Lessons & Scars of COVID19 in Daegu: Shall This Be a Memory of Solidarity?
  • Jinkyung Byun
  • Updated 2020.05.18 14:43
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On the evening of March 25th, (from Left to right) Chief Lim, Seung-gwan of Anseung Hospital, Professor Kim, Dong-eun of Keimyung University Dong-san Hospital, Researcher Kim, Myeong-hee, of the Citizen Health Lab had a conversation. ⓒSisa-IN Sunyoung Shin

Daegu was in the midst of hate and exclusion, solidarity and humanism that represented the era of COVID19. There were signs saying “No Daegu Gyeongbuk visitors” at hospital front doors in the metropolitan Seoul area. Thousands of online replies criticized a confirmed patient from Daegu who visited his children in Seoul and was confirmed positive with the virus in Seoul. Political offenses, such as the result of voting which exploited the historical geopolitics, left other scars in the hearts of many Daegu citizens and others after the blow of the epidemic.

At the same time, people loved Daegu. Watching the grim realities on television, people were tearful and sent gifts and letters to Daegu. Many healthcare workers took the train to Daegu and volunteered all night in hospitals and outside. Moved by their volunteers, others sent help. Daegu citizens returned the favor, thus forming a positive feedback. What is this contradictory love and hate relationship? What shall remain at Daegu and South Korea after it is all over?

We had to talk about ‘Daegu’ at least once in the ‘Weekly COVID19.’ Besides the regular members - Researcher Kim, Myeong-hee of the Citizen Health Lab (preventive medicine specialist), Chief Lim, Seung-gwan of Gyeonggi province Anseung Hospital (infectious disease medicine specialist, Chief to the Gyeonggi COVID19 Emergency Task Force) - we needed a voice from the site; Otolaryngologist Professor Kim, Dong-eun of Keimyung University Dong-san Hospital took this role. Being the director of planning at the Daegu Gyeongbuk Association of Physicians for Humanism, Professor Kim volunteered at Daegu Dong-san Hospital and Dalseo-gu Screening Center, while running his otolaryngology clinic. After finishing four surgeries on March 25th, he took the night train to Seoul. The train was empty except for two people in one compartment. Until 30 minutes before the last train to Daegu at 11pm, the conversation went on at the 〈Sisa-IN〉 Editorial Department, discussing hand cream and MediCity, marlene cookies and Choi, Dae-jip, the chair of the Korean Medical Association. 
 

How was your last week?

Myeong-hee Kim: I went to the countryside and planted beans and potatoes. I was planning to get a small piece of land and to learn farming techniques, but I had to postpone it for two weeks until the last weekend. I enjoyed the spring weather and not wearing a mask in the town since there were not many people around. I’ve heard that many Americans are buying guns in the U.S because they are anxious about the lack of food and losing their possessions. While they bought guns and bullets, I planted a plot of potatoes and beans. 

Dong-eun Kim: I should buy your potatoes instead of the ones promoted by the governor of Gangwon Province (laugh). 
Seung-gwan Lim: many people came back to Korea from abroad. Other citizens and the media said that South Korea is one of the safest places, and I felt the same in my personal life. 

Dong-eun Kim: Besides three outpatient treatments and two surgeries a week, I have volunteered at the COVID19 ward in Daegu Dong-san Hospital and the Dalseo-gu screening center. The Daegu Gyeongbuk Association of Physicians for Humanism has conducted a drive-through specimen collection with a team of one physician and three nurses since March 2nd. My usual job was to organize the rotation shifts for the medical personnel from all over Korea and to deliver the gifts from citizens to the workers in the hospitals and screening centers. Yesterday a truck with two hundred bowls of lotus leaf rice - still steamy - came from Daejeon. I delivered them to soldiers, government officials, physicians, and nurses so they could have it warm when they finished their shifts.

On Tuesdays, Saturdays, and Sundays, I work as a nurse in the COVID19 ward of Daegu Dong-san Hospital. Since it is an isolation ward, nurses in protective suits have to do everything including catering. People tend to think that physicians can do everything that nurses can, but it is not true. Physicians are not as good as nurses in starting an IV. Instead, physicians can cater to patients. This is a very important task. There are two different meal types: normal diet (rice) and soft diet (porridge). It is critical to serve the right type to the right patients. Also, when patients tend to come out of their rooms because they feel stuffy inside, we give them a stern look in our protective gear to make them go back inside. This is how we maintain order in the ward. 

On March 11th, a member of the Daegu Dong-san Hospital medical personnel is changing shift after finishing his early morning shift. ⓒSisa-IN Sunyoung Shin

How does it feel on-site in Daegu?

Dong-eun Kim: There is a 3·28 Daegu movement. The Daegu City government proposed this movement in reference to to the 2·28 Democratic Movement in 1960. The government printed and pasted posters all over the streets, promoting social distancing and cleaning hands until March 28th. Now we have four days left. Then what are we going to do from the 29th on? I wish the government bought facial masks and hand sanitizers for the people in shanty towns instead of printing posters. They proposed to give an emergency COVID19 relief check after the election in April, but it does not make sense. One city council member asked the Daegu mayor, Young-jin Kwon, about this, but the mayor just left the meeting without answering the question. Despite all of this, Daegu citizens criticized only two people: President Moon and the Pontoon of the Shincheonji Church of Jesus, Man-hee Lee. They criticized the government for not prohibiting Chinese from entering Korea. Daegu is often called the Holy Land of the conservative party. To be conservative is to preserve something, but I am not sure what that is. It is too bad that they are not ideologically conservative but support a certain political faction.

Myeong-hee Kim: When there were many confirmed patients in Daegu, I could not help but imagine ‘what if this happened in Gwangju.’ It would have been more hatred and discrimination beyond control. In the early spread of COVID19, many Koreans hated Chinese until all Asians faced discrimination and terrorism in Europe. This made them think ‘this is not right.’ I wish Daegu Gyeongbuk citizens would think in the shoes of the discriminated people, but I am not sure if it happens.

Seung-gwan Lim: The movie critic, Dongjin Lee, once said “if there is a hell we can see, isn’t it the reply section on NAVER?” I kept thinking how unfortunate it is, looking at what has happened and the responses of the people. How could it be worse? An infected person who came to Korea from Japan happened to be of Chinese nationality, a large-scale infection happened to occur in Daegu, and it happened to be a church member of the Shincheonji Church of Jesus…. Each and every case was unfortunate insofar as it could lead to hate and discrimination. Approaching the general election, I felt like it confirmed the worst scenarios of ‘what if politics engages in this situation,’ and ‘how bad could Korean society be.’ I’ve seen how problems - such as whether the central and other regional governments help Daegu or not and what and how much treatment or other medical services to provide - became corrupted by political conflicts. It was scary and pitiful to see how correct public health advice gets politically interpreted and evaluated. 

Public opinions on the death of a high school patient whose cause of death was pneumonia is divided based on one’s political affiliations.

Dong-eun Kim: Everyone focused on the positive / negative results of screening, but the core of the discussion should have been ‘is it okay for patients other than COVID19 to be dead as much as it is?’ Daegu City Council (against the Korean Center for Disease Control pointing out an error in the Yeungnam University hospital screening result) was upset and released a statement saying “5700 Daegu doctors will not remain silent.” I am one of those 5700.... We should have talked about the systematic problems that made the student die, but instead the council made it a problem of doctors losing face. 
Myeong-hee Kim: Being under attack, the government began to emphasize ‘it was negative’ or ‘it was COVID19 or not’, even though the problem remains regardless of COVID19. 

Seung-gwan Lim: When conducting a very sensitive screening such as PCR, it is natural to find an indecisive state such as false positive or false negative. It is partially KCDC’s fault for briefing the press as if a screening producing a false result is a disaster. It should have been “the reliability of screening is not always 100%. We will investigate this and introduce measures accordingly” instead of “we will close the screening lab because there is an error.”

It is necessary to evaluate the medical situations in Daegu precisely. Is it really true that Daegu's medical system is paralized?

Dong-eun Kim: On February 25th, I received a text saying ‘5700 Daegu doctors should rise’ while seeing a patient. It was a statement from the Daegu City Doctors Association. The contents were the following: “Our beloved parents, brothers, sisters, and children are stricken with fear. The economy is paralized, and the city is becoming an empty ghost town… In emergency rooms and at screening centers in the health centers, our colleagues are falling one by one, because of overwork and isolation, by contacting COVID19 patients during their treatment.

It is important to remind the public of the dire conditions of the citizens, but it was exaggerated and overly emotional. It brought anxiety saying the medical system has collapsed and the doctors are falling. I received a call from a doctor in Gwangju after reading it. “It is not the time to see patients. Should we depart now?” The Daegu City Doctors Association played an important role through volunteers. However, it would not have been too late to ask for help after creating a place to volunteer. Because they asked “Please come to the screening centers after getting off from your work,” many private doctors came, but there were only two screening centers open during the night, and they had public health doctors. There were mostly mild cases in the hub hospital, so the role of doctors was ambiguous. 

The Daegu health system has never been paralyzed. Daegu has many university hospitals and the most hospital beds per capita in the country. However, it was problematic to close the emergency room. One day, a hospital closed around 3pm, and three more hospitals closed one after another. All except Chilgok Gyeongbuk University Hospital were closed. It could be dangerous for patients with myocardial infarctions  or strokes who have to be treated within the golden hour. It was indeed a crisis, and under the crisis, we needed even more precise decisions.

On February 26th, members of the Daegu Gyeongbuk Association of Physicians for Humanism are delivering COVID19 sponsored goods ⓒKim, Dong-eun

132 people died of COVID19 (by March 26th). It cuts to the heart that the majority of them are from the Daegu Gyeongbuk area. Looking back, what could have been done differently to decrease the mortality?

Seung-gwan Lim: The Daegu City government should have had more time to think. If I expected the current situation and I were in a position in KCDC, I would have taken Daegu patients outside of Daegu Gyeongbuk for the first few days. In the early spread of Daegu, only 30% of the government assigned hospital beds were occupied. It was possible for the trained places to take around 100 patients in total. If a disaster happens, the on-site response system should be separated from the outside rescues. The rescue teams should do simple tasks - receiving and treating patients. The region of disaster should establish regional governance to organize a voluntary system. There are many specialists, professors, and committed activists who provided with more time, could have organized an internal system to overcome the disaster. With more time to take a breath and prepare strategic responses, wouldn’t the result be different?

Dong-eun Kim: There were many hospital beds in Daegu, but there are few public hospital beds. It is a shame to miss that and prepare the beds accordingly. The first confirmed patient was on February 18th, and on the 20th, I received a text regarding the opening emergency professor meeting at 11pm. It was then when disease control authorities and the regional governments recognized the critical situation. In the morning of February 21st, the authorities announced Daegu Dong-san Hospital and Daegu Medical Center as infectious disease dedicated hospitals and issued a patient eviction order. Before the situation became dire, other regions had confirmed patients 2-3 weeks earlier. What should have been done in that time gap? A response for a large number of infections and hospitalization should have been prepared, but there was no plan with only one epidemiological investigator and lacking public medical infrastructure.

While Dong-san hospital fortunately had recently constructed a new building to move the patients to, Daegu Medical Center patients had to figure out on their own what to do. Another difficult question at this point is ‘who is in more danger - a mild COVID19 patient or an existing seriously ill patient?’ It was then that the Daegu Gyeongbuk Association of Physicians for Humanism issued a statement to send the mild COVID19 patients to places like training centers instead of hospitals. In fact, there is nothing to do for mild COVID19 patients. Most of them just wait to see two negative test results. The biggest problem was that those mild cases took the hospital beds and later seriously ill patients could not find a bed. At the worst time, there were 2300 people waiting at home to be hospitalized. 23% of the entire death toll was outside of the hospital, people waiting for a hospital bed.

Myeong-hee Kim: This is hard to understand. It is surprising that the authorities waited without preparing a response for the surge when things were uncertain. This is precisely the reason why the U.S. government is being criticized. What was it doing when the virus went viral in Asia two months ago?

Dong-eun Kim: On January 29th, the Daegu City government held an emergency meeting with relevant authorities and released counter measures, which did not include a plan for the lack of public hospital beds. It only included things like ‘printing and distributing advertisements for preventative measures’. On February 4th, two weeks before the first confirmed patients in Daegu, Mayor Kwon said in a staff meeting, “Daegu City’s responses to MERS confirmed patients were exemplary. Other regional CDCs referred to the MERS White Paper written by us as the model and so did the KCDC.” They should have planned for the use of hospital beds instead of praising themselves. 

Myeong-hee Kim: It would be crucial to have an alternative white paper prepared by the Daegu civic society after the epidemic of COVID19. 

Seung-gwan Lim: One of the thoughts looking at Daegu is if other 16 municipalities indeed thought that this is their own business as well. It was a matter of chance - lucky or unlucky - that the COVID19 outbreak happened in Daegu. It wouldn’t be a surprise if the same situation as in Daegu emerged in other places. Furthermore, why don’t we think that what’s happening in the U.S. and Europe could happen to us?

On March 14th, the mothers of the victims Eunhwa and Dayoon of the Sewol Ferry incident sent hand creams and a letter to medical personnel in Daegu. ⓒKim, Dong-eun

132 people died of COVID19 (by March 26th). It cuts to the heart that the majority of them are from the Daegu Gyeongbuk area. Looking back, what could have been done differently to decrease the mortality?

Seung-gwan Lim: The Daegu City government should have had more time to think. If I expected the current situation and I were in a position in KCDC, I would have taken Daegu patients outside of Daegu Gyeongbuk for the first few days. In the early spread of Daegu, only 30% of the government assigned hospital beds were occupied. It was possible for the trained places to take around 100 patients in total. If a disaster happens, the on-site response system should be separated from the outside rescues. The rescue teams should do simple tasks - receiving and treating patients. The region of disaster should establish regional governance to organize a voluntary system. There are many specialists, professors, and committed activists who provided with more time, could have organized an internal system to overcome the disaster. With more time to take a breath and prepare strategic responses, wouldn’t the result be different?

Dong-eun Kim: There were many hospital beds in Daegu, but there are few public hospital beds. It is a shame to miss that and prepare the beds accordingly. The first confirmed patient was on February 18th, and on the 20th, I received a text regarding the opening emergency professor meeting at 11pm. It was then when disease control authorities and the regional governments recognized the critical situation. In the morning of February 21st, the authorities announced Daegu Dong-san Hospital and Daegu Medical Center as infectious disease dedicated hospitals and issued a patient eviction order. Before the situation became dire, other regions had confirmed patients 2-3 weeks earlier. What should have been done in that time gap? A response for a large number of infections and hospitalization should have been prepared, but there was no plan with only one epidemiological investigator and lacking public medical infrastructure.

While Dong-san hospital fortunately had recently constructed a new building to move the patients to, Daegu Medical Center patients had to figure out on their own what to do. Another difficult question at this point is ‘who is in more danger - a mild COVID19 patient or an existing seriously ill patient?’ It was then that the Daegu Gyeongbuk Association of Physicians for Humanism issued a statement to send the mild COVID19 patients to places like training centers instead of hospitals. In fact, there is nothing to do for mild COVID19 patients. Most of them just wait to see two negative test results. The biggest problem was that those mild cases took the hospital beds and later seriously ill patients could not find a bed. At the worst time, there were 2300 people waiting at home to be hospitalized. 23% of the entire death toll was outside of the hospital, people waiting for a hospital bed.

Myeong-hee Kim: This is hard to understand. It is surprising that the authorities waited without preparing a response for the surge when things were uncertain. This is precisely the reason why the U.S. government is being criticized. What was it doing when the virus went viral in Asia two months ago?

Dong-eun Kim: On January 29th, the Daegu City government held an emergency meeting with relevant authorities and released counter measures, which did not include a plan for the lack of public hospital beds. It only included things like ‘printing and distributing advertisements for preventative measures’. On February 4th, two weeks before the first confirmed patients in Daegu, Mayor Kwon said in a staff meeting, “Daegu City’s responses to MERS confirmed patients were exemplary. Other regional CDCs referred to the MERS White Paper written by us as the model and so did the KCDC.” They should have planned for the use of hospital beds instead of praising themselves. 

Myeong-hee Kim: It would be crucial to have an alternative white paper prepared by the Daegu civic society after the epidemic of COVID19. 

Seung-gwan Lim: One of the thoughts looking at Daegu is if other 16 municipalities indeed thought that this is their own business as well. It was a matter of chance - lucky or unlucky - that the COVID19 outbreak happened in Daegu. It wouldn’t be a surprise if the same situation as in Daegu emerged in other places. Furthermore, why don’t we think that what’s happening in the U.S. and Europe could happen to us?

On February 24th, the president of the Korean Medical Association, Dae-Jip Choi, spoke at the press conference on COVID19 Alert Level Red ⓒYonhap News

It was Daegu where most encouragement and solaces was exchanged during the hardship.

Dong-eun Kim: We probably have more bottled water than we can drink in three years. It is all from the people. They also sent videos encouraging us. The mothers of the Sewol Ferry victims Eunhwa and Dayoon sent hand creams, and someone sent madeleine cookies for the nurses. After a doctor bought ginseng chicken soup for some soldiers, a parent of one soldier sent short rib soup. After his screening at the center, an old man tried to give 20 facial masks saying “doctors and nurses who work here should have the masks rather than me,” so we had to persuade him to take them home. 

Seung-gwan Lim: In Anseong Hospital, one of the public health centers in Gyeonggi province, it was tense at the beginning. We were proud when the media focused on us and most encouraged when treated patients sent messages of gratitude. In the past two months, hospital staff have become more proud of working here. Even less urgent places like ours have such heartwarming events, so I assume through this period Daegu medical personnel have found more pride and identity in their work. 

Myeong-hee Kim: Koreans are very passionate, warm, and touching...

The name, Association of Physicians for Humanism, is misleading. Shouldn’t doctors be humanists to begin with?

Dong-eun Kim: 〈JoongAng Ilbo〉 recently wrote a column that the Association of Physicians for Humanism, with less than 500 members, was the left-wing organization on the forefront of fighting for the impeachment of President Park. Us? That monumental event? (laugh) The column compared the association with the Korean Medical Association with 130,000 members, but I am one of those 130,000. Would every doctor in 130,000 share the same opinion with the president, Dae-jip Choi? The president Choi released a statement saying that he would pull out all the doctors in volunteers if the government did not agree with their demand. As one of the volunteers, I was outraged and wished to sue him for defamation. Other doctors and I did not volunteer because the president Choi told us to do so. It is ridiculous that he thinks as if he has some power to pull out the volunteers. 

Looking at the citizens who cared and worried about the doctors working in the front line of the pandemic, despite the actions of the Korean Medical Association and other concerns that doctors gave to the citizens, made me think a lot. A small effort could have improved the relationship. I thought the relationship between the doctors and the people was broken, but it wasn’t. There are some people thinking ‘since no one respects us, let's go to the interest group and take advantage of it as much as possible,’ and some young doctors followed. But when I saw many people concerned and worried about doctors who did the right thing even if we had disappointed them, I looked back on myself.  

Myeong-hee Kim: I didn’t know what to say about the Korean Medical Association when I had to write a statement of the People's Health Institute on the situation in Korea for the international civic society. Doctors are, generally and internationally, conservative, but it is difficult to explain the Korean Medical Association. 

Seung-gwan Lim: I don’t know if humanism can change society, but I think it is essential. I think this epidemic was a chance to find that the essence of medical treatment lies in humanism. 

Myeong-hee Kim: I don’t know how it is like these days, but when I was a resident during the late 1990s, there was some sense of basics. It was like, friends who would drink and hang out would not come if I asked ‘let’s go to protest’, but if I asked ‘let’s go to an immigrant workers clinic,’ they said ‘I will go if the schedule works.’ There is a professional specificity of doctors. They are a social elite class with knowledge, power, and wealth, but they meet the vulnerable the most of  any social elites. How many of the vulnerables in poverty and illness with crooked hands would professors, rich entrepreneurs, and fundmangers meet? There are plenty of opportunities for doctors to empathize with the sufferings of the ill and to speak for them as specialists. There was a foundation but no real transition, but I hope this epidemic provides a chance to change that.

In addition, while doctors appear on the front page, the media did not cover the nurses who play the more important role. People who lead the Korean Nurses Association consider it taboo to view nurses as a profession in the midst of conflicting views between specialists and workers. They worry something might happen if we talk about the workers. Most of the people who suppress the labor unions are head nurses. The internal elites related to nursing block the path for nurses to obtain social expertise. In fact, doctors don’t meet patients face to face so often. Nurses take care of the patients, cater meals to them, wash their heads, and etc. I wish more stories of the nurses, overshadowed by the doctors, could be read in the media at this time. 

Dong-eun Kim: When our Association of Physicians for Humanism decided to open a screening center and called for volunteers, I was a bit worried. What if no one volunteers? But over twenty people volunteered to come, from a first year who just finished the internship to Professor Do-myeong Baek in Seoul National University Graduate School of Public Health. Everyone was positive and eager to do something first. It was an opportunity for me to think about the original calling and the profession of a doctor. A junior doctor who came this week, is a graduate of 2005 and turned out to be a student of mine. Students sleep in class even if we emphasize the education for humanism and medical humanism. I think it is better for the senior doctors to demonstrate in the field instead of lecturing in classrooms.

What is necessary to change the scars and lessons of Daegu to memories of solidarity?

Myeong-hee Kim: We’ve talked about the alternative white paper earlier, and it is very important to publicize the social justice and experiences of solidarity when a social problem occurs. It is ‘publicity’ discussed in John Rawls’ 〈A Theory of Justice〉. It feels like a loss to keep the principles if one does not know that others obey the principles of justice. It is necessary to document the experiences of solidarity beyond the moving stories. Instead of documenting what Daegu City has done well, what was done right and wrong and what civic society did to cover those gaps should be documented. When the 2007 South Korea oil spill happened, a million people went down to wipe out the oil; it did not transform into a social movement, but ended up as a moving story. If we document carefully how citizens voluntarily overcame the hardships and how many donations came, beyond the narrative of ‘it is a pity so we should help’, next time it won’t be the same. I wish Daegu civic society would do this work. 

Dong-eun Kim: I couldn't agree 

more. It is difficult for ordinary citizens to recognize in detail how much other regions or they themselves helped and bonded together. Documentation is essential. Another wish is for Daegu City to take over Daegu Dong-san Hospital as a public hospital since it became the dedicated COVID19 hospital, and to use the same name and refurbish the building so we can remember the experiences of COVID19. We can’t remember without a space. Make a small museum containing the collection of all the handwritten letters. The city plans to spend three thousand million KRW for the new Daegu City hall, but isn’t this more important?
 

translated by Sohun Kang
translation supervised by Lisa De Silva, Sumi Paik-Maier

https://www.sisain.co.kr/41684