How South Korea Triumphed, and the US Floundered, Over the Pandemic

How South Korea Triumphed, and the US Floundered, Over the Pandemic

How South Korea Triumphed, and the US Floundered, Over the Pandemic

Testing, national health care, and transparency saved the day.

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On March 12, a startling chyron went up on CNN after a congressional briefing on the rapid spread of the dangerous coronavirus known as Covid-19. “Health officials tell lawmakers only about 11,000 people tested for virus in U.S.; South Korea testing about 10K per day,” it read, as the visibly shocked hosts Jim Sciutto and Poppy Harlow pressed their guests for an explanation.

In fact, the actual figures were even higher. “South Korea has been on average testing 12,000 patients a day—about as many as the U.S. has managed to test over the last two weeks,” the Los Angeles Times reported on March 14. By that time, the government of President Moon Jae-in had tested 261,335 people since January 3, when it reported its first confirmed case of the virus.

Many of the tests, as seen in this video from The Korea Times, were conducted at sites where citizens could be served in their cars, and are highly praised by people who live in South Korea. “The drive-through testing was quick, creative, innovative, free, and protective for all,” Brenda Paik Sunoo, an author and photographer with dual US–South Korean citizenship, told The Nation in a telephone interview from the island of Jeju.

Sunoo, who is from the San Francisco Bay Area and retired to Jeju a few years ago, explained that face masks are also readily available to Koreans in local pharmacies. “We’re allowed two a week,” she said, with distribution based “on the last number of your birth year.” In contrast, masks are in short supply in the United States and are sold out at stores throughout the country.

After statistics and anecdotes like these were broadcast on CNN that day in March, South Korea instantly became the hottest topic of the day. Americans glued to their televisions reeled in shock from the realization that the US government was woefully behind a country that is often portrayed as owing its democracy and economic system—indeed, its very existence—to the beneficence of the United States.

“It is shameful, disappointing, & tragic that the greatest country in the world, the US, has only tested 14,000 people” in comparison to South Korea’s huge numbers, Representative Maxine Waters tweeted on March 16.

“South Korea has proven that #COVID19 can be controlled,” Laurie Garrett, the prominent health and science writer, added on Twitter, pointing out that the country had pushed its epidemic down from a high of 909 new cases a day in late February to just 74 cases by March 16. “How did they get such dramatic results? Testing, testing, testing.”

The contrast is particularly shocking because health authorities in both South Korea and the United States learned of their first coronavirus case on the same day in late January, according to an investigation published by Reuters. Seven weeks later, the Korea Centers for Disease Control and Prevention had tested close to 300,000 people out of a population of 51 million, while the United States is “not even close to meeting demand for testing,” with only 60,000 tests in a population of 330 million, Reuters reported.

South Korea’s rapid rollout of its testing was crucial because “speed is paramount” in outbreak situations, Sanghyuk Shin, an assistant professor of nursing at the University of California at Irvine and the director of UCI’s Infectious Disease Science Initiative, told The Nation. “The longer the delay, the greater the mortality, and the public health response becomes much more difficult,” he said in an interview.

“South Korea started its response early, which was extremely important for slowing the spread” of coronavirus, Shin added. “In stark contrast, the slow pace of rolling out testing in the US has significantly hampered our ability to slow the spread of this virus, and now we clearly have widespread community transmission in the US.” Shin was born in Seoul but grew up in the United States, where he’s lived since he was 8 years old.

Many of the Korean tests were administered in drive-in centers around the country, where the procedure was available for free to any citizen who asked for one and results were available by text or e-mail within six to 12 hours. Moreover, test kits have been provided to “frontline” private hospitals and screening clinics since the beginning of February. As the news of the program spread, South Korean officials explained that their model could be duplicated throughout the world.

“By quickly diagnosing COVID-19, we’ve been able to minimize its spread and provide quick treatment, and that’s kept the mortality rate low,” Kang Kyung-wha, South Korea’s foreign minister, told the BBC. “I hope that South Korea’s experience and approach will not only benefit other countries but also lead to greater international cooperation on preparing for the next [viral outbreak].”

But the news, and Kang’s offer, wasn’t welcome at the White House, where President Trump has been presiding over daily briefings characterized by misinformation, outright lies, racist characterizations of the virus’s origin, and fantastic stretches of defensiveness (most of his claims have been repeated and amplified on Fox News). Time after time, Trump has downplayed the Korean tests—and the need for tests in general—and boasted that his approach was superior.

“Yeah, we can do that,” he replied to a question on March 7 about South Korea’s testing program during a visit to the Centers for Disease Control in Atlanta. But, as usual, he falsely claimed that South Korea was only “doing samples,” and “that’s not effective like what we’re doing.”

A week later, Trump again downplayed Korea’s record during his daily press conference at the White House. “I noticed a lot of people are talking about South Korea because they’ve done a good job on one side, but on the other side, tremendous problems at the beginning,” Trump told reporters. “They had tremendous problems and great numbers of death.” His refusal to even acknowledge the Moon government’s success was underscored the day before, when he went out of his way to praise Japan’s Prime Minister Shinzo Abe for overseeing construction of Japan’s “magnificent” Olympic venues in Tokyo.

“He has done an incredible job, one that will make him very proud,” Trump said of the conservative Abe, whom he often consults before Moon on issues related to North Korea. “Good things will happen for Japan and their great Prime Minister.” In Japan, of course, Abe has been soundly criticized for his own inaction on the coronavirus, and many analysts now believe the Olympic Games, scheduled for July, will be postponed, possibly to next year. Moreover, by March 18, Japan had tested only about 32,000 people, compared to the much larger numbers in South Korea.

But Koreans I interviewed said the tests were just one aspect of the Moon government’s success in combating the epidemic. The most important, most agreed, was South Korea’s national health care system. It was introduced in stages beginning in 1977, when the authoritarian government of Park Chung-hee mandated health insurance for large firms employing more than 500 people.

Then, in 1989, after the country was democratized, national health insurance was extended throughout the nation. “Within the span of 12 years, South Korea went from private voluntary health insurance to government-mandated universal coverage,” Jong-Chan Lee, a South Korean academic, wrote for the American Journal of Public Health in 2003.

Residents of South Korea cited three other factors: the Moon government’s reliance on health and infectious disease experts to transmit daily information to the public; the availability of high-speed Internet and Wi-Fi throughout the country, making for easy communication; and the traditional Korean practice of placing the public need first, above the individual, which is shared by many countries in Asia.

That latter characteristic, Sunoo told me, was critical in the willingness of South Koreans to socially isolate themselves, a practice so woefully lacking in the United States. “Social distancing has been the main weapon of mass protection,” she said. “Coronavirus has been contained because we’re staying at home. It’s less about protecting ourselves, and more about we don’t want to spread this throughout the community.”

In late January, Sunoo’s husband, Jan Sunoo, a labor educator, returned from a visit to Thailand and “self-quarantined” in a separate apartment for two weeks, she said. “Every decision we make we have one single goal: not spreading it.” She said she has been spending much of her time lately advising friends and relatives back home to follow South Korea’s example and warning, like many Italians have, that the consequences of ignoring social isolation guidelines could be fatal.

Convincing the public in South Korea to follow these guidelines was enhanced by President Moon’s decision to make public health officials the official voice of the government. Unlike Trump, who sparked widespread confusion and apathy with his conspiracy-laden pronouncements as the crisis unfolded, Moon ceded the public stage to Jeong Eun-kyeong, a former doctor who heads the Korea Centers for Disease Control and Prevention.

“Since the first COVID-19 case was recorded in South Korea, Dr Jeong from KCDC has briefed the public, on air, EVERY DAY for hours, answering journalists questions, explaining everything and detailing next steps,” Laura Bicker, the BBC’s correspondent in Seoul, tweeted, adding: “(She has visibly aged in those weeks) Lots of info = less panic.”

The KCDCP and other health agencies have provided, on a daily basis and via texts, detailed information about Covid-19 patients, including where they have been and where they may have contracted the virus. The government has also strongly advised the population to practice social distancing, even as the number of cases began to fall in mid-March.

“The high level of transparency, the availability of testing, the round-the-clock heroism of doctors and nurses, and the government’s refusal to initiate military-style lockdowns like in China will be seen down the road as parts of a blueprint for how to handle such a crisis democratically,” Seth Martin, a musician and teacher from Washington state who has been living in Seoul since 2015, told The Nation in an e-mail.

The ride has not been completely smooth, however. “In my opinion, the government does not pay enough attention to individual rights, and has fully disclosed the personal details of patients” in public pronouncements, Gayoon Baek, a South Korean historian and human rights activist in Seoul, told The Nation in an interview. “That’s not even necessary to prevent the spread of Covid-19.” In fact, the country does have a history of mass surveillance, which is in part a residue of its authoritarian past.

In response to such criticism, the KCDC recently issued new guidelines to local governments asking them “not to release specific addresses or workplace names so as to protect patients’ privacy,” the progressive Hankyoreh reported. “Local governments are also being asked to stop disclosing patients’ travel path and the places they’ve visited.”

It was also rough going in the beginning of the crisis. In February, as the epidemic in China reached a peak, President Moon angered many Koreans when he predicted that the coronavirus would “disappear before long” and decided against closing South Korea’s borders to China. Right-wing politicians and groups who have been gunning for Moon ever since he was elected in 2017 even supported an online petition seeking his impeachment. It was eventually signed by over a million people.

But since the early stumbling, public anger has ebbed as Moon’s government seized control of the crisis.

“In the early days of the virus, many South Koreans were furious with their government,” said Martin, the musician, who is married to a South Korean artist and lives in a working-class area of Seoul. “Yet, as the scenario played out, it became increasingly clear that South Korea was on top of its game, and the government had actually done a really amazing job of mostly containing the virus without diving into denialism on the one hand and totalitarianism on the other.”

“But look where we are now,” he added. “I spend most of my time now worrying deeply about my friends and family in the Pacific Northwest, where I am hearing daily from loved ones about the dangers and how they fear for the future. We are really lucky to be in such a well-prepared situation under a government that chose to take an aggressive, yet democratic, stance.”

The day after we spoke, Vice President Mike Pence appeared at the White House to tell Americans that “tens of thousands” of coronavirus tests are being performed daily. But even as the death toll from the virus mounted and the number of US cases soared, he added that “if you don’t have symptoms, you don’t need to get a test.” His admonition defied the advice of many health officials in areas hit hard by the virus, including in South Korea.

As of March 19, according to the World Health Organization, the number of confirmed cases of coronavirus had exceeded 200,000 globally. Out of those, South Korean authorities said, they had 8,652 cases, with 94 deaths, and had conducted 316,664 tests. In the United States, the CDC reported 10,442 cases, 150 deaths and a total of 44,872 tests—one-seventh the number conducted in South Korea.

For two countries with an entwined history that goes back over 70 years, the contrast in their approaches to one of the worst pandemics in history could not be clearer.

Correction: this post has been updated to reflect the correct number of individuals tested for Covid-19 by the South Korean government between January 3 and March 14.
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