Costly Lessons From the 2015 Middle East Respiratory Syndrome Coronavirus Outbreak in Korea

Lee, Sang-il

It is worth evaluating the major reasons for the rapid spread of MERS-CoV in Korea. Several health care system issues seem to be linked with the rapid transmission of MERS-CoV that oc- [3] . These factors included lack of awareness among health care professionals and the public about new emerging infectious disease like MERS; weakness in preventing and controlling healthcare associated infections in hospitals; close and prolonged contact of infected MERS patients in crowded emergency rooms and multibed rooms in hospitals; the system permitting patients' free choices in seeking care (known as "doctor or hospital shopping"); the custom of family members and visitors spending time with infected patients in hospital rooms facilitating the secondary spread of infections among contacts. In a thought experiment, these factors can modelled like the holes in slices of Swiss cheese [4] . In this model the holes in any one "slice" do not normally lead to an accident, as the accident is curtailed elsewhere in the system. A bad outcome can occur only when the holes, that is, the risk factors in many slices momentarily line up to permit an accident the opportunity to take a straight trajectory through the layers. In this case the failure of the Korea Centers for Disease Control and Prevention (KCDC) to control the MERS outbreak in its early stage can be regarded as one hole in one slice. Korea still had to take countermea-