Park, in her 70s, visited the hospital a few days ago with a sudden fever and cough and was confirmed to have COVID-19. He was surprised to be hospitalized, saying, "I thought it was a cold." COVID-19 is an infectious disease that still poses a serious risk to the elderly and immunocompromised. According to the status of inpatients in Korea, people aged 65 or older account for 60% of the total.
Experts view COVID-19 as an infectious disease that needs management, not an 'end disease'. Lee Dong-gun, a professor of infectious diseases at Seoul St. Mary's Hospital, said, "The seasonal wave is already fixed," adding, "The big wave in winter and the small wave in summer are repeated." "If people's immunity declines after this fall, COVID-19 is likely to spread again," he added.
The actual indicators are also on the rise. According to the Korea Centers for Disease Control and Prevention, the number of hospital-level inpatients has steadily increased from 63 at the end of June to 139 in the fourth week of July, 220, 272, 302, 367, and 399 in August. The proportion of COVID-19 viruses detected in hospital-level respiratory patients also jumped from 13% to 37.7% during the same period. Sewage monitoring indicators have also been steadily rising since the 26th week.
An official from the Korea Centers for Disease Control and Prevention said, "The spread continues as contact between people increases due to summer vacations and various events, and indoor ventilation decreases due to the heat," adding, "In particular, the elderly and immunocompromised people have a high risk of worsening to severe in case of infection, so they must follow basic rules such as wearing masks and washing their hands."
Experts reiterate the need for vaccination. Professor Lee said, "Last fall's vaccination vaccine targeted the 'JN.1 mutation', but now the dominant species in Korea is 'NB.1.8.1'. "The effect may be somewhat less effective, but it has not completely disappeared, so the higher the risk group should be vaccinated."
However, the actual vaccination rate is sluggish. As of April this year, the vaccination rate for high-risk groups was 47.4%, less than half. There is still a perception among the elderly that "do you need it?" and ghost stories spread among cancer patients and immunocompromised people that "they said that the vaccination and the sick recurred," and vaccination is often delayed. Professor Lee said, "Even if we recommend vaccination out of the country, half of them refuse," and added, "The government needs to continue its campaign to repeatedly inform safety and correct ghost stories."
From October 15 to the end of April next year, the government will implement the "25-26 season COVID-19 vaccination" for residents of infectious facilities such as nursing hospitals and nursing facilities with immunocompromised patients over 65 years of age and 6 months of age. 5.3 million new vaccines aimed at mutant "LP.8.1" will be used for this inoculation. It is also possible to vaccinate simultaneously with the influenza vaccine.
In addition to vaccines for preventive purposes, treatments are considered the core of COVID-19 patient management. Currently, treatments used in Korea include "Paxlovid," "Lagebrio," and "Becklury."
Paxlovid is the most widely known oral treatment and is prescribed first to the elderly or underlying patients at high risk of severe exacerbation. However, it is pointed out as a limitation that ritonavier inhibits liver metabolic enzymes and interacts with various drugs such as anticancer drugs, anticoagulants, hypertension drugs, and diabetes drugs.
Lagebrio is an oral treatment, and unlike Paxlovid, it is relatively easy to prescribe due to its low drug interaction. However, the World Health Organization (WHO) carefully recommends its use even in high-risk groups as it has been steadily pointed out that its effectiveness is limited in clinical practice. In Korea, it is limitedly used mainly in patients who have difficulty using Paxlovid because it is not officially approved by the Ministry of Food and Drug Safety.
Professor Lee said, "It is not easy to use oral treatments because 20-30% of elderly patients are already taking several drugs. Patients who are difficult to chew or swallow and patients with digestive disorders are also restricted from taking them."
Veclury is an intravenous drug that has clearly been confirmed to be effective in reducing the risk of severe progression and shortening the recovery period in clinical practice, making it an important treatment option for high-risk patients. In particular, it is considered the only alternative for patients who have difficulty using oral drugs. However, it is pointed out that it is necessary to systematically supplement patient accessibility as benefits are currently applied only to patients with severe and pneumonia, and for patients with mild and moderate symptoms, the burden of their own expenses is inevitable when the government reserves are exhausted.
Experts stress that COVID-19 treatments should be stockpiled to a certain level, like Tamiflu to prepare for influenza. Even if it is discarded without use, a social consensus is needed that it is "fortunately not used." At the same time, some say that the pay system should be supplemented so that injections can continue to high-risk patients who have difficulty using oral drugs.
Earlier in August last year, the surge in patients clearly showed the need to prepare. At that time, as the number of COVID-19 patients increased rapidly, the use of treatments increased 48 times in a month, and hospitals and pharmacies were in short supply. Professor Lee said, "If the number of patients suddenly increases, it is natural that the demand for treatment outpaces the supply," adding, "We should keep in mind that similar situations can recur at any time."
When confirming COVID-19, it is most important not to miss the timing of administering the treatment. In general, five days after the onset of symptoms are considered the right time. Risk signals that high-risk groups should pay special attention to are difficulty breathing, less than 94% oxygen saturation, continuous high fever of 38.5 degrees or higher for more than 3 days, loss of consciousness and dehydration. When visiting a hospital, it is safe to bring a list of medicines you are taking with you to check whether you interact with the medical staff.