Efficient and effective: South Korea’s healthcare response to coronavirus

This article is an expanded and updated version of the South Korea section of our feature Analysis: How do world leaders’ responses to coronavirus stack up?.

For a while, Moon Jae-in did not seem like the most popular man in South Korea. His decision to not immediately impose a travel ban on China – he has historically been emollient with the superpower, South Korea’s largest trading partner – came in for criticism. “China’s difficulties are our difficulties,” he intoned on 20 February, with unintentional irony: South Korea’s coronavirus case numbers were doubling as he spoke. 1.5 million South Koreans, generally resentful of Beijing’s overweening power in the region, went on to sign a petition demanding Moon’s impeachment. Yet as the crisis wore on, Moon’s approval ratings began to climb, as leadership approval ratings often do amid crises. On 16 April, Moon’s Democratic Party and a small coalition partner party won 180 out of 300 seats in the national assembly – the most convincing majority in the history of South Korean democracy. At 66%, turnout was at its highest in 28 years.

Much has been written about South Korea’s phenomenal testing programme: with test numbers on a par with Singapore, South Korea rolled out innovative tests that release results within six hours. It implemented this programme quickly and on a mass scale, so that by the end of February over 46,000 South Koreans had undergone affordable, often free, tests. By this point, the US, which also recorded its first coronavirus patient on 20 January, had only tested 426 Americans. By mid-March, 270,000 South Koreans had been tested. Mass testing meant that those who were known to have it could be traced locationally (in a process known as “contact tracing”), so those they were interacting with could be warned, tested and, if necessary, quarantined. As a result, only 240 people have died – and there has been no lockdown. Meanwhile, South Korea has exported test kits to over 20 countries, including the US.

Something that has received less press attention is the nature of South Korean leadership in this case, which might be said to be radically decentralized: a leadership style in which a population shouldered collective responsibility, mobilized itself and endogenously took control of virus containment. Tens of thousands of businesses elected to shut themselves down and apply for government grants before it was mandated. Churches began delivering sermons online. The country’s strong social glue stood it in good stead at a time when collective sacrifice was sorely needed.

Not that this didn’t need active, often invasive leadership from above, as well as a very trusting populace. Governments used CCTV footage, GPS tracking, phone data and card payment records to track patients’ (or potential patients’) movements and catch quarantine-flouters. The authorities also encouraged companies to develop apps such as Corona 100m, which alerted users when they breached the 100-metre radius of a coronavirus patient. That much of this data is anonymized does not change the fact that such potentially invasive apps are more viable for mass take-up in Asian countries, where trust in governments is higher than in Europe or the Americas. This trust is embedded in the unwritten social contract between citizen and state in South Korea.

Armed with a PhD in social welfare at the University of California, Park Neung-hoo, before becoming South Korea’s minister of health and welfare, helped shape the country’s principal social welfare system, the Basic Livelihood Security Programme, which provides cash, housing and education benefits to 3% of the country’s population. He has been the incumbent health minister since Moon assumed the reins in May 2017; since then, he is most noted for expanding South Korea’s National Health Insurance (NHI) programme, introducing coverage for medical services previously considered non-essential. He has long stressed the importance of universal health coverage and balancing this with data privacy, which helps explain why South Korea has managed to gather so much healthcare data from its citizens while also anonymizing that data. App alerts contain only the gender and age of infected people, and the names of the places they’d visited.

The leadership has also made investments in what might be termed “infrastructure”: hundreds of drive-thru and walk-in testing facilities were dotted around the country. There were also care packages (masks, hand sanitizer, fresh produce and other essentials) for those in enforced quarantine. Moreover, as of 1 April, a two-week quarantine is mandatory for Koreans and non-Koreans entering the country from abroad. European countries such as the UK have done no such thing.

But right now, South Koreans are beginning to return to normal. Restrictions on shops, restaurants, bars and religious venues were eased this week, and though social distancing continues, socializing has, tentatively, begun once again.