‘Select and focus’: exploring South Korea’s controversial new Covid strategy

As South Korea struggles to contain the Omicron variant, President Moon Jae-in’s government has drastically changed its tactics from enforcing a strict “zero-Covid” policy to prioritising a new game plan: “select and focus”.

The country reported 109,831 new cases on Friday – about a 25-fold increase from January levels, according to Associated Press figures. With fast-spreading Omicron infections threatening to overwhelm South Korea’s public health system, the government’s new pandemic response is all about putting the elderly and vulnerable first.

This dramatic change of tack has left citizens feeling unsettled and abandoned, with Kim Woo-joo, president of the Korean Vaccine Society, likening it to a “survival-of-the-fittest situation” in an interview with The New York Times (NYT).

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Shining example

Up until December, South Korea had been heralded for escaping the pandemic “relatively unaffected economically”, said Devi Sridhar, chair of global public health at the University of Edinburgh, in The Guardian.

Not only was it one of the first high-income countries to see its economy recover to pre-pandemic levels, but South Korea was also praised for its remarkably low death count of just 3,137 out of a population of 51.8m at the end of 2021. By contrast, the UK at that time had seen 142,945 Covid deaths from a population of 67.2m.

South Korea’s early success in the battle against the virus had been down to a three-pronged strategy: testing early, often and safely; implementing aggressive contact tracing using tools developed during an outbreak of Middle East Respiratory Syndrome (MERS) coronavirus in 2015; and treating patients by segregating mild cases to government-monitored centres.

This “so-called three-T strategy”, as the NYT described it, meant that the country was able to keep the virus at bay without imposing a national lockdown – a pandemic response that helped its economy grow by 4% in 2021.

The three-T strategy was coupled with a forceful vaccination push, which saw the non-vaccinated banned from restaurants, cafes, shopping centres and other crowded spaces. South Korea now has one of the highest vaccination rates in the world, with 85.6% of the population having received at least two doses of a jab.

Overwhelmed by Omicron

But despite South Korea’s extraordinarily decisive strategy enabling it to flatten the curve quickly without needing to enforce a national lockdown, it hasn’t been enough to contain the super-infectious but less deadly Omicron variant over the last couple of months.

As cases exceeded the one million mark in early February, Moon’s government abandoned its world-leading test-and-trace system, announcing that it would instead focus its resources on the elderly and vulnerable, thought to constitute around 13.5% of new cases.

Now, people under the age of 60 with no underlying medical conditions are expected to monitor their own condition if they test positive for Covid, with members of their household free to go out to buy medicine, food and essentials if they are vaccinated.

This is a drastic change. Over the past two years, the movements of those infected have been monitored by health officials using GPS trackers and twice-daily check-ins, with a strict two-week quarantine period being the norm.

However, these officials have now been “redeployed to assist with at-home treatment for the severely ill”, said the Financial Times (FT).

People with Covid under 60 will also no longer be provided with a medical kit including an oxygen saturation measurement device, a thermometer and a fever remedy – supplies that were previously available to all patients treating themselves at home, said Reuters.

Patients under 60 with mild or no symptoms will now have to purchase such items “at their own expense”.

Disadvantages poorer citizens

This has led critics to claim that the government’s new “select and focus” approach disadvantages poorer people who lack access to medical care and other services, and may struggle to absorb the cost of any necessary pharmaceuticals.

Infected citizens are also now able to release themselves from quarantine without taking a PCR test after seven days if they’re no longer showing symptoms – another shift in policy which “reflects the intense pressure on the supply of laboratory tests”, added the FT.

“The previous scheme is no longer realistic in light of our limited resources, and takes massive social and economic costs compared with our medical needs,” health ministry spokesperson Son Young-rae told a briefing earlier this month.

‘Home abandonment’

This new approach has “unsettled” South Koreans who have “grown used to the government’s heavy-handed virus intervention”, said the NYT. “As the number of​ people fending for themselves at home has surged, so have the complaints.”

Citizens have said that being deprioritised by the government feels like “home abandonment”, with reports suggesting that people with Covid were left waiting for promised medical supplies including thermometers and hand sanitiser.

“The government’s partially hands-off approach is a shock to people who have dutifully followed what the government told them to do, like wearing masks and getting vaccinated, and in return expected it to take responsibility for protecting their lives,” said Korean Vaccine Society president Woo-joo.

But despite the criticism, evidence suggests the government’s new strategy is working. South Korea’s death tally remains low at just 7,283 deaths out of more than one million infections.