COVID-19 Outbreak In South Korea Research Articles

654. Changing trends of molecular characteristics and antimicrobial susceptibility of hypervirulent Klebsiella pneumoniae in community-acquired liver abscess before and after COVID-19 outbreak in South Korea

Abstract Background Hypervirulent Klebsiella pneumoniae (K. pneumoniae, hvKP) causes invasive infections, usually community-acquired liver abscess. In this study, we aimed to compare the molecular characteristics and antimicrobial susceptibility of hvKP in community-acquired liver abscess over times, especially before and after COVID-19 outbreak. Methods This study was performed on K. pneumoniae isolates of community-acquired liver abscess collected from Keimyung University Dongsan Hospital from 2014-2015 and 2020-2021. Clinical and microbiologic data were collected from medical records. Capsular serotypes and virulence factors were identified by polymerase chain reaction using specific primers. Results A total 79 patients were analyzed, 39 (49.4%) of 2014-2015 and 40 (50.6%) of 2020-2021. Capsular serotype K1 (61.5% vs. 62.5%) and K2 (25.6% vs. 30.0%) were no significant differences between the two periods. In virulence factors, IutA (82.1% vs. 97.5%) was significantly increased in 2020-2021 compared to 2014-2015 (p=0.028). RmpA (84.6% vs. 90.0%), kfu (61.5% vs. 70.0%), allS (56.4% vs. 67.5%) were showed no significant changes between two periods. Antimicrobial susceptibility of ciprofloxacin (100.0% vs. 95.0%), ceftriaxone (97.4% vs. 89.7%), and imipenem (100.0% vs. 97.5%) were no significant differences between the two periods.Table 1.Molecular characteristics of hypervirulent Klebsiella pneumoniae in community-acquired liver abscess Conclusion In liver abscess, the virulence factors showed a tendency to increase during the study period such as IutA, but the limitation is that there were small numbers of isolates included in this study. Further studies with larger number of isolates will be required to findout the changing characteristics of hvKP over times. Disclosures All Authors: No reported disclosures

Implication of close contact testing in eliminating an epidemic: Application to COVID-19 epidemic in South Korea and New York City

After the first wave of the coronavirus epidemic, temporary stability in the disease spread dynamics was observed in many regions. This behavior can potentially be attributed to the measures implemented to contain the spread, particularly close contact testing. We propose a deterministic mathematical model that simulates the dynamic spread of the disease while considering the actions of the public health system. The developed model achieves a non-forced balance in daily confirmed cases, reproducing the observed epidemic behavior during the COVID-19 outbreak in South Korea and New York City. Our finding indicated that, although the quasi-steady state behavior can only be attained within a certain range of model parameters, an increase in the health system’s interventions does not eliminate the epidemic. We conclude that the observed stationary state of daily COVID-19 cases does not result from setting the basic reproductive number to one. Instead, it emerges as a natural consequence of the policies implemented by authorities to mitigate its spread.

The Impact of Social Media on Preventive Behavior During the COVID-19 Outbreak in South Korea: The Roles of Social Norms and Self-Efficacy.

Social media are important channels to propagate health information and influence preventive behavior during a public health crisis, as witnessed during the coronavirus pandemic (COVID-19). This study explored the association between social media use and preventive behavior during the outbreak of COVID-19 in South Korea. Using the national survey data (N = 1,500), the study examined the mediating role of social norms in the association between social media use for news and information about COVID-19 and preventive behavior. In addition, the study tested the moderating effect of self-efficacy on the mediating path of social media use for preventive behavior via social norms. Conducting a moderated mediation analysis method, this study found that social norms mediated the relationship between social media use and preventive behavior (b = 0.046). Moreover, the study revealed that the indirect relationship between social media use and preventive behavior through social norms becomes stronger as an individual's level of self-efficacy decreases (low: b = 0.044, middle: b = 0.036, and high: b = 0.030). The study provides empirical evidence of the beneficial impact of social media use on preventive behavior. The findings of the study recommend promoting messages on social norms through social media for facilitating preventive behavior.

The changes in smoking stigmatization during the COVID-19 pandemic

ObjectivesThis study aimed to analyze the changes in smoking stigmatization in relation to an individual's smoking status after the COVID-19 outbreak. Study designA 2 (before vs. after COVID-19) X 2 (smoking status: smoker vs. non-smoker) factorial design was developed. MethodsTwo national surveys were conducted, one each before (between January 7th and 15th, 2020) and after (between January 26th and February 18th, 2021) the COVID-19 outbreak in South Korea. A total of 7296 representative adult responses were finalized. Respondents were categorized into two groups: non-smokers and smokers. Smoking stigma was measured in two ways: social and personal. ResultsIn general, smoking stigmatization intensified after the COVID-19 outbreak. However, there was a discrepancy in responses based on smoking status—non-smokers exhibited a heightened negative stigma toward smokers, whereas smokers had generous perspectives about themselves. ConclusionsThe health-oriented environment generated by the response to COVID-19 is leading to increased stigmatization of smokers who pose a risk to public health. However, the discrepancy between smokers and non-smokers shows that social efforts are required to alter smokers’ generous views about themselves and to persuade them to cease smoking.

Research on Korean Translation in the Context of Epidemic Prevention and Control

An emergency like COVID-19 requires a theoretical framework for policy implementation that involves public and private sector collaborations. After policy failures, new institutions have formed that trigger PPP's later, allowing the incumbent administration to continue in office longer. It focuses on novel approaches to dealing with pandemics. The present administration put these rules in place to keep COVID-19 under control. When it comes to Real Time - polymerase chain reaction (RT-PCR) testing, South Korea's government and corporations partnered to swiftly raise the quantity of testing in the country. Models of policy change are shown to be dynamic, cyclical, and recursive. During the COVID-19 outbreak in South Korea, an empirical content research was conducted. Even though South Korea's leader was at risk of losing public support to the point where impeachment was mentioned as a possible option, he dramatically reversed public mood to win general elections by a wide margin in April 2020, while the pandemic scenario persisted. To win reelection, democratic administrations are under more pressure to effectively perform crisis management when faced with a crisis. As a result, they are under even more pressure to immediately mobilize public and private resources. The emergency use authorization (EUA) protocol for test kits is an example of "leapfrogging actors" – up-and-coming innovators – who helped turn a pandemic tragedy into a possibility for sustained leadership and for them. The results based on infected premises culling rate ratio is 82.3%, number of measles cases report is 86.4%, spread and epidemic ratio is 84.2%, important of epidemiology is 89.35%, transmission potential of COVID-19 is 91.24% and illustration of epidemic control is 92.45. The results based on infected premises culling rate ratio is 82.3%, number of measles cases report is 86.4%, spread and epidemic ratio is 84.2%, important of epidemiology is 89.35%, transmission potential of COVID-19 is 91.24% and illustration of epidemic control is 92.45.

COVID-19-related anxiety and lifestyle changes.

This study aimed to identify factors that affect lifestyle changes and focused on coronavirus disease (COVID-19)-related anxiety since the COVID-19 outbreak in South Korea. Data from 213,848 individuals from the 2020 Korean Community Health Survey were analyzed using a complex sampling design. Descriptive statistics, t-tests, one-way ANOVA, and multiple regression analyses were performed. Participants reported a high level of COVID-19-related anxiety, with a score of 19.28 out of 25. The score of healthy behavioral change index was -0.51, indicating negative changes in physical activity, dietary habits, and sleep patterns. A slight positive change was reported for addictive behavioral change index, such as smoking and alcohol consumption, at 0.27 scores, indicating a decrease in these behaviors. COVID-19-related anxiety was an important factor that negatively affected health behavior. The high-risk groups that were vulnerable to anxiety included older adults and those who have little social support or few social encounters. Thus, identifying high-risk groups with the potential for worsened health behavior and providing interventions to reduce the anxiety caused by COVID-19 are necessary.

Changes in health risks of pest control and disinfection workers after the COVID-19 outbreak in South Korea

Changes in health risks of pest control and disinfection workers after the COVID-19 outbreak in South Korea

South Korean validation of the COVID-related-PTSD scale in a non-clinical sample exposed to the COVID-19 pandemic

The threat of COVID-19 outbreak in South Korea and around the globe challenged not only physical health but also mental health, increasing the chances of disorders such as posttraumatic stress disorder (PTSD). Such pandemic situation can be referred to a traumatic event for citizens. The present study aims to examine the psychometric properties of the PTSD Checklist (PCL-5), which is named the K-COVID-related-PTSD. The scale measures PTSD symptomology in the context of the COVID-19 pandemic in South Korea. A total of 1434 South Korean citizens were included in this study. The data were statistically analyzed using SPSS 21.0 and Mplus 8.0. The results of confirmatory factor analysis demonstrated a superior fit for the seven-factor hybrid model (x2 = 1425.445 (df = 149), CFI = 0.950, TLI = 0.937, SRMR = 0.033, RMSEA = 0.077) consisting of re-experiencing, negative affect, anxious arousal, dysphoric arousal, avoidance, anhedonia, and externalizing behaviors. Furthermore, the K-COVID-related-PTSD showed a satisfactory level of internal consistency (α = 0.793 to α = 0.939) with good convergent and discriminant validity. Finally, concurrent validity was confirmed by the significant correlations with all the negative mental health outcomes, such as PTSD symptoms, somatization, depression, anxiety, anger, negative affect, job burnout, and suicidal ideation. Overall, the current results demonstrate the K-COVID-related-PTSD is a valid scale and therefore has important implications for future pandemic-related studies.

Screening for Diabetes Complications during the COVID-19 Outbreak in South Korea

This study aimed to investigate the implementation of diabetes complications screening in South Korea during the coronavirus disease (COVID-19) outbreak. Data from the Korea Community Health Surveys conducted in 2019 and 2020 were used. This study included 51,471 participants. Multiple level analysis was used to investigate the relationships between screening for diabetic retinopathy and diabetic nephropathy and variables of both individual- and community-level factors in 2019 and 2020, before and after the COVID-19 outbreak. Diabetes nephropathy complications screening in 2020 had a lower odds ratio. However, regions heavily affected by COVID-19 showed a negative association with diabetes complications screening after the COVID-19 outbreak. For those being treated with medication for diabetes, there was a significant negative association with diabetic nephropathy screening after the outbreak. The COVID-19 outbreak was associated with a reduction in the use of diabetes nephropathy complications screening. Additionally, only regions heavily affected by COVID-19 spread showed a negative association with diabetes complications screening compared to before the COVID-19 outbreak. In this regard, it appears that many patients were unable to attend outpatient care due to COVID-19. As such, these patients should be encouraged to visit clinics for diabetes complications screening. Furthermore, alternative methods need to be developed to support these patients. Through these efforts, the development of diabetes-related complications should be prevented, and the costs associated with these complications will be reduced.

Aspects of Psychiatric Comorbidities in Breast Cancer Patients in Tertiary Hospitals Due to COVID-19 Outbreak in South Korea: A Single Center Longitudinal Cohort Study.

Background and Objectives: This study aimed to analyze the prevalence of mental disorders in patients with breast cancer at Ajou University Hospital. In addition, the patterns and prevalence of mental disorders according to the occurrence of coronavirus disease (COVID-19) were analyzed. Materials and Methods: From 1 January 2008 to 30 June 2021, psychiatric disorders were identified in 5174 female patients diagnosed with breast cancer at Ajou University Hospital. Based on the time when COVID-19 occurred, the pattern of onset of mental disorders in patients with breast cancer was analyzed. In addition, the prevalence of mental disorders according to the time of breast cancer diagnosis and age was evaluated. Results: A year before the diagnosis of breast cancer, 371 patients were diagnosed with a mental disorder. Of these, 201 patients were diagnosed with stress and adjustment disorders, and 97 patients had anxiety disorders. The overall frequency of psychiatric disorders after breast cancer diagnosis peaked two months later. Among psychiatric disorders reported before the COVID-19 pandemic, the proportion of stress/adaptation disorders was 52%, and among psychiatric disorders reported after the pandemic, it was significantly higher at 94.7%. Anxiety was found to be high in the elderly group aged ≥ 60 years, and the prevalence of stress and adjustment disorders tended to increase in the non-elderly group. Conclusions: Breast cancer patients showed different patterns of psychiatric disorders according to age, time of breast cancer diagnosis, and the occurrence of COVID-19. Owing to the COVID-19 pandemic, delays in treatment and anxiety about infection have increased the rate of stress and adjustment disorders in cancer patients. Mental health management during the pandemic and after cancer diagnosis can improve the quality of life of patients with cancer.

The COVID-19 Outbreak in South Korea: Lessons to Be Learned

The COVID-19 Outbreak in South Korea: Lessons to Be Learned

Predictors of Burnout in Hospital Health Workers during the COVID-19 Outbreak in South Korea.

This study aimed to identify the factors that influence the components of burnout—emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA)—among hospital health workers, including doctors and nurses, during the COVID-19 pandemic. We analyzed 200 healthcare workers’ responses to the Employee Health Promotion Survey conducted at a general hospital in Seoul with over 200 hospital beds. The questionnaire included items about COVID-19-related burnout and its influencing factors. We performed three different multiple regression analyses using EE, DP, and PA as the dependent variables. The results show that sex, marital status, workload of treating suspected COVID-19 patients, fear of COVID-19 infection, anxiety, and depression predicted EE. The predictors of DP were job category, consecutive months of work in the current department, satisfaction with work environment, anxiety, and depression. The predictors of PA were the workload of directly interacting with patients, socioeconomic status, and job stress. For EE and DP, burnout was found to be worse in doctors and nurses than in other health workers; moreover, burnout was worse among nurses than among doctors across all three aspects of burnout. The findings can be used to establish tailored policies to address each burnout component.

Impact of NPIs for COVID-19 on Other Infectious Diseases and Mental Illnesses in South Korea

Due to COVID-19, high-intensity nonpharmaceutical interventions (NPIs) are implemented and these regulations may trigger changes in the incidence of other infectious diseases. The goal is to determine the impact of NPIs on other infectious diseases and mental illnesses in South Korea. Data were collected from an open-source dataset concerning NPIs covering the period of January 2018 to July 2020. The data comprised average daily mask production volume and number of companies newly authorized to offer disinfection and sterilization services, and numbers of patients with sentinel surveillance infectious disease and mental illness. This study compared changes in NPIs and incidence of infectious diseases and mental illnesses before and after the COVID-19 outbreak in South Korea. 
 In 2020, the average daily mask production volume and the number of companies newly authorized to offer disinfection and sterilization services markedly increased following the virus outbreak (380% and > 94.8–99.5%, respectively). Meanwhile, the incidence of respiratory and intestinal infectious diseases declined, including those of influenza (49–55%), acute respiratory infection (78–79%), hand-foot-and-mouth disease (84–94%), enterovirus (94–97%), and intestinal infectious disease (36–40%). The weekly incidence of sexually transmitted diseases in 2020 remained constant regardless of the COVID-19 outbreak. Meanwhile, the number of outpatients increased by 7–16% for depressive episodes, 5–12% for other anxiety disorders, and 10–28% for sleep disorders. NPIs significantly reduced the incidence of respiratory and intestinal infectious diseases and negatively affected mental health. Therefore, while NPIs should be continued to prevent the spread of infections, systematic policies must be enacted to support mental health.

The multifaceted impact of social media on risk, behavior, and negative emotions during the COVID-19 outbreak in South Korea

ABSTRACT This study examined how social media use is associated with risk perception and social distancing as preventive behavior, which in turn can elicit negative emotions. The study is based on data collected from a nationwide online panel survey conducted during the COVID-19 outbreak in South Korea. Results show that social media use directly and indirectly impacts people’s negative emotions through risk perception and social distancing. The analysis also shows that risk perception and social distancing directly influence negative emotions, which plays a mediating role in the relationship between social media use and negative emotions. The findings of the study provide important implications for effective risk and health communication and health policy during an infectious disease outbreak.

COVID-19 and mental health: Anxiety disorders among immigrants due to COVID-19 outbreak in South Korea

BackgroundThe COVID-19 pandemic has affected various facets of health. While mental health became a major concern during the COVID-19 outbreak, the impact on the migrants’ mental health has still been neglected. The purpose of this study was to examine the COVID-19 outbreak's impact on the mental health of immigrants in South Korea.MethodsA total number of 386 immigrants in South Korea participated in this quantitative cross-sectional study. The standardized e-questionnaire, including the General Anxiety Disorder (GAD-7) scale, was used to measure the anxiety level. Logistic regression analysis was performed to find out the determinants of anxiety disorders among immigrants.ResultsThe prevalence of severe anxiety among immigrants was found to be 47.2%. Female immigrants (28.6%) had a lower anxiety disorder than males (71.4%). Immigrants who were married, living alone, had a low income, had a history of health problems were suffered from moderate to severe anxiety. Immigrants who were unemployed (OR 2.302, 95% CI = 1.353–3.917) and lost their jobs due to the COVID-19 outbreak (OR 2.197, 95% CI = 1.312–3.678) have a higher anxiety disorder. Immigrants aged over 30 years were found to suffer from a high level of anxiety (OR 2.285, 95% CI = 1.184–4.410). Relief support from the government was significantly associated with anxiety disorder among immigrants (p < 0.01, OR = 3.151, 95% CI = 1.962–5.061).ConclusionWith very limited studies on immigrants’ mental health during the COVID-19 pandemic, this paper provides scientific research evidence of the COVID-19 outbreak's impact on the mental health of migrants. Our study has consequences for implementing integrated psychological interventions and health promotion strategies for the well-being of immigrants’ mental health.

Development, Acceptance, and Concerns Surrounding App-Based Services to Overcome the COVID-19 Outbreak in South Korea: Web-Based Survey Study.

BackgroundSince the COVID-19 outbreak, South Korea has been engaged in various efforts to overcome the pandemic. One of them is to provide app-based COVID-19–related services to the public. As the pandemic continues, a need for various apps has emerged, including COVID-19 apps that can support activities aimed at overcoming the COVID-19 pandemic.ObjectiveWe aimed to determine which apps were considered the most necessary according to users and evaluate the current status of the development of COVID-19–related apps in South Korea. We also aimed to determine users’ acceptance and concerns related to using apps to support activities to combat COVID-19.MethodsWe collected data from 1148 users from a web-based survey conducted between November 11 and December 6, 2020. Basic statistical analysis, multiple response analysis, and the Wilcoxon rank sum test were performed using R software. We then manually classified the current status of the development of COVID-19–related apps.ResultsIn total, 68.4% (785/1148) of the respondents showed high willingness to protect themselves from COVID-19 by using related apps. Users considered the epidemiological investigation app to be the most necessary app (709/1148, 61.8%) overall, followed by the self-management app for self-isolation (613/1148, 53.4%), self-route management app (605/1148, 52.7%), COVID-19 symptom management app (483/1148, 42.1%), COVID-19–related information provision app (339/1148, 29.5%), and mental health management app (270/1148, 23.5%). Despite the high intention to use these apps, users were also concerned about privacy issues and media exposure. Those who had an underlying disease and had experience using COVID-19–related apps showed significantly higher intentions to use those apps (P=.05 and P=.01, respectively).ConclusionsTargeting users is very important in order to design and develop the most necessary apps. Furthermore, to gain the public’s trust and make the apps available to as many people as possible, it is vital to develop diverse apps in which privacy protection is maximized.

Precautionary Behavior Practices and Psychological Characteristics of COVID-19 Patients and Quarantined Persons.

Background: since the coronavirus disease (COVID-19) was first reported in 2019, South Korea has enforced isolation of patients with confirmed cases of COVID-19, as well as quarantine for close contacts of individuals diagnosed with COVID-19 and persons traveling from abroad, in order to contain its spread. Precautionary behavior practices and psychological characteristics of confirmed and quarantined persons were investigated for planning pandemic recovery and preparedness. Methods: this study was conducted with 1716 confirmed patients and quarantined persons in Daegu and Busan, regions where a high number of cases were confirmed during the early stage of the COVID-19 outbreak in South Korea. We collected online survey data from 23 April to 20 May 2020, in Daegu, and 28 April to 27 May 2020, in Busan, in cooperation with Daegu and Busan Infectious Disease Control Centers and public health centers in the regions. COVID-19 symptoms, pre-cautionary behavior practices, psychological states, and the need for improvement in isolation/quarantine environments were examined using an online survey. Results: compared to patients infected with coronavirus, quarantined persons engaged in more hygiene-related behaviors (e.g., hand washing, cough etiquette, and proper mask-wearing) and social distancing. COVID-19 patients had a strong fear of stigma, while quarantined persons had a strong fear of contracting COVID-19. Study participants responded that it was necessary to provide financial support and adequate information during isolation/quarantine. Conclusions: the study highlights the importance of precautionary behavior to prevent COVID-19 infection and the need to provide support (both psychological and financial) to patients and quarantined persons, to reinforce effective communication, social solidarity, and public health emergency preparedness (PHEP) in a pandemic situation.

Differences in seroprevalence between epicenter and non-epicenter areas of the COVID-19 outbreak in South Korea.

To compare the standardized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence of high epicenter region with non-epicenter region, serological studies were performed with a total of 3,268 sera from Daegu City and 3,981 sera from Chungbuk Province. Indirect immunofluorescence assay (IFA) for SARS-CoV-2 IgG results showed a high seroprevalence rate in the Daegu City (epicenter) compared with a non-epicenter area (Chungbuk Province) (1.27% vs. 0.91%, P = 0.0358). It is noteworthy that the highest seroprevalence in Daegu City was found in elderly patients (70’s) whereas young adult patients (20’s) in Chungbuk Province showed the highest seroprevalence. Neutralizing antibody (NAb) titers were found in three samples from Daegu City (3/3, 268, 0.09%) while none of the samples from Chungbuk Province were NAb positive. These results demonstrated that even following the large outbreak, the seropositive rate of SARS-CoV-2 in the general population remained low in South Korea.

The Role of Coping Strategies in Maintaining Well-Being During the COVID-19 Outbreak in South Korea

The COVID-19 pandemic continues to pose an unprecedented challenge for the world as people strive to cope with this significant threat to their well-being. This intensive longitudinal study of the first 94 days of the COVID-19 outbreak in South Korea (Phase 1: initial outbreak, Phase 2: intense social distancing) examined individuals’ changes in well-being, in relation to their use of coping strategies and fear of infection. A sample of 10,464 South Koreans participated in surveys during Phase 1 and Phase 2, resulting in 35,846 observations. Multilevel growth models revealed a decrease in well-being while different coping strategies moderated the individual rate of change in well-being. Although preventive measures were associated with a greater decrease in well-being, cognitive appraisal and behavioral strategies predicted stable well-being during the pandemic. Coping strategies further mediated the association between fear of infection and deterioration of well-being.

Assessing the Effectiveness of Isolation and Contact-Tracing Interventions for Early Transmission Dynamics of COVID-19 in South Korea.

Recent COVID-19 outbreaks pose serious public health challenges all around the world. South Korea had experienced the early outbreak of the COVID-19 pandemic and implemented early effective interventions. The 2020 COVID-19 outbreak in South Korea showed spatial hot spots and super-spreading events. As a result of these super-spreading events, three huge outbreaks of the COVID-19 have occurred in Korea from February to December 2020. To capture the intrinsic nature of heterogeneity, an agent-based model has been developed focusing on early transmission dynamics of COVID-19 in South Korea. Based on the social empirical contact information of early confirmed cases of COVID-19, we have constructed a scale-free network. Our agent-based model has incorporated essential individual variability such as different contact numbers and infectivity levels. In the absence of vaccines or treatment, contact tracing, case-isolation, quarantine are the most critical interventions to prevent larger outbreaks. First, we investigate the impacts of critical factors on various epidemic outputs such as incidence and cumulative incidence. These critical factors include contact numbers, transmission rates, infectivity of presymptomatic or asymptomatic cases, and contact-tracing with quarantine intervention. Furthermore, the effectiveness of case isolation and contact-tracing (followed by quarantine) is evaluated under various scenarios. Our results indicate that case isolation combined with contact-tracing quarantine is much more effective under a moderate level of n}{}mathcal R_{0}n (smaller transmission rates or contact numbers) and presymptomatic cases. However, the efficacy of interventions reduces significantly for a higher level of n}{}mathcal R_{0}n (larger transmission rates or contact numbers) with a high level of infectivity (in presymptomatic cases). This highlights the key role of efficient contact-tracing and case-isolation to mitigate larger outbreaks or super-spreading events.