What’s happening with COVID-19 in South Korea? Buckle up if you really want to know.

We pause our fun travel stories for a moment to let you know about COVID concerns here. When we arrived in South Korea (ROK) on July 31, the count of new COVID cases for the day was 36. On August 14, our first day out of quarantine, that number was 103. On August 27, it was 441, the highest total since the pandemic spiked here in March. Cases have spread to all 17 regions of the ROK rather than being localized to one area, which was the case with previous outbreaks.

Despite this all starting as we finished quarantine, we’re pretty sure we didn’t cause the new outbreak, but here we are. So, you might ask, how worried should we be?

Our Observations

• During our two weeks of quarantine, there were few top headlines in media here discussing COVID-19 worries. There were stories, but they mostly discussed the economy as related to the pandemic. I noticed a change in the news trend around August 18, the fifth day in a row that new coronavirus cases remained above 100. As of August 30, many of the top headlines are about coronavirus.

• There are two televised government briefings every day with updates about the numbers of new cases, tests, and deaths, broken down by region. The briefings are conducted by a single member of the Korea Centers for Disease Control (KCDC) and last 15-20 minutes. During this time, the KCDC health official also updates the public about current guidelines. Officials generally emphasize that there is no cure and only a handful of treatments for coronavirus, and the effectiveness of most of those treatments is still under study. We are able to watch the briefings on YouTube with English translation.

• At some restaurants, markets, and major sights we’ve had our temperature taken and have been asked to sign in with our name and phone number for contact tracing purposes. This has not happened everywhere, but it has been a regular occurrence.

• Social distancing does not seem to come easily to Seoul. There are fewer people out than usual, so we haven’t felt crowded. However, there have been few visible efforts on public transportation, in restaurants and retail spaces, or even on sidewalks to maintain any particular distance. This is likely to change as of August 30 – see below.

To Mask or Not to Mask

In Seoul, basically everyone wears a mask all the time, except when actively eating and drinking. As it’s considered rude in Korean culture to eat and drink while walking down the street, most people remain in a contained area when eating. Since the implementation of a new rule that makes mask-wearing in Seoul compulsory, we have witnessed almost 100% compliance, even in parks and on hiking trails.

There is no shortage of disposable face masks here. The surgical-style masks can be found everywhere, including in convenience stores. It’s also easy and cheap to buy KF-94 masks, which block more particles than the regular medical masks but are not as high-grade as N-95s. South Korea, a democratic country, took over control of mask production and distribution early in the pandemic as profiteering was making affordable masks hard to find. This has enabled the public and medical professionals to have ongoing easy access to quality masks.

There does not seem to be any public debate about wearing masks, at least not any that is reflected in our media sources.

There are signs everywhere reminding the public to wear masks, observe social distancing, wash hands, and take temperatures regularly.

Public Guidelines

South Korea has a 3-tiered response system for social distancing and other COVID guidelines.

Level 1

Pretty much business as usual. This is the level the country had achieved over this summer. Schools, churches, restaurants, museums, galleries, movie theaters – everything was open. And the numbers of new infections were staying low: well below 100 for the the entire country for many weeks.

Masks are required when using public transit and taxis, although in our experience most people were wearing them all the time in public anyway.

Level 2 (currently in effect nationwide)

This intermediate level was adopted on August 19 for Seoul and then was expanded nationwide on August 23. Churches, museums, galleries, bars, singing rooms (karaoke rooms), cyber cafes, and large restaurants are closed. All private and public indoor meetings of 50 or more and outdoor meetings of over 100 are banned.

• Wearing masks in any public place, indoors and outdoors, was mandated in Seoul on August 24.

• Schools remained open at first, but starting on August 26 all primary and secondary schools have gone virtual for the next two weeks. The shut-down was mandated after 337 students and 89 educators around the country tested positive for the coronavirus.

• The National Assembly (legislative body) closed temporarily on August 27 after receiving word that a reporter who recently had been in the building had tested positive for coronavirus.

• On August 30, the government implemented “Level 2.5,” under which cafes will offer to-go service only, and restaurants will be take-out only after 9pm. (Presumably to prevent customers from staying and drinking all night with no masks on.) Gyms and other recreational facilities will be closed. This level is anticipated to last until next Sunday, September 6, at which point the government will re-evaluate the level that is needed.

• As of August 30, restaurants, bakeries, and cafes are required to have customers sign entry logs.

• The government has asked citizens to cancel unnecessary trips and to observe stricter social distancing guidelines, such as postponing in-person meetings. Many businesses are having employees work from home.

Level 3

This is the level everyone dreads and hopes not to need. It’s the widespread shutdown phase that many in the world have experienced, and is essentially what was implemented in Daegu during its major outbreak in February. The government is ramping up Level 2 restrictions in an effort not to have to go to Level 3.

At Level 3, all meetings of 10 people or more will be banned and all businesses will be asked to have employees work from home. This would effectively close restaurants, cafes, department stores, and all remaining non-essential businesses and government offices.

How Did We Get Here?

Well, there is some finger-pointing going on. However, the consensus is that this outbreak blossomed in a large, protestant Seoul church. The Sarang Jeil Church allegedly was having large, in-person church services with singing while not wearing masks. Because this church attracts visitors from all over the country, it is thought that travelers who worshiped at the church then went home and spread coronavirus to multiple provinces.

Sarang Jeil has had a fraught relationship with the government for some time. The outbreak at the church had already been identified when the church’s pastor sponsored a political rally in Seoul on Liberation Day that was attended by more than 20,000 people. The church then declined to cooperate with the government’s contact tracing and testing efforts, a backbone of South Korea’s successful coronavirus containment strategy.

Unfortunately, other churches have followed suit and decided not to adhere to guidelines meant to protect their congregants, who are mostly older people more susceptible to serious illness. This is not endearing churches to the public, which is really disheartening, especially since some churches are trying to prevent COVID from spreading.

As of August 27, 978 positive COVID cases had been identified among Sarang Jeil congregants (including the pastor), and 140 cases connected to 23 different establishments had been traced to the Sarang Jeil outbreak. 5,900 additional church members have been asked to present for testing.

So far, 294 positive cases have been connected with the Liberation Day rally, and this number is expected to grow as 51,000 people have been traced to the vicinity of the rally and have received notification that they should be tested. The government’s commitment to contact tracing and testing is undeniable.

In addition to the church outbreak, South Korea had begun large-scale re-opening in July to encourage economic recovery. This led to other small cluster outbreaks, such as one among employees of a fast food chain and one at a Starbucks.

It’s notable that the mortality rate during this August outbreak is higher than in the earlier South Korean outbreak. Officials believe this is because the lack of cooperation from the church in getting people tested caused them to lose the “golden time” of testing as soon as possible after exposure. The KCDC recommends that people in high-risk categories, such as those over 65, be monitored carefully during their first week of illness so that they can be transferred to an appropriate hospital immediately upon displaying more severe symptoms.

Delays in testing mean that window is lost, and more people will die before they can receive appropriate care. This country, with one of the lowest COVID mortality rates in the world, believes that widespread, timely testing is a key to preventing critical illness and death.

What Happens Now?

At this point, we have no reason to mistrust the ROK’s handling of this outbreak or the medical system’s capability. It’s reassuring to witness a system that is tracing, testing, clarifying what citizens should do, and following a plan. We are being more careful when we go out, always wearing good quality masks and mostly staying outdoors or in large, uncrowded spaces. Hand sanitizer is everywhere.

We have kept up a fairly frenetic pace of sight-seeing despite the discomfort of the August heat, mainly because we want to do what we can ahead of any further shutdown that may be coming.

Even Seoul Forest and the Lego Store are doing their part to stop COVID-19!

We won’t have to guess whether we have been exposed to COVID. Though no system is perfect, we get emergency alerts on our phones generated through the government’s contact tracing. They tell us what neighborhoods in Seoul are reporting new COVID cases, and they often provide a website link that details the public places an infected person visited in the two days before diagnosis. (The website contains no identifying information – just a list of places the infected person visited.) If you’ve been to any of those places and somehow end up not getting notified through contact tracing, you can present to be tested.

Though it is possible the government ultimately will opt for a Level 3 shutdown to contain the virus again, we are finding it useful to keep some perspective:

• Though case numbers are rising in the ROK, the positive rate (the share of tests returning a positive result) is still very low: 1.1%. The WHO has stated that a positive rate of <5% is an indicator that a country has the virus under good control. The positive rate in the U.S. is at 6.4%, which is an improvement over a few weeks ago.
• As of August 30, the ROK has carried out 1,924,170 tests since January. On August 28 there were 50,711 people listed as awaiting test results. Note: that’s not the total number of people being tested – that’s just the number of people pending test results. The number of tests per confirmed case in the ROK is down from a few weeks ago to 47.5, although that’s still well above the WHO guidelines, which recommend this number remain at least in the 10-30 range. In the U.S. right now, the number of tests per confirmed case is 15.7.
• The mortality rate among coronavirus patients in South Korea is still very low – about 1.7% – giving it one of the lowest COVID mortality rates in the world. In the U.S., the COVID mortality rate remains at 3.1%, which is about average worldwide.

So How Worried Should We Be?

On August 30, the number of new cases in South Korea is back down to 299.

Despite this decreasing number, the government has committed to maintaining the “Level 2.5” guidelines for at least the next week. I find this smart and reassuring.

We are being careful and feel pretty safe when we are following the recommendations. Although it will be disappointing if we have to curtail our travels for the next few weeks to adhere to social distancing guidelines, we support doing whatever it takes to keep the spread of COVID-19 in check. We were staying at home when we were in the U.S., and we can stay at home here, too.

In the meantime, we’re storing up a nice collection of adventures to tell you about, so we will let the (virtual) good times roll! Everyone stay smart and safe, wherever you are.