SEOUL — It was 2 a.m. when Kim Do-gyun called South Korea's coronavirus hotline. He had a fever after returning from Malaysia. The hotline advice: Get tested.
By Min Joo Kim
and The next morning, March 7, he received a text message from the testing center. The results were negative.
Kim is one of more than 240,000 people who have been tested for the coronavirus in South Korea — or about one test per every 250 people, among the highest testing rates in the world.
More than 10,000 tests have been administered each day over the past few weeks since a sudden spike in infections in the southern city of Daegu in late February.
From drive-through kiosks to hospitals to local clinics, hundreds of test sites are available across the country, and the tests are largely free. For the elderly or those too ill to step out, medics visit their homes to take swabs for testing.
South Korea’s testing blitz has emerged as one of the models for rapid and comprehensive responses as some other countries, including the United States, lag well behind.
On Friday, the Trump administration — under fire for the slow U.S. testing response — announced steps seeking to boost the availability of coronavirus tests, including giving $1.3 million to two companies to develop one-hour tests.
South Korea’s planning dates to a 2015 outbreak of Middle East respiratory syndrome, or MERS. Then, the limited availability of test kits was blamed for aggravating the epidemic, which killed 38 people around the country.
That experience led the Seoul government to introduce an “emergency usage approval” system, which allowed for a fast-track approval for test kits during any outbreaks.
On Feb. 4, two weeks after South Korea reported its first coronavirus case, the government gave “emergency approval” for Seoul-based Kogene Biotech to move ahead with the test kits.
The company already had lab work underway for the test kits, anticipating that the coronavirus would spill over from China.
Production has been steadily ramped up to 10,000 kits a week. Each kit can administer 50 tests, and each person is tested twice on average for accuracy. That leaves the potential to test 250,000 people a week.
Kogene currently exports test kits for the novel virus to 35 countries in Asia, Europe and the Middle East.
It was a similar story in China, which faced the outbreak of severe acute respiratory syndrome, or SARS, in 2002-03 and had plans in place to expand testing dramatically this time around.
But Japan, largely bypassed by those epidemics, has been much slower on getting test kits to the public.
In the United States, the furor has been growing. U.S. public health experts, politicians — and anxious people seeking tests — have grown increasingly alarmed about the lack of testing across the United States, which has run only about 14,000 tests at the Centers for Disease Control and Prevention and its network of public health laboratories, according to data updated Thursday.
U.S. officials have acknowledged they do not know how many tests are running at hospital labs or by companies, although those capabilities are just coming online this week.
“I’m being asked over and over again why the United States is so far behind other countries and why the American people cannot get tested,” Rep. Carolyn B. Maloney (D-N.Y.) said at a House Oversight and Reform Committee Hearing earlier this week. “South Korea can test more people in one day than we tested over the past two months.”
Critics, including former FDA commissioner from the Trump administration Scott Gottlieb, began arguing in early February that U.S. officials should have been doing more to encourage hospital laboratories and companies to speed up test development and increase capacity. But the nation instead remained reliant on its backbone of public health laboratories, which have limited capacity to scale up.
Things are beginning to improve. U.S.-based companies have started to manufacture test kits and hospital labs have been given new flexibility to test. In some areas, including quarantined New Rochelle, N.Y., drive-through testing is being set up to emulate South Korea’s successes.
But the U.S. health system is still playing catch-up.
“The system is not really geared to what we need right now, what you are asking for. That is a failing. Let’s admit it,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases at a congressional hearing Thursday.
“The idea of anybody getting it easily the way other people are doing it, we are not set up for that,” he added. “Do I think we should be? Yes, but we’re not.”
South Korean officials credit the ease of testing — and the waiving of most medical fees — with allowing for quicker quarantines and other actions to try to contain the virus. Nearly 8,000 confirmed cases have been detected in South Korea with 66 deaths.
The test, normally about $134, is free for anyone with a doctor’s referral or for those who came in contact with an infected person. South Korean government also covers the full cost of medical treatment for every coronavirus patient in the country.
“I felt nervous waiting for the test result, but at least I did not have to worry about money,” said Kim, who used the drive-in center near his home in Namgyangju neighboring Seoul.
South Korea encourages even undocumented foreigners to get tested for the virus, and public health officials are not obliged to report their status.
“Immigration authorities will not collect information of undocumented immigrants who get tested for the virus, or inspect hospitals for such instances,” South Korea’s Justice Ministry said in a statement late January. “So please visit a nearby health center to get tested for the virus if you have symptoms related to the new coronavirus.”
South Korean government’s response to the epidemic has not been without its critics.
More than 750,000 people signed a petition in the initial weeks of the outbreak criticizing President Moon Jae-in for not imposing more stringent travel restrictions from China.
But South Korea’s ability to expand its testing capabilities so rapidly has been admired across Asia.
“We are bombarded with calls from all over the world urgently seeking covid-19 test kits for import,” said Kogene Biotech director Baek Myo-ah. “Putting out a novel pathogen test kit can take as long as a year, but we jumped into production within weeks thanks to the emergency approval system,”
Baek said her company started working on the kit Jan. 10, a full 10 days before the first coronavirus case in South Korea.
“The prospect of the kit’s usage was unclear back then,” she said, “but our lesson from developing MERS test kit in rush was that forewarned is forearmed for an epidemic.”
Denyer reported from Tokyo. Carolyn Y. Johnson in Washington contributed to this report.
