It’s a weekday morning and Eunha Shim is at Soongsil University in downtown Seoul where she works in the mathematics department.

The country is in its second two-week phase of extreme social distancing and Shim said there are far fewer people on the streets than normal, although some students are meeting on campus.

The country’s quick reaction to COVID-19, through a variety of strict measures, including social distancing tied with steep fines for violation of these guidelines, and mass testing, has been able to slow the spread of coronavirus and reduce the rate of death compared to other countries, according to two studies co-authored by a number of researchers, including Shim, a Canadian who moved to Seoul five years ago.

One study found, on average, a person infected with COVID-19 in South Korea passed the virus on to 1.5 people, which is referred to as the reproduction number and indicates how fast the virus spreads.

“Without social distancing or other measures, the number would have been much higher,” said Shim. “For example in China and Japan, the reproduction number was around seven.”

In confined spaces, the reproduction number can reach 11, according to a separate study of the outbreak aboard the Diamond Princess Cruise Ship off Japan in February, which served to provide evidence of how quickly the virus can spread in hospitals and nursing homes.

The public health interventions in Korea have kept the death rate relatively low, around 1.4 per cent, according to a second study by Shim and Gerardo Cowell, a mathematical epidemiologist at Georgia State University, among others.

Information and data has been one plank of South Korea's agressive approach to stopping COVID-19 in its tracks. The Korea Centers for Disease Control and Prevention's (KCDC) website provides a regularly updated and detailed analysis of cases in South Korea as well as countries around the world. It also provides daily briefings broken down to the local level across the country. KCDC

In China, fatality rates reached 15 per cent in Wuhan, the epicentre of the outbreak, and five per cent in Hubei province, excluding Wuhan, said Cowell. In the rest of the country, the death rate was similar to Korea at about one per cent, he said.

South Korea, a country of 51 million, now has fewer new cases a day than Ontario.

Shim grew up in Korea and moved to Vancouver when she was 20. She did her undergraduate degree and her master’s in mathematics at UBC. She moved to Arizona State University for her PhD and afterwards, worked as an associate research scientist at Yale. A mathematician by training, Shim does mathematical modelling of infectious diseases and is now focusing on the transmission of coronavirus as well as intervention strategies.

She keeps up with what’s happening in Canada through her parents who still live in Vancouver.

“From what I hear and see in the news, it seems that social distancing is well practiced in Canada, in general,” said Shim. “Further control measures, solving the face-mask shortage and wearing face masks, as well as widespread testing, would help to contain the outbreak in Canada, and mitigate the morbidity and mortality impact of COVID-19.”

Nearly half the new cases in South Korea during the last three weeks are imported cases as travellers return home.

“Without those, the curve was going down,” said Shim.

The country moved decisively after the first case of coronavirus was confirmed in Korea on Jan. 20, in a woman who arrived at Incheon International Airport from Wuhan, China with a fever that was picked up by thermal scanners.

Health officials instituted a number of measures, including mandatory two-week periods of self-quarantine for anyone who came in contact with a confirmed case, and, in February, rolled out a newly-developed diagnostic test that can detect the virus in six hours at a number of health facilities.

And they tested widely, nearly one test for every 100 people as of Wednesday, setting up drive-through stations around hospitals.

“The person doesn’t have to get out of their car,” said Shim. “They just lower their window, the staff take swab samples, and the person’s temperature, and, in 10 minutes, the testing is done.”

About 6,000 people were tested on the day Shim was interviewed by the Star.

The swabs are analyzed at conventional labs — the country expanded its capacity to test by creating partnerships with private labs — and people typically receive the results the next day.

Companies in Korea began manufacturing test kits early and the country had enough to take samples from 20,000 people a day during the height of the pandemic.

On April 1, the government instituted a mandatory two-week period of self-isolation for inbound travellers, and a few days later legislated a fine of 10 million won (about $11,500 CAD), and a year in prison, after public outcry over news that some people were flouting the requirement.

As around 30 per cent of cases are asymptomatic, according to one study, the government has recommended people wear masks, which, Shim said, nearly everyone has donned.

The start of the school year in March was put on hold, but, in April, the government made the decision to put classes for all grades, including university and college, online.

The Korean government also hasn’t forced businesses to shut down, although people are encouraged to stay home and only go out for groceries or other necessities. Still, some employees still go to work for meetings.

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There’s still no maximum number of people who can be in a group, said Shim, but most people are very strict about social distancing and they are required to keep two metres apart. The younger generation may be getting tired of it, she noted.

Shim said she saw some younger people lined up at Starbucks. And she points to the data, which shows that the largest proportion of confirmed cases so far is among 20-somethings, which may indicate they are not as strict about the requirements.

“They just had two weeks of intense social distancing before and it was just extended,” she said. “I think they are a little bit frustrated.”

Shim said it’s difficult to predict how much longer the country will need to keep the restrictions in place.

“It’s hard to say at the moment, because we still have people coming in with new infections,” she said.

Throughout the crisis, government officials have opted for transparency and openness, publicizing information about confirmed cases on websites, such as the Korea Centers for Disease Control and Prevention, including the location and assuring people that public areas where the person visited were sanitized.

They have also adopted a number of measures that Cowell points out wouldn’t really work in a Western democracy, including using mobile apps to ensure people are complying with quarantine orders.

As well, they have retraced the steps of infected cases using the GPS on peoples’ phones, or tracked their credit card use, and distributed the anonymized information via a website or on television, so people could determine if they had been anywhere near an infected person.

After an outbreak was identified in the Shincheonji Church of Jesus, which the government has called a cult, officials seized church records in order to find members and conduct contact tracing and testing.

The outbreak was directly related to nearly 4,500 cases in Korea, about 40 per cent of the total cases which stand at 10,384 as of Wednesday.

Much of the country’s response to COVID-19 was determined by an outbreak of Middle East Respiratory Syndrome in 2015.

The outbreak was a result of a man who returned from a trip to the Middle East with the virus, and, unknowingly, spread it from clinic to clinic, then to hospitals, as he searched for a diagnosis and eventual treatment. He also passed the virus on to a patient outside one of the hospitals.

In all, a total of 186 people were infected — 85 of them were healthcare workers — and 36 people died.

The outbreak lasted for two months and the government quarantined nearly 17,000 people for two weeks in order to control it. The country went into an economic slump that was estimated to have cost about $8.5 billion U.S.

After the outbreak, the government created the Emergency Operations Centre, a central command centre that co-ordinates the country’s response to infectious diseases, including a rapid response team of epidemiologists and staff that can be sent to an outbreak.

The government also changed a number of protocols at hospitals to guard against infection, and, in 2016, enacted a new law that allows the use of unapproved diagnostic test kits during public health emergencies, when there is no licenced test available.

Five companies in South Korea are making test kits for COVID-19, based on instructions from the World Health Organization, and now other countries are looking to import them.

“They have learned lessons from the 2015 outbreak,” said Cowell. “They were able to quickly jump into it, because they knew the sooner they were able to implement all these interventions, the sooner they would be able to contain it and keep incidence levels low.”

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