[Q&A] COVID-19 Now on Par with the Flu... "Is It Really Okay?" "What About Testing Costs?"

From the 31st of this month, the classification of COVID-19 as an infectious disease will be downgraded from level 2 to level 4. This is based on the reduced risk of COVID-19, with the intention to manage it within the general healthcare system like influenza (flu).

On the 23rd, the screening clinic set up at the Yongsan-gu Public Health Center in Seoul showed a quiet scene as the Korea Disease Control and Prevention Agency announced that it would lower the COVID-19 infectious disease classification from level 2 to level 4 starting on the 31st. Photo by Jinhyung Kang aymsdream@

Going forward, except for high-risk groups, the financial burden on the public for various COVID-19 tests and related costs will increase. For example, the cost of rapid antigen tests (RAT), which used to be around 5,000 won at clinics and hospitals, will rise to between 20,000 and 50,000 won. Polymerase chain reaction (PCR) tests will cost around 60,000 to 80,000 won. However, for the time being, 50% of the costs will be covered by health insurance for seniors aged 60 and above, patients aged 12 and older with underlying conditions, high-risk hospitalized patients, and patients admitted to emergency rooms or intensive care units.

Hospitalization treatment costs, which were previously fully covered including the patient's share under health insurance, will now only be supported for severe patients until the end of the year. The daily count of confirmed COVID-19 cases, which has continued for 3 years and 7 months, will be discontinued and replaced by a sample surveillance method estimated through some medical institutions.

The mask-wearing mandate will be maintained in hospital-level medical institutions and infection-vulnerable facilities. A representative from the Korea Disease Control and Prevention Agency (KDCA) explained, "Despite various relaxations in quarantine measures, the recent COVID-19 fatality rate has dropped to 0.02%, which is lower than that of the flu, but it was judged that COVID-19 still poses a risk to elderly people in their 70s and 80s."

Jiyoungmi Chief [Image source=Yonhap News]

This is a Q&A summary of explanations from Ji Young-mi, head of the Central Disease Control Headquarters (KDCA Commissioner), during the regular briefing of the COVID-19 Central Accident Response Headquarters, along with insights from three quarantine experts (Namjoong Kim, Professor of Infectious Diseases at Seoul National University; Jaehoon Jung, Professor of Preventive Medicine at Gachon University College of Medicine; Eunhwa Choi, Deputy Director of Pediatric Care at Seoul National University).

Q. COVID-19 continues to spread during the summer. Is it okay to switch to level 4?

The COVID-19 fatality rate in July and August dropped to 0.02%, and the severe case rate fell to 0.09%, reaching the lowest levels ever. The reason for switching to level 4 is that medical resources and infrastructure are limited. Our healthcare system has been heavily focused on COVID-19, but now medical personnel can be redistributed to also focus on tuberculosis, chronic diseases, and others. For the general public, since the COVID-19 risk has decreased, emphasis will be placed on voluntary quarantine, while protection and support for high-risk groups will continue for the time being.

Q. Is the medical response capacity really sufficient?

Currently, as the COVID-19 fatality rate has significantly decreased, the occupancy rate of hospital intensive care unit beds has fallen below 50%. Medical capacity has greatly improved compared to the past.

Q. Why was the COVID-19 crisis level maintained at "alert" rather than lowered to "caution"?

The decision to maintain the alert level does not mean that the situation in Korea is dangerous. At the alert level, the Ministry of Health and Welfare is responsible for the response, whereas at the caution level, the KDCA’s Quarantine Countermeasures Headquarters takes charge. Since Korea’s COVID-19 response strategy focuses on minimizing harm to high-risk groups, it was judged that continuing support for these groups is better managed through the Ministry of Health and Welfare and the Central Accident Response Headquarters for the time being.

Q. The COVID-19 case counting is shifting from full surveillance to sample surveillance. Won’t there be a big difference from the actual number of confirmed cases?

As the COVID-19 pandemic continues, the proportion of infected individuals who are confirmed cases is decreasing. This means that full surveillance currently does not accurately reflect the total scale of infections. Due to this limitation, countries worldwide are shifting from full surveillance to sample surveillance.

The KDCA is conducting sample surveillance through wastewater epidemiology, which measures the total virus amount in sewage, and monitoring hospitalized patients. Combining these two methods, it is believed there will be no difficulty in estimating the overall scale of infections. Results from sample surveillance will be announced every Wednesday.

Q. Will vaccination require payment? With the recent spread of the EG.5 variant, is the domestically planned XBB lineage vaccine effective?

Vaccinations will remain free for all citizens. The recommended vaccination targets are high-risk groups. The new vaccine to be used this winter is a monovalent vaccine including the XBB strain, and clinical trials have shown that it produces sufficient neutralizing antibodies against the currently increasing EG.5 variant.