The Washington PostDemocracy Dies in Darkness

South Korea loosened covid rules after massive vaccine uptake. Now cases and hospitalizations are surging.

A medical worker guides people waiting to receive coronavirus tests at a screening clinic in Seoul. (Yonhap/EPA-EFE/Shutterstock)

SEOUL — Less than three weeks after South Korea relaxed pandemic restrictions under a new living-with-covid policy, the country is experiencing a surge in coronavirus cases.

On Wednesday, the country reported a record 522 coronavirus patients hospitalized with moderate to serious symptoms requiring intensive care, intubation or oxygen to help with breathing. It tallied 3,187 new infections the same day, the second-highest daily figure since the start of the pandemic.

Japan and South Korea never did full lockdowns. It left lessons on how to coexist with the virus.

South Korea’s government began relaxing pandemic restrictions on Nov. 1, deeming that a sufficient proportion of the population had been vaccinated. South Korea has fully immunized close to 80 percent of its 52 million people, despite a later start than many other wealthy countries. Fewer than 10 countries have higher vaccination rates, Washington Post figures show.

Last month, South Korea started vaccinating children ages 12 to 17 and providing booster shots for the elderly and people working at medical facilities. No vaccine has been approved for Korean children younger than 12.

In its first phase of loosened restrictions, South Korea is letting bars, restaurants and cafes stay open longer; previously, most had to close by 10 p.m. Private groups of up to 12 people can gather outside the Seoul metropolitan area (and 10 in the Seoul area), up from four. Professional sporting events can now allow fans into stadiums. (Game 3 of the Korean Series, the local equivalent of the World Series, is on Wednesday evening.)

The rising caseload has stirred concern among health officials. South Korea will stop relaxing measures further if coronavirus case numbers continue to go up, Jeong Eun-kyeong, the country’s top disease control official, said during a parliamentary hearing last week.

Korean officials have previously said that the country’s health-care system could manage 500 coronavirus patients with serious symptoms at any given time without experiencing major strains. Wednesday marked the first time that South Korea surpassed the 500-patient threshold.

Deaths have also been climbing. On Nov. 1, the seven-day average for daily coronavirus deaths was 12.3, according to Our World in Data. That figure has now risen to about 20.

Kim Woo-joo, an infectious-disease expert at Korea University, said the recent surges reflected waning immunity against the coronavirus among those who had been vaccinated several months ago. “This is why we need booster shots,” he said in a phone interview.

Health officials told reporters Wednesday that the spread of the delta variant has driven increases in breakthrough infections at nursing homes and long-term care facilities, where most of the residents are senior citizens who received their initial vaccination doses earlier in the year.

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“We are seeing more serious cases and deaths among the elderly,” said Choi Eunhwa, head of a government panel that oversees vaccine policy.

An Israeli study published in the New England Journal of Medicine last month showed that six months after receiving the second dose of the Pfizer-BioNTech coronavirus vaccine, people’s immune response to the coronavirus “substantially decreased,” especially among men, those age 65 or older and those with immunosuppressed conditions.

More than half of the vaccine doses administered in South Korea so far were of the Pfizer-BioNTech vaccine, although the country has also given out doses of the Moderna, Johnson & Johnson and AstraZeneca-Oxford vaccines.

Though daily deaths are rising, South Korea’s covid fatality rate is low — and has fallen from 2.4 percent in May 2020 to less than 0.8 percent now, according to Our World in Data. This, experts say, is partly due to its high vaccination rate.

“This does show that vaccines work,” said Kim, the infectious-disease doctor. “But this isn’t a cause for celebration. The whole point of vaccines is preventing deaths. The number of deaths is rising.”

“If we want to live with covid like the common cold, the case fatality rate has to fall to less than 0.1 percent,” he said.