Lessons Learned: Responding to MERS Outbreaks
1TBD, Samsung Medical Center, Republic of Korea
In 2015, South Korea was hit by a nationwide infectious-disease crisis due to Middle East Respiratory Syndrome (MERS). The South Korea–World Health Organization MERS Joint Mission analyzed the major factors contributing to the MERS outbreak, and identified a lack of awareness among health care workers and the general public about MERS, and suboptimal infection prevention and control measures in hospitals. In addition to overcrowded emergency rooms and the multi-room–centered hospital structure, it also pointed to the cultural aspect of ‘doctor shopping’ and the many visitors allowed to patients.
Samsung Medical Center (SMC) suffered difficulties in the diagnosis and treatment of MERS patients due to a lack of planning with regard to responding to infectious diseases. Information on the new infectious disease was rapidly shared internally, but the disaster-response system was ineffective when the disease began to spread within the hospital. The difficulties encountered included contact tracing, contact patient management, isolation space management, medical staff management, communication, and a lack of urgency in responding to problems when they arose.
Since the MERS outbreak, SMC has reorganized its infection-response system by establishing a high risk infectious disease warning system, a countermeasures headquarters, and by supporting departments when an infectious diseases outbreak occurs. The environment of the emergency room has been improved, and a negative-pressure Febrile and Respiratory Infectious Disease Unit for triage and treatment has been established in the emergency room (ER). These measures have enhanced safety in the ER, an important pathway by which infectious diseases enter the hospital. In addition, a Communicable Diseases Isolation Unit has been constructed and a negative-pressure isolation ward expansion using a portable negative-pressure machine and supporting medical staff is planned. Also, a Center for Infection Prevention and Control has been set up to control the response to infectious disease outbreaks, and the number of medical staff has been increased. In addition, a multidisciplinary infectious diseases team is being organized, and there are plans to simulate outbreaks of infectious diseases. In addition, we regularly share information on infectious diseases internally and externally by publishing the Communicable Disease Weekly Update.
An effective response to outbreaks of infectious diseases requires coordination with other healthcare agencies and with the disaster response programs of local and national authorities. SMC has cooperated with the relevant agencies to establish an infectious-disease response system and is actively preparing for future outbreaks of infectious diseases.