[이덕환의 과학세상]Now, the paradigm for quarantine needs to be changed: Dong-A Science

From’track’ to’screen’

The flame of Corona 19, which was mistaken for going out, is reviving horribly. It’s not the time to get drunk on the splendid success story of’K Defense’ in March. The lowest level of the Organization for Economic Cooperation and Development (OECD) is 46.3 infections and 0.8 deaths per 100,000 population, which are only good statistics. The real situation is very serious. The bed was exhausted, the medical staff was exhausted, the number of hidden infections increased, and the vaccine was not available. Social distancing standards have also been neutralized by sound economic logic, and quarantine experts’ desperate cry is being ignored. The government and the ruling party must be alert.

From’track’ to’screen’

In the first spread of last February, when the infection route was limited, the’diagnosis and tracking’ using the reverse transcription-polymerase chain reaction (RT-PCR) diagnostic kit developed for the first time in the world showed remarkable power. The success of’K Defense,’ which the government has poured out of KRW 120 billion and boasted around the world, was actually a miracle created by diagnostic kits, credit cards (transportation cards), and CCTV. Of course, this would have been impossible without the patience of the people who silently endured the indiscriminate infringement of personal information.

But now the situation has changed. The number of’hidden infections’ in which the path of infection cannot be traced and’hidden infections’ in which the infection cannot be predicted have increased significantly. Now, the’screen’ that checks the infection status of regions and groups has become much more important than the’tracking’ that follows the infection route. This means that the government should focus more budget and effort on identifying areas and groups where quarantine resources should be focused.

It is not impossible. We can also actively utilize the antigen and antibody’rapid’ diagnostic kit developed for the first time in the world. It is true that the accuracy of the antigen kit and antibody kit is 80%, which is significantly lower than that of the PCR kit. ‘False negative’ that misses the infected person also appears, and’false-positive’ that diagnoses the wrong person as an infected person also appears. Therefore, the rapid diagnosis kit cannot be a means of final judgment of infection.

That doesn’t mean that the quick diagnostic kit is useless. Rather, the quick diagnostic kit is very cheap. A quick diagnostic kit can be used if the price is about buying a mask. It is also a great advantage to be able to know the diagnosis results on the spot. The usage is also simple enough for individuals to use at home.
The rapid diagnosis kit can be used as a means of a’preliminary test’ to screen targets for PCR tests that are expensive, time-consuming, and require trained personnel and equipment in screening clinics. Currently, the positive rate of PCR tests is only 3%. More than 97% means that virtually unnecessary tests are being performed. If the PCR test is performed only on people who test positive in a cheap and simple quick kit, social costs and fatigue of test personnel can be greatly reduced.

The risk of missing an infected person due to an error in the rapid diagnostic kit is also not a concern. If you receive a negative decision with the quick diagnostic kit, you can repeat the quick diagnostic kit test again. For example, in a rapid diagnostic test with a false negative rate of 20%, the probability of receiving’false negative’ twice in a row is reduced to less than 4%. It’s not too difficult. All you have to do is bear the cost and inconvenience of a mask. It is also a work that greatly relieves the labor of the inspection personnel who are trembling in the cold and fatigue in the screening laboratory.

Social trust in the medical field must also be restored

Efforts to clear the government’s deep-rooted distrust in the medical field are also important. The government may preemptively make an exit to medical school graduates who have given up on the’national examination’. Medical graduates’ demands for’unconditional surrender’ are extremely emotional, and in reality, they can’t find any meaning. It is also important to note that if 3,000 medical graduates are abandoned, the entire medical system in Korea will be destroyed.

Controversy over fairness with other fields is also meaningless. This is because the renunciation of medical school graduates was originally a tragedy created by the government’s stubborn administration, which pushed for the establishment of a public medical school where social consensus was not reached out of nowhere in the severe situation of Corona 19. With the second spread of Corona 19 in progress in August, the responsibility for pushing the medical community into a swamp of mistrust is bound to be entirely up to the government.

The reason why the government’s’public health reform’ is still sluggish should be taken seriously. No one refuses to secure public health, which was a pledge for the presidential election. However, it is clear that the government’s efforts for social consensus on the establishment of a public medical school and expansion of medical school capacity, which the government unexpectedly brought out in August, was not enough. The perception of the cause of poor public health care is also widespread, and the problem of depriving public medical school graduates of the freedom of choice of profession is not as simple as it sounds.

Rather, it is necessary to transparently disclose the context of the policy mistakes that blindly pushed for the establishment of a public medical school, ignoring the severe reality of Corona 19, and demanding heavy responsibility. There may be suspicions about the low level of criticism that governs quarantine and medical policies.

The government’s and ruling party’s poorly false excuses for vaccines were also beyond the limits. Prime Minister Chung Sye-gyun’s remarks in the press on the 20th, “There are aspects that have not thought of increasing dependence on vaccines because there are about 100 confirmed cases in Korea.” It means that the government’s willingness to endure confrontation with the medical community and push for the establishment of a public medical school was due to an absurd misjudgment that the corona crisis was over.

There is also a heavy responsibility for breaking down the standard of’social distancing’ set by the government itself and confusing consumers with a stupid’consumption coupon’. The government’s ignorance of laws and standards is a shameful choice, far from the rule of law that the candlelight public sentiment longed for. The government’s flimsy attempt to save the economy is destroying both the economy and quarantine. Neither economy nor quarantine can be saved by reading the poorly announced statement by the Minister of the future, which cannot expect any expertise.

※Introduction

Deokhwan Lee Sogang University Emeritus Professor (Chemical Science Communication). He is the director of the Korean Chemical Society’s Carbon Cultural Center. In 2012, he served as president of the Korean Chemical Society and published 2500 columns and papers on social issues such as science and technology, education, energy, environment, and health and hygiene. He translated 《Equal and Not Same》 and 《The History of Almost Everything》, and his main book is Deok-Hwan Lee’s Science World.