Operating Protocols of a Community Treatment Center for Isolation of Patients with Coronavirus Disease, South Korea

Abstract

Most persons with confirmed coronavirus disease (COVID-19) have no or mild symptoms. During the COVID-19 pandemic, communities need efficient methods to monitor asymptomatic patients to reduce transmission. We describe the structure and operating protocols of a community treatment center (CTC) run by Seoul National University Hospital (SNUH) in South Korea. SNUH converted an existing facility into a CTC to isolate patients who had confirmed COVID-19 but mild or no symptoms. Patients reported self-measured vital signs and symptoms twice a day by using a smartphone application. Medical staff in a remote monitoring center at SNUH reviewed patient vital signs and provided video consultation to patients twice daily. The CTC required few medical staff to perform medical tests, monitor patients, and respond to emergencies. During March 5-26, 2020, we admitted and treated 113 patients at this center. CTCs could be an alternative to hospital admission for isolating patients and preventing community transmission.

Keywords: 2019 novel coronavirus disease; COVID-19; CTC; SARS; SARS-CoV-2; South Korea; community treatment center; coronavirus; coronavirus disease; quarantine facility; respiratory infections; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.

Figure 1

Overall structure of the SNUH community treatment center (SNUH-CTC) for isolating mildly symptomatic or asymptomatic patients with coronavirus disease, South Korea. SNUH-CTC was divided into a monitoring center at SNUH in Seoul and a patient center 153 km away in Mungyeong. Boxes indicate various agencies and organizations the provided staff to help run SNUH-CTC and support operations. Arrows indicate direction of information, services, or patient transport. RT-PCR, reverse transcription PCR; SNUH, Seoul National University Hospital.

Figure 2

Diagram of the patient center of Seoul National University Hospital community treatment center (SNUH-CTC) located in the Mungyeong Human Resource Development (HRD) Center, Mungyeong, South Korea. CTCs were set up to isolate and monitor mildly symptomatic or asymptomatic patients with coronavirus disease. Green indicates the clean areas in which staff worked. Red indicates contaminated areas in which patients stayed. Gray zone indicates areas in which staff performed other activities, such as collecting patient’s samples or removing waste. Yellow indicates routes for patient admission and removal of patient waste. Blue indicates external services kept outside of the building.

Figure 3

Flow chart of protocols for admission and management of mildly symptomatic or asymptomatic patients with coronavirus disease admitted to the Seoul National University Hospital community treatment center (SNUH-CTC) for isolation and monitoring, South Korea. COVID-19, coronavirus disease; CTC, community treatment center; RT-PCR, reverse transcription PCR.