Seoul announces post-MERS plan for infectious diseases

All general hospitals with 300 or more patient beds in South Korea will be required to establish negative air pressure rooms to prevent cross-contamination, Seoul announced on Tuesday as part of its post-Middle East respiratory syndrome plan to better deal with contagious diseases.

The Ministry of Health and Welfare also announced that the head of Korea Center for Disease Control and Prevention will be appointed as the ministry’s joint vice minister to strengthen public health sector, and establish an emergency operations center that runs 24-hours a day to readily detect any possible epidemic.

The nation’s shortage of nursing staff and negative pressure rooms had been blamed for the MERS spread earlier this year, which claimed 36 lives. Many Koreans who contracted the virus did so while caring for their family members at MERS-affected hospital rooms.

“Not sharing information with the public (in the early stages of MERS outbreak) and not having an emergency operations center and therefore not being fully informed of the virus (in advance) were some of the biggest problems the government had during the MERS crisis,” said Chung Chin-youb, the newly-appointed Health Minister.

The Health Ministry has been heavily criticized for its inept handling of the MERS outbreak, particularly for lacking public health specialists in its high-ranking posts.

Former Health Minister Moon Hyung-pyo, who was in charge of the MERS outbreak, was a former economist whose expertise was pension reform. President Park Geun-hye recently appointed medical doctor Chung as the new leader for the ministry.

Chung also said he would hire more full-time epidemiologists whose main focus will be to investigate and identify risk factors and causes for disease and targets for preventive health care.

The ministry is to hire a total of 64 disease detectives in the next three years, who will be the first responders to public health emergencies by investigating disease outbreaks and detecting new microbes.

When there are no health emergencies, they will be in charge of coming up with preventive measures against infectious diseases.

“We wanted to make sure the disease detectives have job security (even when there is no disease outbreaks or health emergencies,” said Minister Chung.

The government’s plan to launch a new system of having two ministers -- in charge of health and welfare, respectively -- instead of having a separate office specializing in disease control in the wake of MERS outbreak has been criticized by the largest presentative body of medical doctors here.

They claimed that the CDC will not be make its own, prompt decisions in health emergencies as it will have to consult with the Health and Welfare Minister. The government stressed that the head of the CDC will take charge of human resources and the budgetary right to manage the organization upon the change.

“We’ll collaborate with and support the CDC. But we won’t interfere with what the CDC is in charge of,” said Minister Chung.

The government also vowed to change the current system which involves family members staying with patients at medical facilities as main caretakers, by introducing fulltime nursing care in as many hospitals as possible.

Also, in order to prevent general hospitals from becoming overcrowded -- which may make inpatients with serious conditions more vulnerable to infection -- the government said it would start charging fees for those who file request forms to see a doctor at tertiary hospitals. Up until now, patients who wished to see a doctor at a general hospital could do so with a referral from their doctors at smaller clinics, free of charge.

“We are also requiring doctors to write down symptoms of patients who may have infectious diseases when writing their referrals,” said Kwon Deok-cheol, the assistant minister for health care policy at the Health Ministry.

“This way, doctors at general hospitals as well as health authorities will be informed immediately when there is a patient with unusual symptoms.”

Negative pressure rooms require using a special ventilation system that produces negative pressure to make sure air flows into the isolation room for infected patients, but does not escape from the room. The system is normally used to quarantine patients with airborne contagious diseases such as tuberculosis.

The government plans to expand the number of such rooms to 1,500 nationwide by the year 2020. A total of 43 government-designated high-level general hospitals, including the Samsung Medical Center and Asan Medical Center in Seoul, as well as hospitals with 300 or more patient beds, will be required to establish and run the rooms.

Meanwhile, a recent study showed that the government may need to spend 4.6 trillion won ($4.3 billion) to establish a new system that offers full nursing care including assistance usually provided by patients’ families. Korea currently has the lowest patient-to-nurse ratio among the OECD nations, at 0.28 nurses per patient.

To increase the number of nurses, the Health Ministry has announced it will establish a two-year nursing program at universities. Currently, there are two types of nursing certificates in Korea. One can be obtained by attending a four-year university program, while the other only requires a yearlong certification program offered in non-university institutions. With the newly established program, there will be three types of nurses with different skills and responsibilities, including caring for inpatients,

However, the plan has been fiercely opposed by the representative bodies of Korean nurses, who claim that nurses with degrees in four-year programs would likely be replaced by those with less prestigious degrees once the new system gets established.

By Claire Lee (dyc@heraldcorp.com)