Korean hospitals are on extreme alert for novel coronavirus, as the nation’s Lunar New Year Holiday ended on Monday. They have to be -- symptoms caused by the infection with the virus are similar to those of influenza or cold.

After the authorities said the third confirmed patient was found to have had various community activities such as visiting a clinic, a hotel, and restaurants during the incubation period without symptom, the general public raised concerns for additional transmissions.

Medical institutions expected that patients who could not see a doctor during the holiday might rush in from Tuesday. The hospitals decided to conduct a fever test for all visitors and run a separate examination room to sort out people with a possible infection with the new coronavirus. They also set a patient visit restriction time.

Despite such response measures, it is not easy for physicians to distinguish patients infected with the novel coronavirus from those with flu or cold just by fever tests, especially in the winter when flu or cold is common.

“I’m frustrated how I should distinguish the Wuhan pneumonia from the flu or cold. I think the only way to sort them out is to use the Drug Utilization Review system to check whether the patients visited China recently,” a clinician said. “But the DUR system could be useless of additional infections start to spread in local communities.”

Another physician said ordinary clinics could not test patients without any symptoms. Even if a patient who recently visited China goes to an emergency room and demands a test for the virus, the hospital cannot run the test unless it is a state-designated one, the doctor added.

“If a patient has symptoms, he or she should call a public health hotline at 1339 or contact a local public health center, rather than visiting a hospital. That way, we can reduce chaos at medical institutions,” the doctor said.

The Korean Medical Association (KMA) held an urgent news conference on Sunday, asking people who have been to high-risk regions recently to restrain from unnecessary outdoor activities for a maximum incubation period of two weeks, even if they had no symptoms. If a fever develops or respiratory symptoms show, people must call 1339, the KMA added.

The Korean Hospital Association (KHA) is operating a response room to deal with the pandemic 24 hours a day. The association said it would form an emergency response division to strengthen response measures.

“As the third and fourth confirmed Wuhan pneumonia patients showed symptoms belatedly, there might be more patients who came from Wuhan to Korea last week,” an official at the KHA said.

When the MERS hit Korea in 2015, medical institutions established separate examination rooms to distinguish patients with suspected cases of the MERS infection from others.

‘Raised alert level should not hurt KCDC’s disease control authority’

Experts said the government’s elevation of infectious disease alert level from “caution” to “alert” should not interrupt the disease control power of the Korea Centers for Disease Control and Prevention (KCDC).

Infectious disease alert levels are divided into four stages – interest (blue), caution (yellow), alert (orange) and serious (red).

The Ministry of Health and Welfare on Monday raised the alert level to “alert,” among four stages of interest, caution, alert, and serious. During the Middle East Respiratory Syndrome (MERS) outbreak in 2015, the nation maintained the level at “caution.”

The ministry immediately established a “New Coronavirus Infectious Disease Response Center,” led by Minister Park Neung-hoo. The center will dispatch the workforce to support KCDC’s disease control and share real-time situations.

Professor Lee Jae-gap at the Infectious Disease Department of Hallym University Kangnam Sacred Heart Hospital said during the MERS outbreak in 2015, the government maintained the alert level at “caution” due to issues over responsibility for failure in early response, even though experts urged the government to raise the level to “alert” from “caution.”

“This time, with the level listed to ‘alert,’ the health and welfare ministry started to intervene. I hope the raising of the level to ‘alert’ will not lead to a mere increase of reports,” Lee said.

As the KCDC has been doing an excellent job, the health ministry should support what’s lacking, such as human resources, Lee went on to say. The health ministry should not act as if it were a superior institution to control KCDC or demand briefings, he added.

‘No evidence proves novel coronavirus is infectious during incubation’

Lee claimed that the Chinese health authorities’ recent announcement that the novel coronavirus could be transmittable during the incubation period was “groundless.”

China’s National Health Minister Ma Xiaowei said in a news conference on Tuesday that despite the limited information on the virus, the incubation period could be varied from one day to two weeks. Ma also said that unlike Severe Acute Respiratory Syndrome (SARS)-related coronavirus, the novel virus seems to be infectious during the incubation period.

However, Lee said the authorities should not make a hasty conclusion about the possibility of transmission during an incubation period. “I think China could have exaggerated that Wuhan pneumonia is such a dangerous disease to avoid responsibility for its failure in pandemic control,” Lee said.

He said he heard KCDC requested China to provide evidence of the possibility of transmission during incubation. “To date, very few viruses have caused asymptomatic infections,” Lee added.

China’s National Health Commission said the country reported 2,844 cases of Wuhan pneumonia, 5,794 suspected cases, and 81 deaths as of 10 p.m. on Monday.

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