Innovative screening tests for COVID-19 in South Korea

Abstract

Recently, the number of Corona Virus Disease 2019 (COVID-19) cases has increased remarkably in South Korea, so the triage clinics and emergency departments (ED) are expected to be overcrowded with patients with presumed infection. As of March 21st, there was a total of 8,799 confirmed cases of COVID-19 and 102 related deaths in South Korea that was one of the top countries with high incidence rates [1]. This sharp increase in infection is associated with 1) outbreaks in individual provinces, 2) deployment of rapid and aggressive screening tests, 3) dedicated healthcare staffs for virus screening tests, 4) quarantine inspection data transparency and accurate data reporting, and 5) public health lessons from previous Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) outbreaks. This commentary introduces innovative screening tests that are currently used in South Korea for COVID-19, e.g., Drive-Through and Walk-Through tests, and compare the advantages and disadvantages of both methods.

Keywords: COVID-19 diagnostic testing; Early Detection of Disease; Infectious Disease Outbreak; Virus Diseases.

Fig. 1.. The Drive-through (DT) testing site.

1) Registration: Healthcare staff assists the check-in process.K 2) Medical exam: Healthcare staff records testee’s symptoms, personal information, and epidemiologic association. The staff completes this process using a mobile phone without making contact with the testee. If the testee is suspected of coronavirus infection, his/her samples are collected before he/she gets transferred to a designated hospital. 3) Collection of specimens: Healthcare staff leans over the open window for naso- and oro-pharyngeal swabs, and then the testee closes his/her car windows to collect his/her sputum specimen. Car ventilation is set at the “recirculation” mode to minimize the risk of infection for healthcare workers. After receiving the samples, the healthcare staff puts on a new vinyl apron and disinfects his/her hands using alcohol-based hand sanitizer. 4) Discharge instructions: The testee gets the information about how to check the test result and is asked to self-quarantine until further notice regarding the outcome. Instructions are also provided regarding what the testee should do if his/her symptoms get worse.

Fig. 2.. The Walk-through (WT) test using the negative pressure booth. (Top) Flow diagram of the testing, and (Bottom) a picture of four “safe assessment and fast evaluation technical booths.”

1 & 2) Patient registration and waiting in the reception area: A one-stop kiosk assists the check-in process, reducing the risk of infection for both the healthcare staff and the testee. 3) Patient exam: Healthcare staff records testee’s symptoms, personal information, and epidemiologic association. The staff can complete this process using a mobile phone or a Personal Computer (PC) system. 4) Collection of specimens and discharge instructions: The testee enters the clean booth once the check-in process is complete. The testee stays inside the negative pressure booth, while the healthcare staff is outside the booth the whole time. The booth was designed with transparent walls, one of which has a pair of long gloves for a healthcare worker to use to make naso- and oro-pharyngeal swabs. The testee collects the sputum sample by himself/herself in the closed booth. The testee then receives information about how to check the test result and how to self-quarantine. Instructions are also provided regarding what the testee should do if his/her symptoms get worse. After the exit of the testee, the booth gets ventilated and disinfected for 2 minutes the first time and 10 minutes after that.

Fig. 3.. The Walk-through (WT) test using the positive pressure booth [7].

1) Medical exam: Healthcare staff records testee’s symptoms, personal information, and epidemiologic association. The booth is installed in a tent or a container house separated from the hospital. The staff can complete this process using a mobile phone without making contact with the testees. If the testee is suspected of coronavirus infection, his/her samples are collected before he/she gets transferred to a designated hospital. 2) Collection of specimens: The tester enters into the positive pressure booth and stays inside, while the testee is outside. The booth is designed with transparent walls, one of which has a pair of long gloves for a healthcare worker to use to make naso- and oro-pharyngeal swabs. The testee collects the sputum sample by himself/herself outside the booth. 3) Discharge instructions: The testee receives the information about how to check the testing result and is asked to self-quarantine until further notice regarding the outcome. Instructions are also provided regarding what the testee should do if his/her symptoms get worse.