious diseases are misfortunes which threatens humans. But we cannot say necessarily that there are only negative side in infectious diseases. The diseases have made us notice social issues which we could not find. When we can solve the problems properly, we can step up to more matured society. There are some who understand in wrong way. However, a lot of enterprises and politicians are trying to introduce desperately paid holiday systems (they can take holidays without losing salaries), remote medical treatment and biotechnologies. (Be ashamed to say, Korea is the only country among OECD member nations that has neither paid holiday systems nor allowance for sick and wounded.)
The discussion mentioned above are based on evaluation on success of “K-epidemic preventions”. I can say it is better than other countries where they cannot practice any measures for prevention and cannot foresee how they should discuss.
Frankly speaking, I am worried about missing my both lesson which we learn from epidemics of coronavirus and chances which we can develop to better societies.
SGRA Kawaraban 635 in Japanese (Original)
Choi_Kyu-jin / Professor Inha Medical University (Medical History and Medical Ethics),
This essay was written in the Korean language.
Korean to Japanese translation by Saori Hasegawa
Japanese to English translation by Kazuo Kawamura
English checked by Sabina Koirala