1. Updates on MERS Outbreak (as of 6:00 on July 23)

There have been 186 confirmed cases, and among them, 138 patients have been discharged from the hospital and 36 have died. Currently, 12 patients are hospitalized for treatment. Four of them are in critical condition relying on devices for the maintenance of oxygen saturation such as an artificial respirator and ECMO (extracorporeal membrane oxygenation). Of the 12 patients under treatment, 11 have tested negative for MERS-CoV by two PCR tests, and eight of the 11 patients have been transferred from negative-pressure isolation rooms to general wards for continued treatment.

A total of 138 patients have been discharged from the hospital. They received injections of antibiotics and antiviral drugs and other symptom-specific treatments. Patients are declared cured if they have no respiratory symptoms such as fever and test negative for MERS two consecutive times.

Among 36 deaths, 33 (91.7%) were categorized as high-risk, either because of old age or preexisting chronic conditions, including cancer or diabetes as well as heart, lung and kidney diseases or immunodeficiency disorder)

Number of Those Under Quarantine and Those Released

MERS Quarantine Status

2. Government Response System

Immediately after the identification of the first confirmed case (index case), MERS alert level was elevated from ATTENTION to CAUTION, and a task force was formed at the Korea Centers for Disease Control and Prevention (KCDC) on May 20.

With the number of MERS patients increasing and fears of the spread of the MERS virus rising, the Ministry of Health and Welfare established the Central MERS Response Task Force on May 28, headed by the Vice Minister of Health and Welfare. On June 2, the level of the Task Force was elevated from Vice-Minister to Minister.

MERS Response Policy Coordination

The Prime Minister presided over the Government-wide Meeting for MERS Response on a daily basis to check reports from the Central MERS Response Task Force and the Rapid Response Team as well as the Pan-Government MERS Countermeasures Support Center. The Center is headed by the Minister of Public Safety and Security in partnership with 10 relevant government ministries to provide support for managing contacts and assisting healthcare workers.

The Central MERS Management Task Force under the Ministry of Health and Welfare is in overall charge of taking key epidemic control and prevention measures. From July 13, as no additional MERS cases have been reported for the 12^th straight day, the chairman of the Government-wide Meeting for MERS Response was changed from the Prime Minister to the Minister of Health and Welfare.

3. Measures Taken

A total of 15 healthcare facilities where confirmed MERS cases occurred were designated hospitals under strict control. The Rapid Response Team consisting of private-sector specialists was sent to hospitals affected by MERS to take on-site control measures, including partial shutdowns. Assistant administrative personnel were also dispatched for rigorous oversight of control measures. In addition, infection prevention training was provided for healthcare workers, including the proper use of personal protective equipment. On June 30, a Crisis Response Center began operation to provide the best possible treatment for patients in serious condition.

Infection control measures at medical facilities were strengthened, to prevent the further spread of the disease. A total of 287 hospitals were designated MERS-free hospitals, where patients with severe respiratory conditions were admitted and treated entirely under quarantine. All medical facilities and emergency rooms were checked for proper record keeping on who had passed through.

Hospital rooms, healthcare staff and other resources necessary for quarantine and treatment of confirmed MERS cases were secured. Hospitals treating confirmed MERS cases and hospitals diagnosing suspected MERS cases were designated by city and province and quarantine rooms were made available. Specialized personnel were dispatched, along with necessary medical equipment, to treat confirmed patients. Eight facilities were provided with a total of 116 personnel and equipment such as portable negative pressure containment systems and Level-D protective gear.

A thorough system was established for finding and monitoring those suspected of infection. The list of hospitals where confirmed cases occurred or visited and the dates of these visits were made public beginning June 7. The system for managing those under home quarantine was strengthened in cooperation with the Ministry of Public Safety and Security, the Ministry of Public Administration and the Ministry of Justice. Every quarantined person was matched with a public official, with monitoring taking place twice a day, and those under home quarantine were banned from leaving the country.

Measures were taken to compensate those affected in the response to the outbreak. Medical facilities received compensation for direct and indirect losses and other assistance. Those under quarantine were provided with subsidies for living expenses and cost of treatment. Assistance was provided for funeral arrangements for the deceased.

Epidemiological research and analysis was conducted as part of MERS response and eradication efforts. Relevant test specimens, clinical data and other research findings were collected and stored.

International cooperation was carried out transparently with specialized organizations such as WHO and the U.S. Centers for Disease Control. The Korea-WHO MERS Joint Mission presented its findings on June 13. In partnership with WHO and the U.S. CDC, the Republic of Korea's system for preventing the outbreak of emerging infectious diseases was comprehensively assessed from June 22 to July 1. A revised Infectious Disease Control and Prevention Act was promulgated on July 6, strengthening the authority of disease control personnel and epidemiologists working in actual situations, increasing the number of epidemiologists, and strengthening the national disease management system to enable quicker responses.

4. Future Plans

Measures will be devised to improve the national system for responding to emerging infectious diseases. This will include strengthening preventive surveillance and monitoring, restructuring related organizations to improve situational response capacity, establishing countermeasures against nosocomial infection, and strengthening the overall public health crisis response capacity, including expanding availability of quarantine rooms.

A comprehensive analysis and assessment of the MERS response process will also be conducted. Carried out at the national level, the epidemiological survey and analysis will look at the cases of all confirmed MERS patients and findings will be made public. Transmission routes and the causes of death among those who developed severe illnesses will be analyzed, and these and other research findings will all be shared transparently with the public. A comprehensive white paper on MERS will be produced providing information on the progression of the outbreak, an analysis of its causes, and a review of the response measures that were taken.