A thread on my editorial in @bmj_latest comparing the response to Covid-19 in South Korea and the UK. Early adoption of a “test, trace, isolate and treat” strategy was the key to South Korea’s success in suppressing Covid-19. https://www.bmj.com/content/369/bmj.m2084

On 29 February 2020, South Korea, a country of similar population size to England, recorded 909 news cases of COVID-19. At the time, this was one of the worst COVID-19 outbreaks outside Wuhan in China, the epicentre of the current global pandemic.

Only 55 new cases of COVID-19 were recorded in England on 29 February. By mid-May, despite several weeks of a “lockdown” and although numbers had declined from the peak in April 2020, the United Kingdom was still recording over 3,000 news cases each day.

The key difference between the United Kingdom and South Korea was the rapid adoption by South Korea of a “test, trace, isolate and treat” strategy whereby suspected cases were tested; contacts identified; strict isolation enforced; and free treatment given to those infected.

The UK did not follow this approach, with very limited testing early on in the pandemic, and then abandoning contact tracing and community testing in March. This policy led to a rapid increase in the number of COVID-19 cases and deaths in the United Kingdom.

South Korea encouraged widespread wearing of face masks, which are now compulsory in many locations, such as on the public metro system. The use of face masks has been described by the South Korean government as a key factor in its success in suppressing COVID-19.

For patients who were unwell in the community, telemonitoring services were established. Innovative methods of taking tests were introduced, such as COVID-19 testing booths, which protected the tester from the risk of infection and reduced the time to perform a test,

There was an urgency in the government and societal response in South Korea, a country which had experience of dealing with previous outbreaks such as MERS in 2015, in contrast to the slow government response in the early part of the pandemic in the United Kingdom.

The UK government relied on mathematical models as a core component of its policy of being ‘led by science’. This resulted in delays in implementing interventions – such as wearing face masks in public places - because the evidence of their benefits was sometimes unavailable.

Only when a “test, trace and isolate” system is in place, and working effectively, can we then say that the UK is following South Korea’s successful approach to suppressing COVID-19; and not at risk of a second wave of COVID-19 once lockdown restrictions are lifted.