[From the scene] Solution to bed crisis? Korea sets up cinics for self-isolating patients

The Vice President for Medical Affairs, Dr.  Kim Seok-yeon, stands in front of a container clinic that COVID-19 patients can visit in isolation at home.

The Vice President for Medical Affairs, Dr. Kim Seok-yeon, stands in front of a container clinic that COVID-19 patients can visit in isolation at home.

Since the fall of last year, the majority of COVID-19 patients in South Korea have been recovering at home. While the patients are usually housebound, they can now break the isolation – to see a doctor.

The revised guidelines follow the hospital bed crisis in December, which resulted in a dramatic increase in the number of patients who died at home. In order to prevent patient supervision and at the same time reserve hospital places only for more urgent cases, the country allows self-isolating patients to receive personal care in clinics.

These clinics are designed for patients who are not sick enough to be in a hospital but who are still unwell. All appointments must be made in advance with the district health center, which then sends a special taxi to pick up the patients. If patients are fit to drive, they can do so.

Seoul Medical Center in Jungnang-gu, a northern district of the city, is one of the first in the country to operate a clinic for home-convalescent patients. The container clinic for COVID-19 patients will be set up outside the hospital so that they do not cross with other patients or staff.

“Hospitals across the country struggled during the recent surge as more than 7,000 patients were diagnosed daily. This can repeat itself as soon as omicron becomes dominant, ”said Dr. Kim Seok-yeon, vice president of medical affairs for the hospital.

“I understand that the government is expanding the home restoration program in preparation for this possibility.”

While he had expected higher demand for the ambulance – one of only six in all of Seoul – only about 30 people had come in the past two weeks. Now it is mostly younger patients who are staying at home, as opposed to back in December when there were more elderly patients, he said.

Pfizer’s oral antiviral medication, paxlovid, should soon be home prescribing to older, more vulnerable patients. Due to its limited availability, the use of the pill is currently restricted to immunocompromised patients aged 65 and over.

“There are many drugs that cannot be taken with Pfizer treatment so they must be prescribed carefully,” he said.

On the flip side, the hospital’s infectious diseases department has chosen not to administer Celltrion’s antibody treatment Regkirona because of its questionable efficacy against Delta and Omicron variants, he added.

This portable clinic is separated from the main building so that visiting COVID-19 patients do not cross with other patients or staff.

This portable clinic is separated from the main building so that visiting COVID-19 patients do not cross with other patients or staff.

Medics examine patients from the other side of the glass wall.  The air flow is pressure regulated to prevent transmission.

Medics examine patients from the other side of the glass wall. The air flow is pressure regulated to prevent transmission.

Kang Soon-won, a head nurse who oversees the hospital’s remote monitoring program, said that patients at home who develop worrying signs such as persistent fever or low blood oxygen can be brought in for outpatient appointments.

Last month, every nurse had to check in 100 or more patients. “That means one nurse made 300 calls a day. Now we’re seeing a third of it, ”she said. “It looks like the busiest days are behind us.”

Seoul plans to have more of these clinics across the city.

Regarding the potential risk of transmission for patients who leave isolation, a senior official from Seoul said, “Patients are asked to wear face masks at all times on their way to and from the clinic. There is also a smartphone app so that you don’t make any detours. “

About two weeks ago, the hospital also opened an emergency room dedicated to addressing urgent care needs for patients at home – the first and only emergency room for COVID-19 patients in Korea. Days after the opening, a patient who had given birth in an ambulance was operated on here, said Dr. Hahm Eun-mi, ambulance doctor.

“Patients usually come here for breathing difficulties and chest pain. Most of them already had pneumonia and would be transferred to a COVID-19 ward if that happened, ”she said.

The Seoul hospital has treated most of the country’s COVID-19 patients. Including the patients currently admitted to the hospital, more than 21,400 have been cared for by the hospital.

In addition to the main hospital in Jungnang-gu, which will soon expand by 80 more beds to a total of 355 beds, the branch in Gangnam-gu has set up modular wards with a total of around 40 beds.

“It’s been two long years and the hardest part is not knowing what to expect. As a public hospital, I believe it is our duty to serve the community to the end, ”said hospital president Dr. Song Kwan-young.

By Kim Arin ([email protected])

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