[Ip-health] PHM Korea statement on COVID-19 outbreak and responses in South Korea

김선 sunkim at health.re.kr
Thu Mar 19 03:10:05 PDT 2020

Dear colleagues,

South Korea (hereafter Korea)’s COVID-19 outbreak and response are still
ongoing, and assessment of it is rather hasty. But we share this
conditional statement because we think it is our responsibility to share
Korea’s experience with civil society around the world, which is
experiencing COVID-19 outbreak one tempo later than ours. In particular, we
hope that the main barriers to the government responses and the efforts of
the Korean civil society to find and fill the blind spots out of reach of
the government policies or existing systems will be a lesson for the civil
society of each country in the responses of COVID-19.


pdf version of the statement:

The full-text as follows;


*PHM Korea statement on COVID-19 outbreak and responses in South Korea*

March 19th, 2020

South Korea (hereafter Korea)'s COVID-19 outbreak and response are still
ongoing, and assessment of it is rather hasty. But we share this
conditional statement because we think it is our responsibility to share
Korea's experience with civil society around the world, which is
experiencing COVID-19 outbreak one tempo later than ours. In particular, we
hope that the main barriers to the government responses and the efforts of
the Korean civil society to find and fill the blind spots out of reach of
the government policies or existing systems will be a lesson for the civil
society of each country in the responses of COVID-19.

●     *Barrier One: Reactionary right-wing alliance makes the situation

One of the most difficult challenges the government is confronted is the
political assaults by the reactionary right-wing alliances, including the
opposition party, Korean Medical Association (KMA) and right-wing news
media. Before the general election in April, the right-wings blame the
government for almost everything. They unnecessarily politicized the
problems, which hampered reasonable and timely decision making by the
government. They deliberately stick to the term ‘Wuhan Pneumonia’ and still
demand a total immigration ban against Chinese people, although many
experts repeatedly pointed out that it was unnecessary and special
immigration process has been working very well. The opposition party
disturbed the formation of an ad-hoc parliamentary commission to plan the
supplementary budget for dealing with the outbreak, insisting that the
commission name should include the term ‘Wuhan Pneumonia’. Even the KMA
denounced the national advisory committee of which members are delegates
from eleven academic societies, claiming that several members of the
committee are leftists and clandestine power figures dominate government
policies. Such a claim was absurd, but the committee was dissolved for
protecting individual scientists from political attacks.[1] <#_ftn1>[2]
<#_ftn2> The KMA strongly criticizes the rationing of face-mask by the
government and recommends that every citizen has to wear disposable
face-mask without re-use in spite of the serious shortage of supply. In
this situation, people are confused and lose trust in the government. Then
the government is more likely to make hasty decisions and adopt populist
measures and has to pay more efforts to rebuke fake news and misleading

●     *Barrier Two: The private, market-oriented healthcare system is the
main barrier to cope with the COVID-19 though the ‘public control’ over the
private hospitals and diagnostic kits industry makes the system keep to

The number of beds owned by public hospitals accounts for around 10% of the
national total, which is the lowest one among the OECD member countries,[3]
<#_ftn3> and the health care delivery system from primary care through to
the tertiary-care hospitals is not well organized. So as the number of
patients sharply increased, it became very difficult for the government to
procure beds and allocate patients according to their severity, especially
in Daegu where the entire healthcare system was overwhelmed by the acute
surge of patients related to the religious event. So-called ‘Big 5’
hospitals located in the capital city Seoul including Seoul Samsung
Hospital which was the hotbed for the MERS-CoV outbreak in 2015[4] <#_ftn4>
are surprisingly invisible in this situation except for the Seoul National
University Hospital, while they account for 35.5% of total National Health
Insurance benefits reimbursed to the tertiary-care hospitals.[5] <#_ftn5>
The CSOs cannot but repeat their aged but never achieved claim that the
government should expand public hospitals.

Now, tentative partial ‘public control’ over the private hospitals works by
utilizing a pre-existing informal public-private network, not sufficiently
but in a more organized way over time. Public control works much better
with regard to the diagnostic kits production and supply.[6] <#_ftn6>
Without the support from the government (Ministry of Food and Drug Safety
and The Korean Centers for Disease Control and Prevention, KCDC) and the
Korean Society for Laboratory Medicine, the industry would have never
achieved the development and production of the diagnostic kits, and
extensive screening tests with high quality would not be performed.[7]
<#_ftn7> The acclaimed Korean test system is not the fruits of
laissez-faire innovative capitalism and deregulation but an excellent
example of tight coordination of public-private partnership and
publicization of innovative technology. We should demand public
benefit-sharing, including affordable prices and stable supplies and the
public control over private sectors in dealing with public health
emergencies instead of unleashed deregulation for innovation.

●     *Barrier Three: Long-standing structural inequality/inequity
paralyzes the control measures.*

Almost 80% of COVID-19 cases in Korea are linked to cluster infections,[8]
<#_ftn8> and many of cluster cases reveal the structural
inequity/inequality pervasive in Korea.

Among them, closed-ward hospitals for chronic psychiatric patients,[9]
<#_ftn9> nursing homes for the elderly mostly in bedridden status, and
living facilities for the severely disabled[10] <#_ftn10> became the hotbed
for infection because of their poor living environments and underlying
health conditions.

Dualized labor market which is caused by long-standing labor market
liberalization makes effective prevention measures impotent; for example,
the largest cluster infection in Seoul occurred in a call-center where
workers cannot exercise ‘social distancing’ in a very crowded condition
without proper ventilation system nor demand paid leaves in fear of layoff.
[11] <#_ftn11> The more people stay at home for ‘social distancing’, the
higher the work demands become in some sectors, such as call-centers and
delivery services. One delivery worker died of Karoshi while dealing with
skyrocketed online orders from the dawn to midnight.[12] <#_ftn12> As
school closure extends, substitute teachers and caregivers in precarious
employment have to work for children who cannot be cared at home, while
regular teachers stay at home with paid leaves.[13] <#_ftn13> Pre-existing
inequality and discrimination against low-waged, precarious workers
aggravate the situation around the public health crisis.

●     *Pros and Cons in the acclaimed ‘openness and transparency’ strategy
of the Korean government.*

Korean Foreign Minister KANG Kyung-wha's interview with the BBC on March
15th is gaining popularity. The strategy of the COVID-19 response by the
Korean government, "openness, transparency and fully keeping the public
informed," appears to be paying off as Minister Kang said.[14] <#_ftn14>

There is a context in the government's commitment to open and transparent
responses. The secrecy strategy adopted by the right-wing government during
the early phase of MERS-CoV outbreak in 2015 led to the failure of timely
control and wide distrust in the government.[15] <#_ftn15> For the current
liberal MOON Jae-in government, who was elected after the impeachment of
the ex-president PARK Geun-hye, open and transparent responses to COVID-19
are becoming the barometers for legitimacy.

Current obsessive tracking/tracing of COVID-19 patients and information
release/disclosure is possible thanks to the passage of the so-called 'MERS
act’ at the time of the MERS-CoV outbreak in 2015.[16] <#_ftn16> Recently,
the government and the National Assembly also passed the so-called
‘COVID-19 acts,’ which allow involuntary testing, quarantine and treatment
of those suspected of infection and the prosecution of those who refuse to
test. This enabled the current aggressive massive screening tests.[17]
<#_ftn17> While the ‘openness and transparency’ strategy is desirable in
principle, there is a rising concern over privacy and human rights
violation at the same time.[18] <#_ftn18> Indeed, many individuals were
blamed and stigmatized as they ‘spread’ out viruses, and restaurants
patients had visited had to shut down in order not to being blamed. After
all, the National Human Rights Commission of Korea[19] <#_ftn19> announced
the recommendation not to release specific addresses or workplace names of
the COVID-19 patients, nor their travel path and the places they’ve visited
to protect their privacy.[20] <#_ftn20> The KCDC had recently updated the
guideline for local governments with incorporating such recommendations.
However, CSOs have to follow up the situation and continue discussing how
to protect population health in balance with individual human rights.

●     *Role of civil societies. *

Many NGOs and CSOs have been monitoring the situation the disadvantaged
population, such as the disabled,[21] <#_ftn21> homeless,*[22]* <#_ftn22>
and migrants*[23]* <#_ftn23> are faced with, and demanded government
measures. Also, trade unions collected situation reports from their locals
and investigated the sufferings of precarious workers who cannot access the
paid leaves and proper protection from the COVID-19 infection.*[24]*
<#_ftn24>*[25]* <#_ftn25> On March 19th, NGOs and CSOs, including more than
40 organizations, national as well as local, announced a collective
statement that the government should provide more support for vulnerable
population, expand public hospitals, protect precarious workers regarding
paid leaves and employment security, publicly control healthcare resources
including face-masks, and organize community-based care system. Also the
statement asserts that the media should stop their way of reporting
obsessed with sensationalism and racism, stigmatizing special population
groups.[26] <#_ftn26>

The government showed rather proper responsiveness; for example,
undocumented immigrants can get the test without risk of deportation
according to the decree of Ministry of Law,[27] <#_ftn27> and the Seoul
Metropolitan Government began to provide ‘emergency care’ services for the
disabled and the elderly who experienced the interruption of daily care
services.[28] <#_ftn28> Although the government has shown unprecedented
efforts and quick responses, the problems rooted in long-time
underinvestment in the social security system cannot be easily tackled.
Many NGOs and voluntary community organizations are now trying to find and
fill the blind spots in cooperation with local governments.

We hope this outbreak could facilitate social discussions for establishing
a robust social protection system in Korea.

●     *Participatory governance is needed dealing with pandemics.*

It is unrealistic to expect that all systems are perfectly in place in
advance of an unprecedented public health crisis such as COVID-19 pandemic.
There are many loopholes in the Korean government's COVID-19 responses.

However, we could manage the situation better if we work together. Such
loopholes could be filled through a ‘healthy’ partnership between the
government and the civil society. The social power, including the CSOs,
works to make the government actions more equitable and effective. The
Korean civil society is closely monitoring the COVID-19 responses, as it
did in the 2015 MERS-CoV outbreak,[29] <#_ftn29> with a focus on human
rights and social justice.

We believe that ‘participatory governance’ would be effective for dealing
with pandemic as well as defending democracy. We will keep working in


[1] <#_ftnref1> The Hankyoreh 21, March 13, 2020,

[2] <#_ftnref2> The SisaIN, March 17, 2020,

[3] <#_ftnref3> OECD Statistics

[4] <#_ftnref4> Ki, 2015 MERS outbreak in Korea: hospital-to-hospital
transmission, Epidemiol Health. 2015; 37: e2015033.

[5] <#_ftnref5> The Young Doctors, May 27 2019,

[6] <#_ftnref6> http://www.hitnews.co.kr/news/articleView.html?idxno=15675

[7] <#_ftnref7> The SisaIN, February 14 2020,

[8] <#_ftnref8> The Korea Herald, March 14 2020, 8 in 10 coronavirus cases
in S. Korea linked to cluster infections

[9] <#_ftnref9> The Washington Post, March 1 2020, How a South Korean
psychiatric ward became a ‘medical disaster’ when coronavirus hit

[10] <#_ftnref10> VOA, February 26 2020, Coronavirus Outbreak Inside 2 S.
Korean Medical Facilities Highlights Vulnerability of Disabled Patients

[11] <#_ftnref11> Yonhap News Agency, March 10 2020, Seoul call center
emerges as city's biggest infection cluster, numbers feared to rise

[12] <#_ftnref12> Korea Joongang Daily, March 17 2020, Union blames Coupang
for delivery worker’s death

[13] <#_ftnref13> The Redian, March 17 2020,

[14] <#_ftnref14> Ministry of Foreign Affairs, March 15 2020, Andrew Marr
interviews Foreign Minister Kang Kyung-wha

[15] <#_ftnref15> Minjeong Kang et al., 2018, From concerned citizens to
activists: a case study of 2015 South Korean MERS outbreak and the role of
dialogic government communication and citizens’ emotions on public
activism, Journal of Public Relations Research, 30:5-6, 202-229, DOI:

[16] <#_ftnref16> The Korea Times, July 9 2015, Install epidemics system

[17] <#_ftnref17> Korea.net (Overseas Korea Centers), March 4 1010, Cabinet
passes laws to fight COVID-19 outbreak

[18] <#_ftnref18> Korean Federation Medical Activist Groups for Health
Rights (KFHR), February 25 2020, http://kfhr.org/?p=129581

[19] <#_ftnref19> National Human Rights Commission of Korea, March 9 2020,

[20] <#_ftnref20> The Hankyoreh*, *Mar 16 2020, Government decides not to
disclose personal information about novel coronavirus patients

[21] <#_ftnref21> The Be Minor, March 18 2020,

[22] <#_ftnref22> CSOs network, March 9 2020,

[23] <#_ftnref23> Workers’ Solidarity, March 9 2020,

[24] <#_ftnref24> Korean Public Service and Transport Workers’ Union
(KPTU), February 28 2020, KPTU Healthcare Workers Solidarity Division
Statement on COVID-19

[25] <#_ftnref25> Korean Public Service and Transport Workers’ Union
(KPTU), March 16 2020, COVID-19 and South Korean Workers, KCTU Demands

[26] <#_ftnref26> CSOs network, March 19 2020, http://health.re.kr/?p=6357

[27] <#_ftnref27> Yonhap News Agency, March 5 2020,

[28] <#_ftnref28> Seoul Metropolitan Government, March 16 2020,

[29] <#_ftnref29> People’s Health Institute (PHI), 2016,

Sun Kim, M.S., Ph.D.
Regional coordinator, People's Health Movement (PHM) South East Asia & Asia
Pacific (SEAP)
Director, Health Policy Research Center, People's Health Institute (PHI)
South Korea

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