There’s no denying that South Korea initially managed to keep a lid on the virus by responding stringently and flexibly when COVID-19 first broke out. Based on aggressive testing, tracing and treatment, the country quickly isolated infected patients and implemented social distancing policies to limit daily infection numbers.

The strategy seemed to work, and as the world applauded the country’s success in flattening the curve, the Moon administration reveled in the attention, dubbing its response “K-Quarantine.” 

However, it was clear by autumn 2020 that the pandemic would stretch on and likely worsen over the colder months. It was also clear that COVID-19 vaccines would be readily available sooner than many expected after rapid development. 

But South Korea did not move to seal deals with major vaccine developers, opting instead to spend millions promoting K-Quarantine as the global standard for public health. The Moon administration seemed to believe South Korea’s COVID-19 response was so successful that vaccine imports were not needed and that the country could develop its own indigenous vaccines, despite medical experts’ skepticism.

To keep this dream alive, the South Korean government chose to enforce ever-increasing social distancing restrictions and sow doubt about the efficacy and safety of foreign vaccines. There is “no rush” to procure mRNA vaccines from abroad, said Ki Mo-ran, a professor at the National Cancer Center and key public health adviser to the Moon administration, as recently as 2021.

The government did allow some groups to get vaccinated beginning in February that year — likely due to public pressure as the U.S. and other countries made vaccines widely available. But it was months before enough supplies were procured for the general population. Once the widescale rollout began, the K-Vaccine drive quietly ebbed away.  Now in the third year of the pandemic, not a single K-vaccine has been approved and prospects for approval at any time in the future appear dim.

The result of the administration’s decision to ignore experts who disagreed with its overly optimistic narrative about vaccine development is that nearly half of the country does not trust the presidential office or elected offices to lead the pandemic response. Trust in public health authorities, such as the Korea Disease Control and Prevention Agency (KDCA), has fallen by around 20 percentage points since 2020.

A vaccine passport system used in South Korea | Image: Lee Jeongsoo via Pixabay

EVALUATING K-QUARANTINE

As Moon Jae-in prepares to leave office on May 9, he and his administration are framing K-Quarantine as a legacy-defining success story. Despite the high daily infection figures published by its own ministries, the government has continued to blow its own trumpet, refusing to listen to criticism. Prime Minister Kim Boo-kyum said the government’s quarantine efforts should not be undermined “based on the current numbers of infection cases.”

Citing South Korea’s relatively low death rate and economic figures, it was “insulting to the people” to call K-Quarantine a failure. “It is unacceptable,” he said. 

The government’s interpretation of the figures ignores reality, according to experts. The actual number of deaths is likely to be much higher, as those who died after their quarantine period or were indirectly affected by COVID-19 aren’t represented in the bracket. As hospitals were inundated with COVID-19 patients, hospital beds were nearing maximum capacity, critical surgeries were delayed and scores of elderly and severely ill patients died waiting for emergency care. In the first two months of 2022, ambulances took some 25 extra minutes to bring patients to the hospital.

Further, the low fatality rate could be due to the country’s high volume of testing. As the rate estimates the proportion of deaths among infected individuals, South Korea is likely to have a larger base of infected patients compared to other countries which would make the death rate smaller, according to Harold Lee, director of the Center for Convergence Approaches in Drug Development at Seoul National University. “As the denominator gets larger, then of course, the rate is going to go down correspondingly,” Lee said. 

Economic figures during the pandemic also shouldn’t be taken at face value. While South Korea’s overall GDP fell by just 0.9 percent in 2020 and grew 4% in 2021, nearly 20,000 small firms went bust every month in 2021, according to a state-funded Small Enterprise and Market Service report, unable to survive indefinite periods of shutdowns and restrictions on business operations. 

Top-line growth rates have been mostly concentrated in the IT industry and driven by external demand for semiconductors and electronics from Samsung, LG and other conglomerates. Most South Koreans do not work for such companies: Over nine in ten firms in the country are small- and mid-size enterprises (SMEs) that have been hit hard by K-quarantine. 

“Once it was clear the situation would stretch beyond just a few weeks, they should have started discussing greater compensation or assistance to help people keep their jobs,” said Yang Jun-sok, professor of economics at The Catholic University of Korea. “The measures came too late and it could have been put to more structured and targeted use, particularly during the first year of the pandemic,” Yang said. 

As small businesses struggled, they were forced to lay off employees. The second year of K-Quarantine saw the fewest number of Koreans employed at SMEs as a proportion of the workforce in nearly two decades. Similar trends appear on the horizon as well, with central bank projections pessimistic for 2022.

King Sejong the Great in Seoul’s Gwanghwamun Plaza, Feb. 2018 | Image: JH Seo via Pixabay

THE FUTURE OF COVID-19 IN SOUTH KOREA

The incoming Yoon government’s goal should stick to the basics of public health: protecting people’s lives and the health care system. 

Its first job should be to elevate and follow the advice of the South Korean scientific community. The outgoing Moon administration was all too willing to subsume empirical evidence in favor of top-down, politically convenient policies. 

“What the government did was preselect a handful of mediocre experts politically aligned with the administration, which led to a very biased policy process,” said Howard Lee of SNU. “No matter how many times we opposed and appealed to the government through channels like the media, we were shut out.”　

South Korea needs a clear, non-partisan pandemic response system, with greater autonomy and capacity for public health authorities to coordinate an effective response, former KCDA chief Jung Ki-seok wrote in a scathing review of K-Quarantine policies. This means increasing transparency and accountability in order to prevent arbitrary or politically motivated intervention and decisions by government offices. 

Public health strategists also need to look beyond short-sighted goalposts and devise strategies that allocate resources more prudently to prevent severe illnesses and deaths, Lee argued. “Testing and tracing worked in the early days of the outbreak but sticking to this was short-sighted. As the daily number of confirmed cases fluctuates widely, basing virus prevention measures on the number of infection cases was basically chasing a moving target,” he said.

The majority of last year’s allocated budget for the government’s response to COVID-19 went toward financial subsidies to encourage spending, purchasing vaccines and strengthening quarantine measures. But South Korea can more effectively “live” with COVID-19 if the medical infrastructure is better positioned to help health care workers deal with a sudden influx of inpatients and if long-term projects to build capacity and develop vaccines for future pandemics are better funded. 

The South Korean people did everything right, putting on masks before they were made compulsory by law, following social distancing rules religiously — even down to the tempo of the music playing at gyms — and jumping at the opportunity to get vaccinated. As of May 2022, 86.8 percent of the population is vaccinated, far higher than comparable rates in the U.S., Germany and Israel.

It was this high level of compliance that kept transmissions and deaths relatively low. But without discerning leadership, there seemed little payoff for the tremendous sacrifices that society was asked to bear. As a new administration takes office in May, what South Koreans need at this juncture is not a  shining story of success, but practical ways forward and, above all else, honesty. 

Edited by Arius Derr