Query: korea covid

title: Lessons learned from Korea: COVID 19 pandemic
abstract: Occupational exposure includes skin and mucosa, respiratory exposure, and needle sticks from confirmed patients. For skin exposure, disinfection with 0.5% iodine or H2O2 for 3 minutes is performed then wiped off with clean water. For mucosal exposure, HCP are required to rinse the exposure site with 0.9% saline or 0.05% iodine. For needle sticks, HCP squeeze the blood out and rinse the wound with flowing water then sterilize with 75% EtOH or 0.5% iodine. For respiratory exposure, the mouth and nose of HCP are protected by a facemask within 1 m of an unmasked confirmed patient. For damaged gloves, HCP should are required to disinfect the hands with 0.5% iodine or H2O2 for 3 minutes and then rinse with copious water. Finally, HCP are required to leave the contaminated area and to report exposures to infection control personnel. By following all of the strategies listed here, we successfully prevented HAIs at shelter hospitals, which have >900 patients per open area in each hospital. Up to now, there has been no occurrence of HCP infection by COVID 19 at shelter hospitals. Therefore, our experience has proven efficacious and successful for hospital infection management and prevention during the COVID 19 outbreak.

title: Searching for Digital Technologies in Containment and Mitigation Strategies: Experience from South Korea COVID 19
abstract: Korea has achieved health policy objectives in pandemic management so far, namely minimizing mortality, flattening the epidemic curve, and limiting the socio economic burden of its measures. The key to the Korean government's success in combating COVID 19 lies with the latest digital technologies (DTs) The prompt and effective application of DTs facilitates both containment as well as mitigation strategies and their sub policy measures.  This article uses an experiential analysis based on an exploratory case study analysis on field applications of the government's interventions. Information is collected by qualitative methods such as literature analysis, meeting materials, and a review of various government reports (including internal ones) along with academic and professional experiences of the authors.  The article presents the unique Korean health policy approaches in the COVID 19 crisis. First, DTs allow the Korean government to embrace various policy measures together listed in containment strategy, namely altering and warning, epidemiological investigation, quarantine of contacts, case finding, social distancing, and mask wearing. Second, DTs allow Korea to integrate containment and mitigation strategies simultaneously. Along with the above measures in containment, healthcare service, medical treatment, and prophylaxis (presymptomatic testing) within mitigation are utilized to prevent a COVID 19 spread.  Korea develops DTs in an integrated manner in the early pandemic stage under strong and coordinated government leadership. Above all, the DTs' functions in each pandemic developmental stage are continuously upgraded. Instead of prioritizing policy measures or strategies, therefore, Korea can implement diverse policies simultaneously by integrating DTs effectively. During the COVID 19 outbreak, DTs work as the enablers to connect these two strategies and their measures in Korea.  DTs should be at the center of the disaster management paradigm, especially during a pandemic. DTs are facilitators and integrators of containing and mitigating strategies and their policy measures.

title: Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID 19) Analysis of Nine Patients Treated in Korea
abstract: This study presents a preliminary report on the chest radiographic and computed tomography (CT) findings of the 2019 novel coronavirus disease (COVID 19) pneumonia in Korea.  As part of a multi institutional collaboration coordinated by the Korean Society of Thoracic Radiology, we collected nine patients with COVID 19 infections who had undergone chest radiography and CT scans. We analyzed the radiographic and CT findings of COVID 19 pneumonia at baseline. Fisher's exact test was used to compare CT findings depending on the shape of pulmonary lesions.  Three of the nine patients (33.3% had parenchymal abnormalities detected by chest radiography, and most of the abnormalities were peripheral consolidations. Chest CT images showed bilateral involvement in eight of the nine patients, and a unilobar reversed halo sign in the other patient. In total, 77 pulmonary lesions were found, including patchy lesions (39% large confluent lesions (13% and small nodular lesions (48% The peripheral and posterior lung fields were involved in 78% and 67% of the lesions, respectively. The lesions were typically ill defined and were composed of mixed ground glass opacities and consolidation or pure ground glass opacities. Patchy to confluent lesions were primarily distributed in the lower lobes (p 0.040) and along the pleura (p 0.001) whereas nodular lesions were primarily distributed along the bronchovascular bundles (p 0.006) Conclusion COVID 19 pneumonia in Korea primarily manifested as pure to mixed ground glass opacities with a patchy to confluent or nodular shape in the bilateral peripheral posterior lungs. A considerable proportion of patients with COVID 19 pneumonia had normal chest radiographs.

title: Transmission potential and severity of COVID 19 in South Korea
abstract: Since the first case of 2019 novel coronavirus (COVID 19) identified on Jan 20, 2020 in South Korea, the number of cases rapidly increased, resulting in 6,284 cases including 42 deaths as of March 6, 2020. To examine the growth rate of the outbreak, we aimed to present the first study to report the reproduction number of COVID 19 in South Korea.  The daily confirmed cases of COVID 19 in South Korea were extracted from publicly available sources. By using the empirical reporting delay distribution and simulating the generalized growth model, we estimated the effective reproduction number based on the discretized probability distribution of the generation interval.  We identified four major clusters and estimated the reproduction number at 1.5 (95% CI: 1.4 1.6) In addition, the intrinsic growth rate was estimated at 0.6 (95% CI: 0.6, 0.7) and the scaling of growth parameter was estimated at 0.8 (95% CI: 0.7, 0.8) indicating sub exponential growth dynamics of COVID 19. The crude case fatality rate is higher among males (1.1% compared to females (0.4% and increases with older age.  Our results indicate early sustained transmission of COVID 19 in South Korea and support the implementation of social distancing measures to rapidly control the outbreak.

title: Identification of Coronavirus Isolated from a Patient in Korea with COVID 19
abstract: Following reports of patients with unexplained pneumonia at the end of December 2019 in Wuhan, China, the causative agent was identified as coronavirus (SARS CoV 2) and the 2019 novel coronavirus disease was named COVID 19 by the World Health Organization. Putative patients with COVID 19 have been identified in South Korea, and attempts have been made to isolate the pathogen from these patients.  Upper and lower respiratory tract secretion samples from putative patients with COVID 19 were inoculated onto cells to isolate the virus. Full genome sequencing and electron microscopy were used to identify the virus.  The virus replicated in Vero cells and cytopathic effects were observed. Full genome sequencing showed that the virus genome exhibited sequence homology of more than 99.9% with SARS CoV 2 which was isolated from patients from other countries, for instance China. Sequence homology of SARS CoV 2 with SARS CoV, and MERS CoV was 77.5% and 50% respectively. Coronavirus specific morphology was observed by electron microscopy in virus infected Vero cells.  SARS CoV 2 was isolated from putative patients with unexplained pneumonia and intermittent coughing and fever. The isolated virus was named BetaCoV/Korea/KCDC03/2020.

title: Use of Convalescent Plasma Therapy in Two COVID 19 Patients with Acute Respiratory Distress Syndrome in Korea
abstract: Coronavirus disease 2019 (COVID 19) caused by severe acute respiratory syndrome coronavirus 2 not yet has established its treatment, but convalescent plasma has been expected to increase survival rates as in the case with other emerging viral infections. We describe two cases of COVID 19 treated with convalescent plasma infusion. Both patients presented severe pneumonia with acute respiratory distress syndrome and showed a favorable outcome after the use of convalescent plasma in addition to systemic corticosteroid. To our knowledge, this is the first report of the use of convalescent plasma therapy for COVID 19 in Korea.

title: Guidelines for Laboratory Diagnosis of Coronavirus Disease 2019 (COVID 19) in Korea
abstract: The outbreak of coronavirus disease 2019 (COVID 19) which began in December 2019, is still ongoing in Korea, with >9,000 confirmed cases as of March 25, 2020. COVID 19 is a severe acute respiratory syndrome Coronavirus 2 (SARS CoV 2) infection, and real time reverse transcription PCR is currently the most reliable diagnostic method for COVID 19 around the world. Korean Society for Laboratory Medicine and the Korea Centers for Disease Prevention and Control propose guidelines for diagnosing COVID 19 in clinical laboratories in Korea. These guidelines are based on other related domestic and international guidelines, as well as expert opinions and include the selection of test subjects, selection of specimens, diagnostic methods, interpretation of test results, and biosafety.

title: How will country based mitigation measures influence the course of the COVID 19 epidemic?
abstract: Governments will not be able to minimise both deaths from coronavirus disease 2019 (COVID 19) and the economic impact of viral spread. Keeping mortality as low as possible will be the highest priority for individuals; hence governments must put in place measures to ameliorate the inevitable economic downturn. In our view, COVID 19 has developed into a pandemic, with small chains of transmission in many countries and large chains resulting in extensive spread in a few countries, such as Italy, Iran, South Korea, and Japan. Most countries are likely to have spread of COVID 19, at least in the early stages, before any mitigation measures have an impact. What has happened in China shows that quarantine, social distancing, and isolation of infected populations can contain the epidemic. This impact of the COVID 19 response in China is encouraging for the many countries where COVID 19 is beginning to spread. However, it is unclear whether other countries can implement the stringent measures China eventually adopted. Singapore and Hong Kong, both of which had severe acute respiratory syndrome (SARS) epidemics in 2002 03, provide hope and many lessons to other countries. In both places, COVID 19 has been managed well to date, despite early cases, by early government action and through social distancing measures taken by individuals. The course of an epidemic is defined by a series of key factors, some of which are poorly understood at present for COVID 19. The basic reproduction number (R0) which defines the mean number of secondary cases generated by one primary case when the population is largely susceptible to infection, determines the overall number of people who are likely to be infected, or more precisely the area under the epidemic curve. For an epidemic to take hold, the value of R0 must be greater than unity in value. A simple calculation gives the fraction likely to be infected without mitigation. This fraction is roughly 1 1/R0. With R0 values for COVID 19 in China around 2*5 in the early stages of the epidemic, we calculate that approximately 60% of the population would become infected. This is a very worst case scenario for a number of reasons. We are uncertain about transmission in children, some communities are remote and unlikely to be exposed, voluntary social distancing by individuals and communities will have an impact, and mitigation efforts, such as the measures put in place in China, greatly reduce transmission. As an epidemic progresses, the effective reproduction number (R) declines until it falls below unity in value when the epidemic peaks and then decays, either due to the exhaustion of people susceptible to infection or the impact of control measures. The speed of the initial spread of the epidemic, its doubling time, or the related serial interval (the mean time it takes for an infected person to pass on the infection to others) and the likely duration of the epidemic are determined by factors such as the length of time from infection to when a person is infectious to others and the mean duration of infectiousness. For the 2009 influenza A H1N1 pandemic, in most infected people these epidemiological quantities were short with a day or so to infectiousness and a few days of peak infectiousness to others. By contrast, for COVID 19, the serial interval is estimated at 4*4 7*5 days, which is more similar to SARS. First among the important unknowns about COVID 19 is the case fatality rate (CFR) which requires information on the denominator that defines the number infected. We are unaware of any completed large scale serology surveys to detect specific antibodies to COVID 19. Best estimates suggest a CFR for COVID 19 of about 0*3 1% which is higher than the order of 0*1% CFR for a moderate influenza A season. The second unknown is the whether infectiousness starts before onset of symptoms. The incubation period for COVID 19 is about 5 6 days. Combining this time with a similar length serial interval suggests there might be considerable presymptomatic infectiousness (appendix 1) For reference, influenza A has a presymptomatic infectiousness of about 1 2 days, whereas SARS had little or no presymptomatic infectiousness. There have been few clinical studies to measure COVID 19 viraemia and how it changes over time in individuals. In one study of 17 patients with COVID 19, peak viraemia seems to be at the end of the incubation period, pointing to the possibility that viraemia might be high enough to trigger transmission for 1 2 days before onset of Published Online March 6, 2020 https:/doi.org/10.1016/ S0140 6736(20)30567 5

title: Case of the Index Patient Who Caused Tertiary Transmission of Coronavirus Disease 2019 in Korea: the Application of Lopinavir/Ritonavir for the Treatment of COVID 19 Pneumonia Monitored by Quantitative RT PCR
abstract: Since mid December of 2019, coronavirus disease 2019 (COVID 19) has been spreading from Wuhan, China. The confirmed COVID 19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54 year old male is the third patient diagnosed with COVID 19 in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, b coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.

title: Report on the Epidemiological Features of Coronavirus Disease 2019 (COVID 19) Outbreak in the Republic of Korea from January 19 to March 2, 2020
abstract: Since the first case of coronavirus disease19 (COVID 19) was reported in Wuhan, China, as of March 2, 2020, the total number of confirmed cases of COVID 19 was 89,069 cases in 67 countries and regions. As of 0 am, March 2, 2020, the Republic of Korea had the second largest number of confirmed cases (n 4,212) after China (n 80,026) This report summarizes the epidemiologic features and the snapshots of the outbreak in the Republic of Korea from January 19 and March 2, 2020.