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Choi Jae-pil, a senior official at Seoul Medical Center, meets with two consultants from the World Health Organization (WHO) on Mar. 19. (provided by Seoul Medical Center)

“We believe it is unlikely that [the novel coronavirus] can be completely reduced to zero.” -- Jung Eun-kyeong, director of the Korea Centers for Disease Control and Prevention (KCDC)

With Mar. 20 marking two months since the first confirmed coronavirus case in South Korea, experts agreed that “aftershocks” of small-scale infection are poised to continue occurring throughout South Korea even if there are no additional explosive increases in patients such as those seen in Daegu and North Gyeongsang Province. The message is that it is unlikely that an “end” to the outbreak can be easily determined. For this reason, the next question revolves around the development of a vaccine that can halt the virus’s spread, or a treatment that can reduce the number of deaths. Clinical testing has begun in the US and elsewhere, but experts are insisting that a medical system needs to be in place for the possibility of a long-term battle, predicting that vaccine development will likely take between 12 and 18 months.

“We expect that in countries with a strong disease prevention system where social distancing is appropriately maintained, 0.1% or less of the population will end up infected, while in cases of relying on social distancing alone with a low level of disease control response, the population infection rate will be in the range of 1-30%,” said Son Jun-seong, a professor of infectious diseases at Gangdong Kyung Hee University Hospital.

“If people relax about social distancing, we’ll continue having a situation where a certain level of infections continues to occur amid the increased frequency of contact among people,” Son predicted.

Vaccine and treatment development efforts have only just begun. According to the US National Institutes of Health (NIH), 53 clinical testing efforts on coronavirus treatments and three clinical testing efforts on vaccines were underway as of Mar. 11. The Kaiser Permanente institute in Seattle began administering coronavirus vaccine injections on Mar. 16 to 45 volunteers. Nebraska Medical Center has been experimenting on confirmed US patients from the Japanese cruise ship Diamond Princess with the drug remdesivir, which had been developed as a treatment for the Ebola virus. In China, experiments are under way on combining HIV medications to develop possible coronavirus treatments.

Among all of these, the treatment the experts are currently paying closest attention to is Gilead Sciences’ remdesivir. Kim Nam-jung, a professor of infectious diseases at Seoul National University Hospital, explained, “When remdesivir was used in animal testing during MERS [the Middle East Respiratory Syndrome outbreak], it worked better at preventing damage in the animal subjects than Kaletra [an anti-HIV medication].” Remdesivir blocks virus replication, with one reported instance of a confirmed US patient’s condition improving over the course of day with its use last January. A total of six related clinic testing efforts are currently under way in the US, China, South Korea, and Singapore, with results expected by early April at the soonest. Clinical testing is also being conducted with Kaletra, the influenza treatment Arbidol, and the malaria treatment chloroquine.

But experts agreed that no vaccine or treatment should be viewed as a “panacea.” Kim Hong-bin, a professor of infectious diseases at Seoul National University Bundang Hospital, explained, “It takes [at least] a year to 18 months for all clinic testing to be completed and a vaccine with guaranteed safety and effectiveness to be produced, but the virus could also have mutated by that time, so [vaccine development] is not an easy matter.”

Bang Ji-hwan, director of the management center for the central infectious disease hospital at the National Medical Center, noted, “The effect of influenza vaccines is only around 20%.”

“The vaccine’s effectiveness is an unknown variable, so we can’t start looking at it now as some kind of miracle drug,” Bang urged.

For this reason, experts are saying that apart from the vaccine and treatment development efforts, a medical system also needs to be put in place for a long-term battle. Lee Jae-gap, a professor of infectious diseases at Hallym University Sacred Heart Hospital, said, “Because the number of patients is going to increase as everyday life is gradually restored, we need to think about how the healthcare system is going to cope with this.”

“We need a system where all patients can receive testing without difficulty, such as the operation of clinics in public facilities where patients with respiratory and fever symptoms can undergo separate treatment,” Lee suggested.

Son Jun-seong said, “To prepare for a sharp rise in patients, not only the base hospitals but most private hospitals will also need to prepare ‘cohort wards’ or ‘critical patient cohort wards’ capable of accommodating multiple patients who have been diagnosed.”

By Park Da-hae, staff reporter

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