Porous MERS quarantine from public servant to health authorities

The first confirmed patient with Middle East Respiratory Syndrome (MERS) in Daegu on Tuesday was a public servant working at a Borough Office. Daegu City Mayor Kwon Young-jin apologized to citizens, saying, “It is deplorable and regrettable that the city’s first MERS confirmed case was a public official.” He visited his mother who was hospitalized for MERS infection at Samsung Medical Center on May 27, Even though his sister who visited the medical center with him was confirmed with MERS on June 10 and he himself got a fever, the civil servant freely went around many places including a public bath ignoring quarantine rules. According to the MERS prevention guidelines from the health ministry, a person who closely contacted with a MERS patient shall report to a community health center and undergo an in-house quarantine period of 14 days from the date of contact. Now concern is growing that a public official’s ignorance of the preventative measures, not just an ordinary civilian, may lead to outbreak of the deadly virus in Daegu.

The Korean government has repeatedly stressed that the public’s cooperation, citizens’ awareness and voluntary reporting are all the more important to contain the respiratory disease. However, the public probably is ignorant of such preventative measures, when considering the fact that even a public official was not aware of such quarantine measures.

A middle school teacher in Cheonan City of North Chungcheong Province continued teaching at school for five days after having contacted with a MERS confirmed patient. Because of this, the school has to go through temporary shutdown from June 15 to 19. As he was not informed of the house quarantine, the teacher continued to teach students, even the day after he called a community health center to confirm that he was subject to the house quarantine. This shows how complacent the teacher was and how poorly the MERS quarantine system worked at the community health center. “Daily monitoring is being thoroughly conducted,” Kwon Jun-wook, head of public health policy in the Ministry of Health and Welfare, said on June 2 despite all this. Was it because of false reports or did he tell a lie?

Failure of the public officials at the frontline of MERS containment is almost the same as what the top-level government did, which started on the wrong foot in the initial containment efforts. So far, information and prediction announced by the health authority have been wrong all the time. The health ministry’s statements such as "MERS is not contagious despite its high fatality rate," or "No risk of contagion if keeping a distance of 2 meters from a MERS patient," have grown distrust of the public against the authorities. Claims that the virus’ dormant period is 14 days at maximum and only those with underlying diseases are at risk turned out not true in reality. Although Health Minister Moon Hyung-Pyo said at a daily briefing on June 2, “It is regrettable that initial containment was not sufficient,” containment measures are still insufficient, sadly. It is doubtful as to whether the health authority’s control tower, which lost golden time with complacent decision-making and belated action-taking, consistently applies unrealistic optimism to the fight against the deadly virus, rather than correcting their wrongdoings.

A turning point in the fight against Severe Acute Respiratory Syndrome (SARS) which devastated China came at a time when Beijing Mayor was replaced. When former Party Secretary of Hainan Wang Qishan (current Secretary of the Central Commission for Discipline Inspection in China) took office replacing the previous Mayor who earned mistrust of the public by concealing information, the atmosphere was changed and finally the war against SARS was put to an end. Such a turning point is desperately needed to restore the public’s trust.

Having faith in success but recognizing the reality is called the ‘Stockdale Paradox.’ It is named after U.S. Admiral Jim Stockdale, who survived after having been held captive for 8 years during the Vietnam War. To overcome the current challenge, we need to keep in mind the Stockdale paradox. The government needs to give hope for containment of MERS to the public, not just vague optimism, but also needs to recognize the cold reality to prepare for the worst scenario.