Policy Alert #101 | June 16, 2015

The Middle East Respiratory Syndrome (MERS) virus in South Korea has killed 16 people and infected nearly 150 in the largest outbreak outside of the Middle East. In this Policy Alert, we examine reactions from South Korea, China, Japan, and Russia to the MERS outbreak.

SOUTH KOREA

South Korean authorities have placed more than 5,200 people nationwide under isolation to impede the transmission of the virus. Meanwhile, one of South Korea’s largest hospitals has suspended many of its services after being identified as the source of almost half the cases. South Korea’s economy has also suffered from the outbreak, with over 100,000 canceled tourist visits to the country and decreased department and retail store sales.

• The Korean health ministry predicted at a press conference held this Monday that the MERS outbreak in South Korea is expected to end in late June unless any “super spreader” emerges further.
• Song Jae-hoon, director of Samsung Medical Center, one of Korea’s largest and best hospitals, announced the suspension of non-emergency surgeries and the closure of its emergency ward until June 24 after one patient at the hospital infected at least 60 others. “The fact that Samsung now has a MERS patient who was a transfer agent is a very serious matter, which says a lot about its inability to control potential exposures,” said Lee Jae-gap, professor of infectious disease at Hallym University Medical Center.
• Korea Times writer Jung Min-ho criticized Samsung Medical Center for failing to “stick to the basic rules of containing the infectious disease,” despite being regarded by many as the nation’s finest hospital.
• The Korea Herald editorialized, “government officials botched their response, failing to contain the Middle East respiratory syndrome outbreak in its early stages. Most of all, authorities’ insistence on withholding crucial information – like the names of hospitals affected by the virus – fanned the spread of the contagious disease.”
• Lee Jong-koo, director of the Center for Global Medicine at Seoul National University stated that, “one of the big reasons for Korea’s MERS outbreak growing so fast and far is that the government failed to act swiftly on the release of information,” adding that “Regional governments also failed to anticipate the MERS outbreak, which prompted public disorder.”
• A Joongang Daily editorial noted Korea’s unique medical environment which may have promoted the spread of MERS: “People who feel sick bounce from hospital to hospital, usually trying to get into one of the big ones. When they get admitted, their family members move into the hospital room with them to provide care. The country also has a peculiar ward setup in which one room is shared by several patients except cases involving serious infectious illnesses.”
• Another Joongang Daily editorial criticized the MERS outbreak in Korea as “inevitable,” due to the countries neglect in “building its expertise in preventive medicine and infectious diseases.”
• Choo Moo-jin, president of the Korean Medical Association, urged the Korean government to take a series of countermeasures to address the outbreak including a thorough quarantine to separate patients and suspected patients from the public, and improved crisis management communication to provide information to the public on how to prevent the continued spread of MERS.

CHINA

China increased its alert against the Middle East Respiratory Syndrome over the past week, updating and improving its guidelines for diagnosis and treatment of MERS cases.

• The Chinese government asked medical institutions to “strengthen monitoring of fever and pneumonia cases with unidentified causes in order to detect, diagnose and isolate MERS patients as early as possible.” China’s civil aviation regulator also ordered all airline companies to strengthen prevention and control of the MERS for flights between China and South Korea.
• China’s quarantine and inspection, health and tourism authorities renewed a joint circular to prevent MERS cases from entering the country last Tuesday. The circular requires those from countries or regions with MERS outbreaks to report actively to quarantine and inspection authorities if they are experiencing fever, coughing or having breathing difficulties.
• Chinese and American scientists have jointly developed a new antibody targeting the Middle East Respiratory Syndrome (MERS) virus. Fudan University, which worked with US National Institutes of Health to develop the antibody, said on Monday that tests on animals had seen “very effective” results and called for immediate clinical trials.
• Judging from the current situation, the possibility of isolated MERS cases in China cannot be ruled out, but an epidemic is not likely, said Jin Qi, director of the Institute of Pathogen Biology of the Chinese Academy of Medical Sciences. “Having gone through SARS, China now has a high awareness of potential epidemics and its monitoring and testing technologies are significantly improved,” he added.

JAPAN

Japanese officials have ramped up public health measures to keep the regional outbreak of MERS at bay.

• Japan’s health ministry has asked those who came into contact with MERS patients and developing a fever after arriving in Japan to notify a public health care center and undergo further checks. “The spread of the infection was mainly seen inside medical institutions in South Korea, so there is a low possibility that Japan will see an outbreak now. But we are strengthening our measures as a precaution,” a health official said.
• Chief Cabinet Secretary Yoshihide Suga told a news conference earlier last week that “all quarantine institutions in Japan have been instructed on steps to be taken in case of suspected infections.”

RUSSIA

Russia began taking health control measures late last week to prevent the spread of MERS into the country.

• Passengers flying into the Russian Far Eastern cities of Vladivostok, Khabarovsk and Yuzhno-Sakhalinsk from South Korea will be screened for MERS, following a warning from Russia’s state health watchdog, Rospotrebnadzor, that the disease could spread to the country. Medical officers will also screen passengers coming into the Russian Far East by train and ship.
• “The risk of any infection being spread to any country in the world exists due to intensive migration within the population…only if someone is completely isolated could one say that there is total protection, and there are no such states,” stated Anna Popova, head of Rospotrebnadzor.

The Rising Powers Initiative Policy Alert project identifies and tracks the world views of major and aspiring powers in Asia and Eurasia. This project is supported by a grant from the Carnegie Corporation of New York.