A masked medical worker in Seoul where infections are spiking but deaths are dropping. Photo: AFP / Ed Jones

SEOUL – A battle is looming between the government and doctors in South Korea, a nation widely praised for its response to the coronavirus. Doctors are threatening a walkout as the virus, which many in South Korea thought had been contained, bounces back with a vengeance.

While the numbers of daily new infections – in the 300 range amid a populace of 51 million – would be the envy of many nations, here it is cause for serious concern.

South Korea has handled the crisis without lockdowns. Only buildings and facilities where infections have been found have been temporarily shuttered. The relatively light hand deployed so far means authorities have a well-stocked toolkit of measures they can roll out, if necessary.

But while national and local governments phase in new tactics, an unwelcome development – medical professionals’ displeasure with government policy – is rearing its head. Ironically, the threatened strike is in response to government efforts to lessen the burden on healthcare professionals by increasing the annual intake of medical school students.

South Korea’s daily average number of new confirmed cases between August 17 and 23 was 307, a major jump from last month when the figure was in the double digits. On August 22, new daily infections hit 397 – a record since March, when South Korea suffered its first and worst outbreak in the southeastern city of Daegu.  

The Korea Centers for Disease Control and Prevention said on Monday that the number of newly confirmed patients had decreased to 266 from Sunday’s 397. However, Monday’s lower numbers may simply reflect a test lag over the weekend. All eyes are now on whether numbers will jump again on Tuesday (August 25).

The virus surge is being largely blamed on massive anti-government demonstrations on August 15 in Seoul as participants converged on the capital from across the country. 

Particular vitriol has been aimed at a high-profile anti-government activist and rally organizers Pastor Jeon Gwang-hoon, who had not observed masking and social distancing guidelines and who has now been infected.

South Korean reverend Jeon Gwang-hoon in a file photo. Image: Twitter

In response, authorities are rolling out a range of new social distancing measures with particular attention on the capital Seoul, where most new cases are being discovered. On Monday, Seoul Metropolitan Government announced that masks are mandatory city-wide.

It is rare to see anyone without a mask in public, but now people in the capital are legally required to wear masks, outdoors and indoors, where people gather. Even when it comes to eating and drinking, citizens are required to mask up in restaurants while awaiting their order and after they finish dining.

In addition, the city is introducing a “one-strike and you are out” system. Under this, any facility may be shut down if it violates social distancing rules. Some 58,353 facilities city-wide are subject to the system.

These include privately run educational institutions, shopping malls, restaurants of more than 150 square meters, water parks, religious facilities, indoor wedding halls, theaters, bathhouses-saunas, indoor sports facilities, multi-room DVD and karaoke rooms, and funeral halls.

In addition, no more than 50 people may gather indoors and no more than 100 outdoors.

The city has also decided to allow anonymous testing for Covid-19. This tactic was first introduced after a cluster of infections broke out at gay nightclubs in the city’s Itaewon district in May. It is hoped that this move will allow more people to come forward for testing.

“People who attended the rally on the 15th, as well as visitors to nearby areas, should visit clinics such as health centers until Wednesday and undergo a diagnostic test,” Seoul’s acting Mayor Seo Jeong-hyup said at a Sunday briefing.

Asia Times has learned a number of businesses and organizations are telling their employees and members not to travel in or outside Seoul, where the bulk of current infections are occurring.

A health worker administers a swab at a temporary Covid-19 novel coronavirus testing centre in Bucheon, south of Seoul, on May 27, 2020. Photo: AFP/Ed Jones

Nationally, the government upgraded social distancing from Level 1 to Level 2 on Sunday. Level 2 is the second tier, with Level 1 being the loosest and Level 3 being the most restrictive. 

Under Level 2 social distancing, a collective ban is imposed on high-risk facilities such as nightclubs, certain bars, and karaoke saloons across the country. Other facilities with heavy foot traffic such as restaurants, bathhouses and wedding halls are obliged to enforce mask-wearing and maintain entry lists. 

Moreover, schools where group infections occur should immediately convert from offline to remote classes. 

Indoor national and public facilities will be shut, and sports events will be held without spectators. Previously, matches had been permitted with just one-tenth the usual number of spectators.

Still, there is rising pressure to upgrade from Level 2 to Level 3.

“As of midnight of Sunday, we moved to the Level 2 phase of nationwide social distancing, but it is not enough to cope with the current trend,” the Korean Society for Infectious Diseases (KSID) said on Monday.

“There have been more than 2,000 new cases of the virus in Korea over the past two weeks, and this trend is likely to cause damage on a different scale than we have experienced,” KSID added. “The quarantine measures can only be fully effective if they are applied early.”

According to a pollster Realmeter’s survey of 500 adults nationwide on Friday, 55.9% of respondents said they thought it was necessary to go to Level 3. Another 40.1% said the decision should be made carefully in consideration of the economic impact and expressed a negative stance on strengthening social distancing.

President Moon Jae-in said Monday at a cabinet meeting that the government may tighten social distancing rules if the country fails to bring the rising curve down this week.

South Korean President Moon Jae-in gives three cheers during the celebration of 75th anniversary of the Liberation Day at Dongdaemun Design Plaza (DDP) in Seoul on August 15, 2020. Photo: AFP/Chung Sung-Jun/Pool

Separately, the Ministry of Health and Welfare added that it could reinforce social distancing guidelines soon.

Under Level 3, meetings of more than ten people are disallowed and public events are banned. Moreover, medium-risk facilities such as cafes, public baths and theaters will be shut down, and sports events will be halted.

So far, Level 3 has not yet been implemented in Korea. President Moon calls it a “final option,” considering the consequences for the economy. 

While the government juggles priorities, doctors are raising their political voice against four major policy proposals.

These are: reducing the price of Oriental medicine via governmental financial support; increasing the number of medical schools; establishing public medical schools (which would lower the tuition fees compared to the current private medical schools); and raising the quota of trainee doctors.

The key issue raising the ire of the Korean Intern Resident Association, or KIRA, is the mooted increase in the number of medical students. Seoul has said it aims to increase the intake to 3,400 from between 2,900 and 3,300 now.

The government proposal came after front-line medical staff complained about being under-manned. KIRA, however, seethes that it is a hasty, poorly thought-out policy. 

“The government’s unilateral push for a hasty policy in the name of increasing the number of doctors in vulnerable areas and unpopular areas without precise estimates of the demand for medical personnel will cause serious health and life risks for the people,” the Korea Medical Association, speaking on behalf of KIRA, told Asia Times.

Thousands of doctors, medical students and healthcare professionals wearing face masks and protective equipment attend a rally in Seoul to protest against a government proposal to increase its annual intake of medical students, August 14, 2020. Photo: AFP/NurPhoto/Chris Jung

Doctors had already gone on partial strikes on August 7 and August 14. KIRA said on August 21 that unless the government alters its proposed policies, it will strike on three as-yet-unspecified days after August 26. 

Some 10,000 out of 16,000 interns and residents nationwide will participate, according to KIRA. Some hospitals have reportedly issued internal notices that they will be unable to accept critical patients in emergency rooms.

The government, however, appears to see the doctors’ opposition as a defense of turf by a privileged professional minority.  

“Anyone can oppose or criticize the government’s policies, but should not go beyond a legitimate line,” Moon said at Monday’s cabinet meeting. “The government has no choice but to sternly respond to the doctors’ illegal collective exercise of power.”

On August 22, Minister of Health and Welfare Park Neung-hoo made clear at a press briefing how seriously it takes the threat of industrial action by interns and residents – and, indeed, by medical institutions.

“The government and local governments may order medical personnel to start work if medical personnel are suspending treatment without justifiable reasons, or if the medical institution’s founders are closing or closing down en masse, causing huge disruptions to medical treatment,” the minister said.

“Failure to comply may result in suspension of license, imprisonment of up to three years or a fine of up to 30 million won (US$25,263).”