Epidemiology and Health

Original Articles

The prevention and response to infectious diseases in long-term care facilities in Korea: a nationwide survey: Sun Hee Na, Joong Sik Eom, Sun Bean Kim, Hyung Jin Yoon, So Yeon Yoo, Kyeong Sook Cha, Jong Rim Choi, Ji Youn Choi, Si Hyeon Han, Jin Ju Park, Tark Kim, Jacob Lee; Epidemiol Health. 2024;46:e2024084. Published online October 17, 2024; DOI: https://doi.org/10.4178/epih.e2024084

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Long-term care facilities (LTCFs) are communal environments for patients with chronic diseases or older adults, making them particularly susceptible to significant harm during infectious disease outbreaks. Nonetheless, LTCFs have historically been subject to less stringent infection prevention and control (IPC) mandates. This study aimed to assess the current state of LTCFs and to develop an IPC system tailored for these facilities following the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
We conducted an online survey of 11,366 LTCFs in Korea from December 30, 2022 to January 20, 2023, to evaluate the components of IPC in LTCFs. The infectious diseases targeted for IPC included COVID-19, influenza, and scabies. Additionally, we compared institution-based and home-based long-term care insurance facilities.
RESULTS
Overall, 3,537 (31.1%) LTCFs responded to the survey, comprising 1,819 (51.4%) institution-based and 1,718 (48.6%) home-based facilities. A majority (87.4%, 2,376/2,720) of these facilities experienced COVID-19 outbreaks. However, only 42.2% of home-based facilities, in contrast to 90.6% of institution-based facilities, were equipped to manage concurrent COVID-19 cases. Similarly, while 92.1% of institution-based facilities were capable of managing influenza, only 50.5% of home-based facilities could do the same. The incidence of scabies was significantly higher in institution-based facilities than in home-based ones (26.1 vs. 4.3%). Additionally, 88.7% of institution-based facilities managed scabies cases effectively, compared to only 42.1% of home-based facilities.
CONCLUSIONS
Approximately half of the LTCFs had a basic capacity to respond to infectious diseases. However, there were differences in response capabilities between institution-based facilities and home-based facilities.; Summary

Korean summary
장기요양기관을 대상으로 실태조사가 시행되었습니다. 50% 기관에서 감염병에 대한 기본 대응능력을 가지고 있었지만 시설급여기관과 재가급여기관 사이 대응능력에 차이가 있었습니다.

Key Message
A survey of long-term care facilities (LTCFs) was conducted. Fifty per cent of LTCFs had a basic capacity to respond to infectious diseases. However, there were differences in response capacity between institution-based and home-based facilities.

Risk of COVID-19 transmission in heterogeneous age groups and effective vaccination strategy in Korea: a mathematical modeling study: Youngsuk Ko, Jacob Lee, Yubin Seo, Eunok Jung; Epidemiol Health. 2021;43:e2021059. Published online September 8, 2021; DOI: https://doi.org/10.4178/epih.e2021059

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6 Web of Science
8 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aims to analyze the possibility and conditions of maintaining an effective reproductive number below 1 using a mathematical model.

METHODS

The total population was divided into five age groups (0-17, 18-29, 30-59, 60-74, and ≥75 years). Maximum likelihood estimation (MLE) was used to estimate the transmission rate of each age group. Mathematical model simulation was conducted until December 31, 2021, by establishing various strategies for vaccination and social distancing without considering variants.

RESULTS

MLE results revealed that the group aged 0-17 years had a lower risk of transmission than other age groups, and the older age group had relatively high risks of infection. If 70% of the population will be vaccinated by the end of 2021, then simulations showed that even if social distancing was eased, the effective reproductive number would remain below 1 near August if it was not at the level of the third re-spreading period. However, if social distancing was eased and it reached the level of the re-spreading period, the effective reproductive number could be below 1 at the end of 2021.

CONCLUSIONS

Considering both stable and worsened situations, simulation results emphasized that sufficient vaccine supply and control of the epidemic by maintaining social distancing to prevent an outbreak at the level of the re-spreading period are necessary to minimize mortality and maintain the effective reproductive number below 1.

Summary

Korean summary
본 연구에서는 질병관리청에서 제공하는 개별 확진자 데이터에 확률통계적 방법을 적용하여 연령군 간의 감염전파 행렬을 추정하였으며 연령군을 고려한 수리모델에 적용되었다. 본 연구에서 우리는 2020년 10월부터 2021년 5월까지 한국에서의 코로나19 유행상황을 정책 구간에 따라 분석하였으며 이를 토대로 거리두기 완화 수준에 따라 거리두기 완화 상태에서도 지속적으로 유효감염재생산지수가 1보다 작아지는 시점이 달라질 수 있음을 보인다.

Key Message
In this research, we estimated age-group-specified transmission rate matrix by applying maximum likelihood estimation into individual based data which was provided by Korea Disease Control and Prevention Agency. Our model simulation showed the moment, when the effective reproductive number is consistently below 1 even the distancing is eased, is ranged from August to the end of 2021 depending on the intensity of the social distancing during eased phase.

Citations

Citations to this article as recorded by

Social contact patterns in South Korea: an analysis of a survey conducted in 2023-2024
Woo-Sik Son, Min-Kyung Chae, Dong-Uk Hwang, Kyeongah Nah, Minsoo Kim, Jong-Hoon Kim, Jonggul Lee
BMC Infectious Diseases.2025;[Epub] CrossRef
Predictive models for health outcomes due to SARS-CoV-2, including the effect of vaccination: a systematic review
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Systematic Reviews.2024;[Epub] CrossRef
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Infection & Chemotherapy.2024; 56(2): 204. CrossRef
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Yonsei Medical Journal.2023; 64(1): 1. CrossRef
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Karan Thakkar, Julia Regazzini Spinardi, Jingyan Yang, Moe H. Kyaw, Egemen Ozbilgili, Carlos Fernando Mendoza, Helen May Lin Oh
Frontiers in Public Health.2023;[Epub] CrossRef
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Youngsuk Ko, Kyong Ran Peck, Yae-Jean Kim, Dong-Hyun Kim, Eunok Jung
Epidemiology and Health.2023; 45: e2023084. CrossRef
Quantifying the Effects of Non-Pharmaceutical and Pharmaceutical Interventions Against Covid-19 Epidemic in the Republic of Korea: Mathematical Model-Based Approach Considering Age Groups and the Delta Variant
Youngsuk Ko, Victoria May P. Mendoza, Yubin Seo, Jacob Lee, Yeonju Kim, Donghyok Kwon, Eunok Jung, E. Augeraud, M. Banerjee, J.-S. Dhersin, A. d'Onofrio, T. Lipniacki, S. Petrovskii, Chi Tran, A. Veber-Delattre, E. Vergu, V. Volpert
Mathematical Modelling of Natural Phenomena.2022; 17: 39. CrossRef
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