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Experts call for easing age limit for antiviral pills, aggressive testing to flatten COVID-19 curve

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People stand in line to receive a COVID-19 test at a testing center near Seoul Station, Thursday. Yonhap
People stand in line to receive a COVID-19 test at a testing center near Seoul Station, Thursday. Yonhap

By Lee Hyo-jin

Korea is grappling with its worst COVID-19 crisis yet, driven by the highly transmissible Omicron variant that is sweeping the country.

The Korea Disease Control and Prevention Agency (KDCA) reported 14,518 new infections for Wednesday, breaking the all-time high of 13,012 set the previous day. The figure has doubled in a week.

The public health authorities predict that the daily caseload will go as high as 30,000 by next week, while some medical experts believe that the spread of the variant may push the tally to 200,000 by March.

Experts pointed out that the government should overhaul its COVID-19 response measures, as Omicron will be extremely difficult to control with the existing tactics that have been designed for earlier variants.

"Antiviral treatments are one of the best scientifically proven ways to prevent Omicron patients from falling into critical condition," Choi Jae-wook, a professor of preventive medicine at Korea University, said. "But so far, the government has been failing to use the pills effectively."

As of Jan. 20, only 109 people have been prescribed Paxlovid, Pfizer's oral COVID-19 pills, although sufficient doses for 21,000 people were shipped to Korea on Jan. 14. The figure of 109 people is far behind the government's expectation that the pills would be given to more than 1,000 people daily.

This handout file photo provided on Nov. 16, 2021, by Pfizer shows the making of its COVID-19 antiviral pills, Paxlovid, in Germany. AFP-Yonhap
This handout file photo provided on Nov. 16, 2021, by Pfizer shows the making of its COVID-19 antiviral pills, Paxlovid, in Germany. AFP-Yonhap

Choi explained that the low prescription rate is attributable to age limits and a complicated prescription process. Under the current measures, the pills can be prescribed only to patients aged 60 and over, or immunocompromised patients.

"The public health authorities should ease the age limit and open the use of the pills up to more people, as well as let doctors decide whether to administer the drugs, depending on a patient's overall health condition," he said.

Chon Eun-mi, a respiratory disease specialist at Ewha Womans University Mokdong Hospital, said, "So far, the Omicron variant appears to cause mild symptoms in young people, but elderly patients are still at risk. If used with the right strategy, the antiviral pills will be able to decrease the fatality rate among elderly patients drastically."

In the wake of the Omicron surge, the government plans to expand the proportion of patients undergoing home treatment to 90 percent by the end of this month, reserving hospitalization only for high-risk groups.

While this scenario may be a viable solution to prevent shortages of hospital beds, Choi warned that patients under home care should be offered face-to-face consultations with doctors.

"Currently, medical workers conduct monitoring of patients at home only through phone calls. The government should utilize more outpatient clinics and local hospitals so that physicians can actually examine the patients in person."

Ma Sang-hyuk, the former vice president of the Korean Vaccine Society, said, "The authorities must establish specific guidelines and provide necessary protective equipment to local clinics so that they can receive COVID-19 patients without risk of virus transmission at their hospitals."

'Aggressive' testing

A box of COVID-19 at-home antigen testing kits is empty at a drug store in Jongno District, Seoul, Wednesday. Yonhap
A box of COVID-19 at-home antigen testing kits is empty at a drug store in Jongno District, Seoul, Wednesday. Yonhap

The experts also stressed the importance of early virus detection, and to do so, the country should ramp up its testing capacity to the maximum level.

From Jan. 29, under the new testing protocol, polymerase chain reaction (PCR) tests, which were previously freely available to anyone, will be offered only to high-risk groups. Others can undergo PCR tests only when they test positive through rapid antigen tests or self-test kits.

The new protocol has led to concerns that the country may miss the early detection of infections, as rapid antigen tests are not as accurate as PCR tests.

But Choi viewed that such a move seems inevitable, saying, "When cases soar to the tens of thousands due to Omicron, we will not be able to handle the situation with PCR tests only."

Chon also stands for the active use of rapid antigen tests. "The government should consider distributing self-testing kits to every household on a regular basis, so that people experiencing COVID-19 symptoms can administer the tests without having to visit a testing center or pharmacy."

Stringent social distancing strategies which have been effective in curbing infections so far, may not be a good option to curtail the Omicron variant, according to these experts.

"Rather than pushing ahead with one-size-fits-all regulations such as social distancing, limits on the operation hours of multiuse facilities and the vaccine pass, the government should take a more tailored approach to protect vulnerable groups," said Ma.

Chon echoed the sentiment, saying, "As we've seen in other countries, such as Israel, further tightening of distancing measures would do little to control the explosive growth of Omicron infections."


Lee Hyo-jin lhj@koreatimes.co.kr


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