A review on Quarantine during COVID-19 Outbreak: Lessons Learned from Previous Epidemics

Background: Since the emergence in December 2019, the novel coronavirus disease 2019 (COVID-19) has caused a global pandemic that has infected so many people all around the world. As there are no vaccination or antiviral treatment available yet, public health measures play a substantial role in the management of this pandemic. Governments of affected countries have imposed different quarantine policies and travel bans. As quarantine can have many controversial aspects, this review intends to clarify its role in disease control and other aspects of human everyday life with due attention to a couple of epidemics in the past (SARS, MERS, and flu) and ongoing COVID-19 outbreak.   Methods: We conducted a thorough search in PubMed, Research Gate, Google Scholar, Excerpta Media Database (EMBASE), and Web of Science databases and collected all relevant articles to Quarantine in the past epidemics (SARS, MERS, and flu) as well as ongoing COVID-19 pandemic.     Results:  A total of 176 articles were extracted in our primary search process. Primarily, 53 articles have been excluded because of duplication. The other 44 articles have been excluded due to different reasons (Lack of useful information and eligibility of data). Finally, 79 articles were selected for more evaluation (published until April 2020).   Conclusion: By having previous epidemics, including SARS, MERS, and flu, in mind, quarantine and isolation seem to be proper choices for this situation. But, as this epidemy is bigger than former ones, stricter public health measurements, such as serious social distancing and community-wide containment, are recommended

Investigating inclusive risk communication in the context of influenza outbreaks

Outbreaks of novel influenza viruses are continually occurring on many places on our planet, with the ultimate and most extreme consequence being a full-scale pandemic. Modern communication technology is widely used for risk communication regarding recommended change in behavior patterns and other precautions in order to mitigate the transmission. However, the assumption and bias that modern communication technology constitutes the norm causes vulnerable groups to be at possible risk of systematic exclusion to correct and updated information. Through conducting a literature- and case analysis, the aim of this study is to identify insufficient or inadequate risk communication efforts in South Korea and Vietnam during influenza outbreaks, especially with concern of vulnerable groups. Further, to analyze how national influenza preparedness plans observe or ignore these insufficiencies. Results show that vulnerable groups are explicitly recognized in the preparedness plan of Vietnam. However, the South Korean preparedness plan show a more homogenous approach. Both South Korea and Vietnam showed a broad variety of channels used in their risk communication strategies which could be positive in terms of a broad outreach to a heterogenous population, including vulnerable groups. Four key factors that moderate the outcomes of risk communication were identified: Channels, Messages, Transparency and Trust

A Case of Three East Asian Cities

학위논문(석사) -- 서울대학교대학원 : 환경대학원 환경계획학과, 2021.8. 김태형.코로나19는 전세계인의 삶에 유례없는 영향을 미쳤다. 코로나19와 같은 전염병의 확산은 공간적인 과정으로써, 지역에 따라 상이한 발생률과 사망률을 보이는 것으로 알려져 있다. 그 가운데 도시는 전세계 인구의 절반 이상이 거주하고 있는 곳으로, 코로나19 확진자의 90% 이상이 도시 지역에 집중되어 있다. 또한, 도시 내 여러 다중 이용 시설 및 공간에서의 집단감염이 보고되면서 도시 공간을 대상으로 코로나19의 역학을 규명하기 위한 연구가 진행되었다. 도시 내에는 다양한 종류의 다중 이용 시설이 존재함에도 불구하고, 많은 연구에서는 일부의 도시 공간만을 대상으로 코로나19의 전염과 확산을 분석해 왔다. 이에 이 연구는 14종의 도시 공간을 연구에 포함하여 코로나19 팬데믹 가운데 도시민의 도시 공간 이용에 영향을 미치는 인식 및 행동 요인을 3개 도시를 대상으로 한 사례연구를 통해 밝히고자 한다. 사례연구를 진행함에 있어, 이 연구는 대한민국의 서울, 중국의 상해, 대만의 타이베이를 연구의 공간적 범위로 선정하였다. 서울, 상해, 타이베이는 코로나19 발병 초기부터 전염병의 영향을 받은 도시에 속한다. 첫 코로나19 확진 사례가 같거나 유사한 일자에 보고되었으며, 이에 따라 일제히 확산을 방지하기 위한 정책적 조치를 시행했다. 그러나 첫 확진자 보고 이후 코로나19 확산과 통제 양상에서 세 도시는 다른 모습을 보였다. 서울에서는 코로나19의 확산과 완화가 반복되며 오랜 기간 코로나19 그늘 아래에서 끊임없이 영향을 받았다. 상해의 경우, 확진 사례 보고 초기에 매우 강도 높은 이동 제한 및 도시 공간 이용 금지 조치를 시행하였고 이로 인해 지속적으로 낮은 신규 확진자 수를 유지하였다. 타이베이 및 대만의 경우, 즉각적이고 선제적인 국경 봉쇄와 과학적인 사례 추적을 통해 전염병을 영향을 매우 제한적으로 경험한 모범 방역국으로 평가받는다. 이 연구는 상기한 도시에 거주하는 만 19세 이상 성인을 대상으로 설문조사를 실시하였다. 서울, 상해, 타이베이 순서로 2020년 9월 23일-10월 7일, 2020년 9월 8일-2021년 1월 8일, 2020년 10월 15일-2021년 1월 4일에 설문조사를 시행하였다. 표본 크기는 각각 537명, 398명, 152명이다. 선행연구 검토를 통해 도시 공간 이용에 영향을 미치는 변수로, 코로나19에 대한 위험인식, 코로나19에 대한 도시 안전도 인식, 방역 및 전염병 통제 정책을 도출하였다. 또한 크론바흐 알파값을 계산해 모형에 포함될 복수의 설문문항을 하나의 요인으로 묶고 이를 통계모형에 투입하였다. 개인의 인식 및 행동 변수가 도시 공간 방문에 미치는 영향을 조명하는 데 있어, 문헌검토를 통해 14종의 도시 공간을 3가지 활동 공간 (필수 활동 공간, 유지 활동 공간, 여가 활동 공간)으로 분류하여 분석 결과를 제시 및 해석하였다. 분석모형으로는 순서형 로짓 모형을 채택하였다. 반응변수가 11점 리커트식 척도로 구성되어 “코로나19 발병 이전과 비교한 현재의 도시 공간 방문 수준”을 질문한 문항이기 때문이다. 반응변수가 순서형 범주를 가진다는 점을 고려하여 순서형 로짓 모형을 수행하였다. 분석 결과, 우리나라 수도권에서 모든 유형의 공간 방문에 공통적으로 영향을 미치는 인식 및 행동 요인으로 여가 및 사회활동 자제와 코로나19에 대한 위험인식이 도출되었다. 개인적인 여가 및 사회활동을 자제할수록, 코로나19에 대한 위험인식이 높을수록 모든 종류의 도시 공간 방문을 덜 방문하는 것으로 나타났다. 필수 활동 공간을 제외한 유지 활동 공간과 여가 활동 공간 방문 증가에 영향을 미치는 요인으로는 도시에 대한 높은 안전도가 도출되었다. 개인이 거주하고 있는 도시가 코로나19로부터 안전하다고 인식할수록 해당 공간을 더욱 자주 방문한다고 해석할 수 있다. 상해 대도시권에서는 방역 정책에 대한 순응이 모든 유형의 도시 공간 방문을 감소시키는 것으로 나타났다. 이는 중국 국민의 정부에 대한 높은 신뢰도와 충성심 등 중국 특유의 사회 정치적 배경에 따른 결과로 추측된다. 여가 및 사회활동 자제는 업무 시설 및 학교를 뜻하는 필수 활동 공간 방문 감소에만 영향을 미치는 것으로 분석되었다. 또한, 서울과 다르게 코로나19에 대한 위험 인식이 높을수록 유지 활동 공간과 여가 활동 공간에의 방문이 증가하는 것으로 나타났다. 설문조사 당시 오랜 기간 낮은 일일 신규 확진자 수가 유지되며 전염병이 효과적으로 통제되고 있었기 때문에, 코로나19에 대한 위험인식이 높음에도 불구하고 해당 공간에의 방문이 줄지 않고 늘어난 것으로 생각된다. 타이베이에서는 모든 유형의 도시 공간 방문에 공통적으로 영향을 미치는 인식 및 행동 요인이 도출되지 않았다. 다시 말해, 코로나19 발병 이전과 비교한 당시의 공간 방문 수준 변화에 영향을 미치는 요인이 존재하지 않는다는 것이다. 타이베이는 전염병의 영향을 매우 제한적으로 경험한 도시이기 때문에, 코로나19 발병 이전과 이후의 도시 공간 이용에 관여하는 변수가 존재하지 않았던 것으로 추측된다. 마지막으로 필수 활동 공간과 여가 활동 공간 방문 증가에 영향을 미치는 요인으로 여가 및 사회활동의 자제가 나타나 나머지 두 도시와는 상반된 결과를 보였다. 위의 과정을 통해 세 도시의 공간 방문에 영향을 미치는 인식 및 행동 요인과 변수를 확인하였다. 이 연구는 코로나19 확산의 중심지인 도시 공간을 조명하고, 도시 공간 이용에 관여하는 도시민의 인식 및 행동 변수를 확인하였다는 점에서 의의를 가진다. 이 연구를 통해 선행 연구에서 제시된 공간 이용 관련 변수를 일부 재확인하였으며, 도시별 코로나19 확산 양상, 감염병 대응 정책, 각 국의 사회 정치적 특성 등을 배경으로 각 도시의 결과를 해석하였다. 이를 바탕으로 감염병 대응 및 통제 정책 설계 시에 시민들의 인식 및 행동 요인을 고려할 필요성과 위험 커뮤니케이션의 중요성에 대한 정책적 함의를 제시하였다.COVID-19 has had an unprecedented impact on people’s lives around the world. The spread of infectious diseases such as COVID-19 is known to be a spatial process, presenting different challenges depending on the region. Cities are home to more than half the world’s population, with more than 90% of confirmed cases of COVID-19 concentrated in the area. In particular, cluster infections of COVID-19 have occurred in various urban spaces, including workplaces, restaurants, bars, religious facilities, healthcare facilities, shopping centers, and sports clubs. Previous studies have been conducted at an urban space-scale; however, studies that have sought to cover multiple urban spaces in one study and identify factors that affect visits to urban spaces during the pandemic have been so far insufficient. Conducting a case study in three East Asian cities, Seoul, Shanghai, and Taipei, this thesis examines individual’s behavior- and perception-related factors that affect the use of urban spaces during the epidemic of COVID-19. Seoul, Shanghai, and Taipei are among the earliest cities where the virus was initially imported. The coronavirus was introduced to those cities around the same time, and lots of policies were accordingly implemented to prevent the spread of the virus. Nevertheless, the three cities showed different patterns in the spread of COVID-19. In Seoul, the city repeatedly experienced the spread and mitigation of the disease. In the case of Shanghai, the city was inevitably affected by infected cases from other provinces in China at the beginning. Shortly after, the city implemented strict movement control and strong containment measures, thereby maintaining a consistently low number of daily new confirmed cases. Taipei in Taiwan implemented strict and consistent border control, quarantine measures, health monitoring, and contact tracing immediately after the first case of COVID-19 was reported in Wuhan. Taipei is considered to be one of the world’s best responders. The study surveyed adults aged 19 or older living in each city. With the same questionnaire in different languages, the survey was conducted between September 23 and October 7, 2020 in the Seoul Metropolitan Area, September 8, 2020 and January 8, 2021 in the Shanghai Metropolitan Area, and October 15, 2020 and January 4, 2021 in Taipei. The sample sizes of the survey are: 537 in Seoul, 398 in Shanghai, and 152 in Taipei. In shedding light on the impact of individual’s behavior- and perception-related factors or variables on urban space visits, a total of 14 types of urban space are classified into three categories (mandatory activity space, maintenance activity space, and discretionary activity space) based on literature review. For the statistical model, an ordered logit model is performed. Since the response variable is set as the level of urban space visits compared to before the COVID-19 outbreak, which is ordinal, employing the ordered logit model is justified under the consideration of the given data. As a result of the analysis, behavior- and perception-related factors or variables that commonly influence the choice of all types of urban space in Seoul are identified as refraining from leisure or social activities and risk perception of COVID-19. It reveals that the more people desist from having leisure time outside and participating in social events, the less likely they are to visit all types of urban spaces. The higher the risk perception of COVID-19, the lower the visits to all types of urban space. The study also finds that high perceived safety in the city influences the increase in visits to maintenance and discretionary activity space in Seoul, except for mandatory activity space. This can be interpreted that the more people perceive their city to be safe from COVID-19, the more frequently they visit those spaces. In shanghai, compliance with preventive measures turns out to affect the decrease of all types of urban space visits. It can be attributed to the Chinese unique social and political characteristics, such as a high level of trust and loyalty in their government. Refraining from leisure or social activities is positively correlated with the decreased use of mandatory activity space only. Interestingly, higher risk perception of COVID-19 increases the use of maintenance and discretionary activity space in Shanghai. Since the epidemic was effectively controlled at the time of surveying, it is assumed that a higher risk of perception did not lead to a reduction in visits to those spaces. Lastly, in Taipei, no factors that are commonly involved in the visit to all types of urban space are derived. The city was well-known for its highly advanced prevention and control strategies that lead to mostly COVID-19-free daily life during the global epidemic. This result can be explained that no behavior- and perception-related factors influenced changes in visiting behavior compared to before the COVID-19. Nonetheless, refraining from leisure or social activities turns out to influence the increased visits to mandatory and discretionary activity space, contrary to the results from the other two cities. The study demonstrates urban resident’s behavior- and perception-related factors associated with urban space visiting amid the COVID-19 epidemic. The study reconfirms some of the findings from previous studies. It also elucidates the results presented herein based on the context of the spread pattern of the virus, policy responses, and social and political backgrounds of each city. Lastly, this study emphasizes the importance of consideration of people’s behavior and perception factors when designing infection prevention and control policies. It also highlights the importance of risk communication as policy implications.Ⅰ. Introduction 1 1. Research Background and Objectives 1 2. Research Scope and Method 3 1) Research Scope and Data 3 2) Research Method and Conceptual Framework 4 Ⅱ. Literature Review 6 1. Urban Spaces and COVID-19 6 2. Changes in the Use of Urban Spaces 8 3. Factors Relating to the Use of Urban Spaces 9 1) Risk Perception of Infectious Disease 9 2) Perceived Neighborhood Safety 10 3) Preventive Measures and Policies 11 4. Summary and Implication 12 Ⅲ. Methodology 13 1. Study Area 13 1) Seoul 15 2) Shanghai 17 3) Taipei 19 2. Data Analysis 21 Ⅳ. Results 22 1. Descriptive Statistics 22 1) Descriptive Statistics of the Survey Results 25 2) Internal Consistency Using Cronbach’s Alpha 27 2. Ordered Logit Models 31 1) Seoul 31 2) Shanghai 35 3) Taipei 38 Ⅴ. Conclusions 40 1. Summary and Conclusions 40 2. Implications 43 References 46 Appendices 57 Abstract in Korean 61석

Knowledge, precautionary actions, and perceived risk of COVID-19 among Indonesian people

Novel coronavirus was first identified in China in December 2019, causing several cases of the new type of pneumonia. The exported cases were found in other countries, including countries in the Southeast Asia region. At the same time, no cases were confirmed in Indonesia. We aimed to assess COVID-19 related knowledge, precautionary actions, and perceived risk among general Indonesian population when there were no confirmed cases in Indonesia. This study was a descriptive cross-sectional study involving 382 participants aged 17 years and above residing in Indonesia. The data was collected through the online questionnaire from February 19th to February 29th 2020. The average score of COVID-19 related knowledge was 88.0%, whereas 83.8% of the participants had a high level of knowledge. The average score of taking precautionary actions was 77.4% and 65.7% had a high level of performance. In terms of the perceived risk of COVID-19, only 11.3% of the participants perceived themselves likely to acquire COVID-19 when compared with other diseases or accidents. The perceived risk of COVID-19 was significantly associated with precautionary action (p<0.05). Perceived risk of COVID-19 was at a low level when there were no confirmed cases. Effective strategies of risk communication are needed to improve precautionary actions to prevent COVID-19

Public Health in Asia during the COVID-19 Pandemic

Every nation in Asia has dealt with COVID-19 differently and with varying levels of success in the absence of clear and effective leadership from the WHO. As a result, the WHO’s role in Asia as a global health organization is coming under increasing pressure. As its credibility is slowly being eroded by public displays of incompetence and negligence, it has also become an arena of contestation. Moreover, while the pandemic continues to undermine the future of global health governance as a whole, the highly interdependent economies in Asia have exposed the speed with which pandemics can spread, as intensive regional travel and business connections have caused every area in the region to be hit hard. The migrant labor necessary to sustain globalized economies has been strained and the security of international workers is now more precarious than ever, as millions have been left stranded, seen their entry blocked, or have limited access to health services. This volume provides an accessible framework for the understanding the effects of the COVID-19 pandemic in Asia, with a specific emphasis on global governance in health and labor

Public Governance Responses to Covid-19 in Italy and South Korea

학위논문(석사) -- 서울대학교대학원 : 국제대학원 국제학과(국제협력전공), 2021.8. 체디아 사라.The year 2020 started with the international community witnessing the outbreak of a major coronavirus infection in China. In just a few weeks, the infection spread out to other countries, strongly hitting in particular Italy and South Korea which have thus become the first two countries to experience a major outbreak outside of China. With similar population ratio and comparable levels of economic development, Italy and South Korea have ranked for several weeks 2nd and 3rd for Covid-19 confirmed cases, becoming the new epicenters in Europe and Asia. However, the different policy implementations endorsed by the two governments to respond to the crisis have determined the two countries to experience very different outcomes, with South Korea slowing down the spread in record time while Italy not only keeps registering high number of daily confirmed cases, but also registers one of the highest mortality rate of the whole OECD area. This paper aims at investigating the degree of effectiveness of the crisis management strategies endorsed by the two countries and to analyze the extent to which such outcomes have been the result of the decision-making process carried out by the two governments and to what extent country-specific factors such as demographic pattern, healthcare system, crisis communication and trust in government have influenced the results.2020년은 국제사회가 중국에서의 코로나 바이러스 감염의 발생을 목격하면서 시작되었다. 코로나바이러스가 발생한지 몇 주 만에 다른 나라들로 퍼져나갔고, 특히 이탈리아와 한국에는 강력한 타격을 받으며, 중국 밖에서 발생한 최초의 두 나라가 되었다. 두 나라는 유사한 인구 비율과 경제 규모로 몇 주 동안 코로나19 확진 환자 수가 2, 3위를 차지하며 유럽과 아시아의 새로운 서사시가 되었다. 그러나, 두 정부가 이 위기에 대처하기 위해 시행한 다른 정책으로 인해 두 나라는 매우 상반되는 결과를 경험하게 되었다. 한국은 기록적인 시간 내에 확산을 늦추고, 이탈리아는 계속해서 많은 일일 확진자를 기록하고 있을 뿐만 아니라 OECD 전체 지역의 사망률도 가장 높은 나라 중 하나가 되었다. 본 논문은 양국이 시행한 위기 관리 전략의 효과 정도를 조사하고, 이러한 결과가 양국 정부가 수행한 의사결정 과정의 결과인지, 인구통계학적 패턴, 의료제도, 위기 커뮤니케이션 그리고 정부에 대한 신뢰 등 국가별 요인이 어느 정도로 영향을 미쳤는지 분석하는 것을 목적으로 한다.I. Introduction 1 II. Literature Review 4 1. Covid-19: What do we know so far? 4 2. How are other countries tackling the virus worldwide? 6 3. How are societies responding to the crisis? 8 III. Research Design 12 1. Research Questions 12 2. Dependent and Independent Variables 12 3. Theoretical Framework 13 4. Limitations 17 5. Data Sources 17 IV. The Case of Italy 18 1. Background 18 2. The Italian Response: Praise 24 3. The Italian Response: Criticism 26 V. The Case of South Korea 29 1. Background 29 2. The South Korean Response: Praise 30 3. The South Korean Response: Criticism 32 VI. Cross-Country Comparison 34 1. How effective have the two responses been so far? 34 2. What factors determined such outcome? 38 i. Crisis Communication 38 ii. Compliance 40 iii. Trust in government 43 iv. Cultural factors 46 v. Demographic factors 50 vi. Material capacity and information asymmetry 54 vii. Healthcare system 59 VII. Conclusion 63 VIII. References 67석

The Spatial Allocation of Hospitals With Negative Pressure Isolation Rooms in Korea: Are We Prepared for New Outbreaks?

Background: Allocation of adequate healthcare facilities is one of the most important factors that public health policy-makers consider when preparing for infectious disease outbreaks. Negative pressure isolation rooms (NPIRs) are one of the critical resources for control of infectious respiratory diseases, such as the novel coronavirus disease 2019 (COVID-19) outbreak. However, there is insufficient attention to efficient allocation of NPIR-equipped hospitals. Methods: We aim to explore any insufficiency and spatial disparity of NPIRs in South Korea in response to infectious disease outbreaks based on a simple analytic approach. We examined the history of installing NPIRs in South Korea between the severe acute respiratory syndrome (SARS) outbreak in 2003 and the Middle East respiratory syndrome coronavirus (MERS-Cov) in 2015 to evaluate the allocation process and spatial distribution of NPIRs across the country. Then, for two types of infectious diseases (a highly contagious disease like COVID-19 vs. a hospital-based transmission like MERS-Cov), we estimated the level of disparity between NPIR capacity and demand at the sub-regional level in South Korea by applying the two-step floating catchment area (2SFCA) method.Results: Geospatial information system (GIS) mapping reveals a substantial shortage and misallocation of NPIRs, indicating that the Korean government should consider a simple but evidence-based spatial method to identify the areas that need NPIRs most and allocate funds wisely. The 2SFCA method suggests that, despite the recent addition of NPIRs across the country, there should still be more NPIRs regardless of the spread pattern of the disease. It also illustrates high levels of regional disparity in allocation of those facilities in preparation for an infectious disease, due to the lack of evidence-based approach.Conclusion: These findings highlight the importance of evidence-based decision-making processes in allocating public health facilities, as misallocation of facilities could impede the responsiveness of the public health system during an epidemic. This study provides some evidence to be used to allocate the resources for NPIRs, the urgency of which is heightened in the face of rapidly evolving threats from the novel COVID-19 outbreak

Public Health in Asia during the COVID-19 Pandemic

Every nation in Asia has dealt with COVID-19 differently and with varying levels of success in the absence of clear and effective leadership from the WHO. As a result, the WHO’s role in Asia as a global health organization is coming under increasing pressure. As its credibility is slowly being eroded by public displays of incompetence and negligence, it has also become an arena of contestation. Moreover, while the pandemic continues to undermine the future of global health governance as a whole, the highly interdependent economies in Asia have exposed the speed with which pandemics can spread, as intensive regional travel and business connections have caused every area in the region to be hit hard. The migrant labor necessary to sustain globalized economies has been strained and the security of international workers is now more precarious than ever, as millions have been left stranded, seen their entry blocked, or have limited access to health services. This volume provides an accessible framework for the understanding the effects of the COVID-19 pandemic in Asia, with a specific emphasis on global governance in health and labor