[세션1-토의]코로나팬데믹, 한국의 대응과 과제_첫번째 토의_박홍준&정승용 외_covid-19

Now, we will move onto the discussions. We have invited two panel members for this part. So, before we begin a full discussion, let us hear from our panel first. The first person on the panel is Dr. Park Hongjoon, who is currently the President of Seoul Medical Association and the Vice-president of Korean Medical Association. You’ve probably seen him many times on TV, and I think he’s probably the best person to represent the medical associations. and I think he’s probably the best person to represent the medical associations. Hello, everyone.

00:57 - The assessment of the Korean government’s response to COVID-19 and cooperative relationship from the Korean Medical Association’s point of view. I think it is too early to make an assessment. As I mentioned in the opening address, this is kind of a mid-term review. The Korean Medical Association is the only legal organization in the medical law that represents doctors. In the US, there’s the American Medical Association, abbreviated as AMA. We call ourselves KMA.

01:31 - If I speak on behalf of the KMA, as I said before, this is not so much an assessment of the response measures, but some positive aspects were mentioned by Dr. Jung just now. I believe that crisis situations require prompt, accurate, and transparent information-sharing. Director Jung of the KCDC and Director Kwon Joonwook of the National Institute of Health came on the media every day at a fixed time to deliver their opinions and message to the media and the people very scientifically and professionally. The faith they enlisted in everyone can be assessed as positive. Next, aspects that were slightly negative? Regarding infectious diseases, experts emphasize bold preemptive responses in the early stages. How to say this… blocking the disease.

02:33 - We talked about shut down and lockdown today, We talked about shut down and lockdown today, In fact, we have been repeatedly saying that we need to block the influx via the media, that we need to close the borders on incoming population from China to block the disease from the source in the early stages. There may be other opinions, but we felt the government’s measures were insufficient. And as mentioned before, we have an alert system for such crisis situations. It took considerable time to raise the alert to Red. This was also regrettable for us. The Seoul Medical Association had many discussions with the Seoul Metropolitan Goverment and the mayor, and about raising the alert level to Red, but this was delayed for some unknown reasons, perhaps political.

03:29 - and we feel that this was not very preemptive. Another thing is that the KMA actually suggested launching a campaign in the first week of March, the 311 campaign. “Let’s rest at home for the first week of March.” As if there’s a big snowstorm, let’s all rest at home and keep social distance. But the government only enforced intensive social distancing twenty days later on March 22nd. The second aspect… there are many. We’ve been saying from the beginning that we lack a control tower. Because of the incoordination between ministries, and between the central and local governments, there has been a lot of confusion on the frontlines and among medical practitioners. The third aspect is the political side taking priority over disease control. We’ve demanded restrictions on entry from China many times, and also suggested building a more coordinated civil cooperation system for response measures. Also, case definitions have been issued continuously, up to eight versions.

04:55 - Every time it was issued, the disease was defined in ways that did not match what we were seeing on-site, so we expressed our regrets about this quite a lot. As mentioned just now, sharing clinical information for treatment. How patients are being treated. If a patient deceased, how this happened. What the pathological problem was. And many other data were rarely shared. So, practitioners had to wing it. There was a lack of sharing. Also, treating critical patients is very important. Every day, we receive updates on the number of confirmed patients and the number of deaths. I think this is because people are invested in hearing these numbers.

05:47 - Nevertheless, a control tower for the treatment of critical patients, which should have been in charge of controlling the number of deaths, was not implemented after many difficulties. We pointed out these problems and made proposals continuously, but they were not accepted. Instead, the government excluded the KMA’s response center from the operations. and political comments which preceded the response measures often made things worse. For example, in early February, the government encourages people to engage in outdoor events and external activities.

06:26 - There were no additional confirmed cases for five days, the politicians and the media said that our initial response was very successful, There were no additional confirmed cases for five days, the politicians and the media said that our initial response was very successful, As a result, from February 19th, the number of confirmed cases increased explosively in the Daegu and Gyeongbuk regions. Then, what kind of cooperative relationship did the government and the KMA have? Concerning policy cooperation, we had some limited discussions through the Medical practitioners-Hospitals-Government consultation group. It was actually a fairly formal discussion. But practical cooperation was very actively conducted, as publicized through the media. The KMA quickly and promptly delivered to all members the various case definitions and guidelines provided by the KCDC, such as the case definitions for respiratory patients, and treated patients accordingly.

07:43 - We encouraged the voluntary participation of members in the containing spread in the Daegu-Gyeongbuk region, and connected the volunteers to the frontlines. The same is true for the local medical councils and the Seoul Medical Association. The local governments, Seoul Metropolitan government, the 25 public health centers, and the 25 medical councils cooperate actively in running the screening clinics, drive- and walk-throughs clinics, and the live-in treatment centers. Even today, many of our volunteers are working at the screening clinics. Daegu Dongsan Hospital actually played a major role in the intensive care unit.

08:28 - The hospital initially had only three beds in the ICU. But they increased it to 20 beds, which contributed significantly to reducing the number of death in the region. The Korean Society of Critical Care Medicine expressed their willingness to volunteer there, with the administrative and medical support from the government. So, I think that we played a significant role at the private level. Lastly, we can see how important the early response is.

08:59 - If you look at the data from Taiwan, Mongolia, and neighboring countries, you can see that it really makes a difference. Second, I think public communication has been quite successful and positive. As seen from the last election, the government’s communication with the people regarding COVID-19 was successful. However, the government’s communication with the medical community was unilateral. This was a pity. Communication should go both ways, but it was unilateral. How was it unilateral? The government made very urgent requests whenever support was needed. But, as I said earlier, it was quite a shame that the government didn’t treat KMA, the only legally-recognized group representing the medical community, as its partner, taking a double-sided attitude. Also, policy decisions about infectious diseases should be based on scientific and medical considerations, not politics, but I feel that politics and administrative considerations were given too much priority. K-quarantine, which was mentioned briefly. And the Together Challenge. You all heard these expressions. I wonder if we put too much focus on making names and catchphrases.

10:23 - We were busy creating catchphrases, but paradoxically, we were passive in data sharing and academic research based on shared data. This pandemic proved how effective private medical care can perform public roles through the organic cooperation between the government and the private sector in emergency situations. This pandemic proved how effective private medical care can perform public roles through the organic cooperation between the government and the private sector in emergency situations. But considering that we are expecting a second wave, and especially when the situation we face today are not even over yet, the many issues raised by the government and politicians now, such as the public medical school, the number of students admitted to medical school, telemedicine, it’s difficult to fathom how we should understand this. Thank you. We have one more panel member. Professor Jeong Seungyong of the College of Medicine at Seoul National University and the Vice-president of Seoul National University Hospital.

11:41 - One of the reasons why the medical system did not collapse despite the sudden burst of patients in Daegu was the creation of live-in treatment centers for treating mild patients. Dr. Jeong headed the live-in treatment center at Seoul National University’s Human Resources Development Center in Mungyeong. If you will please. I will jump right in since we don’t have time. The slides are mostly photos, so we’ll go through them quickly. About 80% the COVID-19 patients are asymptomatic or had mild symptoms, and about 20% were critical or severe patients.

12:41 - To treat this 20%, the 80% need to be managed, which is why the live- in treatment centers were created. Our hospital has been making preparations since the early stages, and we became the third live-in treatment center in Daegu-Gyeongbuk region. We became the third because we wanted a bit more time to prepare, but we have been preparing beforehand. So we started operating since early March. The SNU Human Resources Development Center opened in 2014, and it is capable of accommodating 115 patients, with a total of 101 rooms and family rooms.

13:36 - Seoul National University Hospital sent medical specialists to us, and we received public health support from the Ministry of Public Health and Welfare. And the local military bases, fire departments, police, municipal and welfare departments all collaborated, which I think make us a good role-model. Our operation principle was to completely separate the patient group and the medical practitioners. There are times when a patient’s condition suddenly worsens. We built a system to move these people to another hospital, and a system to conduct tests and verify results at all times.

14:20 - To talk about the transportation of patients, when the patient first enters the center, a transport bus is on standby at the back. The bus is equipped with an x-ray so that all patients have their chest x-rays taken to confirm the non-existence of pneumonia, then they are surveyed and examined by a medical staff wearing protective clothing. After the examination, the patient is admitted through the path designated for patients. Only patients with no or mild symptoms were admitted based on the KCDC’s guidelines. And the release of patients from the Center also followed the KCDC guidelines as well.

15:13 - The patients can only be released when the results of two tests conducted at 24 hour intervals both come out negative. We prepared a central monitoring system similar to the one at the KCDC, and monitored the halls and elevators of each floor where the patients were staying. Of course, no cameras were installs in the rooms due to reasons of privacy. In addition to the medical staff from the Seoul National University Hospital, firefighters and military officials, etc. were also at the Center, so we meticulously trained them on the wearing and removal of protective clothing, etc.

15:59 - The rooms were equipped various daily items as well as a sphygmomanometer, a thermometer, and a device to measure oxygen saturation, etc., and a cell phone holder so that we can make video calls. Also, we prepared these kits with household medicine and emergency medicine. This red tent you see is the walk-through system for COVID-19 testing, and the space on the right is the place where patients are. The examination process goes like this: the patient arrives, takes a chest x-ray, answers the survey, and then we collect the visual materials that the patient brought from another hospital.

16:50 - We input all this data in the system, and the x-rays and video data are read by the SNU Hospital in Seoul. The results from the SNU Hospital is reported right away in the system. As mentioned before, the patients were released once they meet the requirements and through set procedures. Two monitoring centers were created, one at the SNU Hospital in Hyehwa-dong, Seoul, and the other on-site. Nurses examined the patients twice a day, and doctors examined the patients once every other day to check their conditions.

17:34 - As you can see, we have a vehicle that transports corona virus samples to the hospital in Hyehwa-dong, and had the visual materials examined remotely. We didn’t build a new system specifically for this purpose. We established a network like those in hospitals at our center in Mungyeong, and applied the existing hospital information that we already had, so that the patients at the Mungeyong live-in treatment center can be monitored. A special mobile application needed to be developed, but we didn’t have time, so we used video calls via KakaoTalk. So, the visual data shown previously was shared through a cloud system.

18:35 - Now, we have an online dashboard system that allows you to view the status of all patient at a glance. As you can see, we also tried implementing a system for remote monitoring for some of these patients, where EKGs, blood pressure, etc. are automatically monitored using devices with Bluetooth capabilities. These patients can measure their own blood pressure and oxygen saturation while filming it, so that they self-report the information by inputting the data in the application. The main elements were a questionnaire, then an authentication system, which was the most problematic.

19:21 - So, when the patient fills out the questionnaire, it is linked with the hospital’s database. It doesn’t require special equipment, as you can see here. The medical staff in Seoul and the patient at our center communicate through video call for the medical examination. As I said before, nurses visited patients twice a day, and doctors once every two days. SNU Hospital at Hyehwa-dong managed our center in Mungyeong and the SNU Hospital in Bundang managed the one in Gyeonggi-do.

20:01 - Boramae Hospital managed the Taereung Athletes’ Village in Seoul, where we treated about 9,000 patients. We did a survey on the patients’ level of satisfaction, and we receive very high scores on a 5-point scale. This last slide shows the pros and cons. It was inevitably necessary to examine patients without seeing them in-person, which reduced the risk of infecting medical staff and saved some resources, but it was impossible to examine the patient when there was a problem, and we had some issues with security authentication through the web- based service. These issues need to be supplemented, and in actuality, when the patient showed symptoms, wore protective clothing and went into the room to examine and observe the patient. That is all from me. So, the questions we have for you are… The first question seems to be a common question for both Dr. Jee and Professor Lee.

21:12 - One of the biggest questions we have about this pandemic is whether China provided enough data to the WHO. What is your opinion? I’ll speak first, but I think Dr. Lee may have more to say because he actually went on the joint mission. When I saw the data released by China through the Emergency Committee, as I mentioned in my presentation, China released quite a lot of data. According to the IHR, the report needs to be made within 24 hours.

22:02 - People suspect that China made the report after the virus had already spread more than they admit, but I really can’t say. The information we received during the meeting was pretty well organized, and China said they did the best they can. It is difficult to judge how sooner they should have done this. There is a decision-making tree for deciding whether the situation should be reported to the WHO, but I think that it may take some time to be certain that a situation is relevant for reporting. From what I can say, the data I received was quite detailed. Dr.

Lee, what is your point of view as someone who actually went to China…? 23:06 - We can assess information in terms of how much information we need is included. If we look at the data from China, they seem to have been the same situation as we did, unable to collect epidemiological data until now. Because at that time, the diagnostic criteria for this disease was pneumonia. To diagnose pneumonia, you need to take the CT of the patient, and we didn’t have the PCR method in the early stages. China’s CDC announced the emergence of a new disease on January 8th, and about a week before that, on December 31st, I went to Wuhan and started investigating.

23:56 - According to the epidemiological data released by China CDC, the first patient was confirmed on December 8th, and then we have this wet market. Only half of the confirmed cases were suspected to have been infected at this wet market, and they weren’t sure of the other half. Where these people got it. So, what we know is, on December 8th when the first index case was reported, and a week later, an outbreak occurred due to group exposure. But this group exposure didn’t end in that one occasion, and the numbers increased rapidly as though there were multiple sources. There was a lot of controversy over the interpretation of this data, and we couldn’t come to a conclusion and said we will have another investigation later.

24:56 - Our main interest is how Wuhan locked itself down, and what measures China took after the Wuhan lockdown. We received a lot of information from China and discussed it, and the most helpful data from there led to the concept of the live- in treatment center. That is, we got the data on natural deaths. 80% of the patients were normally moderate, 5% were critical, and 15% were severe. In Korea, the numbers are a bit better, because we had the data on natural deaths which we applied to create the live-in treatment centers in Daegu.

25:47 - If we didn’t have this data, we probably would have been at a loss like Wuhan, and end up shutting down the whole country. Secondly, among the natural deaths at the early stages, why doesn’t the disease affect children? Why are there so many household infections? and why there are so many infections among medical staff? Through these questions, completely different responses made after Wuhan. Wuhan was shut down on January 23rd, after which the patients there were unable to move. The other cities in China had imported cases just like us. Concerning imported cases, the numbers usually stopped at around 1,000 to 1,500 people, since the disease was contained through isolation by running a fever clinic at designated hospitals.

26:47 - Seeing these numbers, we had thought that Korea would also contain the infection to about 1,500 to 2,000 people, but a completely unexpected variable of new patients was introduced, and we needed to find a way to deal with these new patients. Should we isolate and quarantine, then treat them as we did so far, or change our direction to focus on the critical and severe cases? Since Wuhan’s situation happened because China was unable to control the number of patients, we decided we will expedite the Wuhan model. For example, if we identify all the affected people within a week and quarantine them, we will be able to contain the spread. So, China’s data on natural deaths and the lab results and patient demographics related to natural deaths and why the infection rate is so high that it required a city-wide shut down, this was all quite a lot of useful data that we received from China. In the initial stages, we were unable to uncover how the people got infected and how the infection spread.

28:06 - There was a limitation to access, because once you go to Wuhan, you can’t come out. This was a problem, and who can go was also limited, so only a few of us went to Wuhan to investigate. We received a lot of information through video conferences, but the lack of transparency in the early stages, as I mentioned before, China was also constantly updating its diagnostic criteria, and didn’t know the symptomatic characteristics, so, I think we should separate the period before this disease was identified as a new infectious disease and the period after the diagnose was made and China gained the administrative capacity to collect data. I mean, they didn’t have the diagnostic capability at the beginning. So, everyone was diagnosed as pneumonia, and later, PCR was introduced.

28:58 - So, there was a lot of confusion in the information, and probably a lot of things happened because of this in the early stages. If you look at China’s diagnostic criteria, etc., I can see that they put in a lot of effort to create the data, and I think you have to give them that. I’m sure many government officials in China tried to prepare documents and respond to the situation, but from other countries’ viewpoint, it would’ve been better if China could’ve shared information more quickly and accurately. We went to China in mid-February, and it was only then that China CDC gave us the full data.

29:39 - Until then, we could only get information sporadically and piece by piece, but if we had the full data earlier, we may have been able to respond more effectively. We have a question for Dr. Jung Kisuck. You talked about the control tower, how it is difficult for the Director of KCDC to make demands to other ministries in terms of her position within the government organization. But at the same time, if the President takes the lead, things can go in unexpected directions like you see in the US or Japan. Can you share your opinions on how the KCDC director or someone can become the control tower, and how the KCDC can implement measures based on scientific data in its cooperation with other ministries? I’ll just briefly express my long-held thoughts on this topic. Rank is everything in civil service organizations.

30:39 - So, to be a proper control tower, we need something like making a temporary vice-president of disease control, to exert power, and not just talk about it. You remember what happened during MERS? The government raised the status of the office to an Agency for Disease Management and Control, and told me that I was being appointed as vice-minister, but when I got there, it was just a name with no practical power. I’m pretty old and I know people, so I was able to do things using my network, but the government didn’t give us a budget or the manpower. If you want to do this properly, a special agency needs to be made or create a Department of Health that more than 50% of the countries worldwide have to establish a detached, independent agency, this problem will not be resolved. How can a vice-minister dare to deter the deputy prime minister from reopening schools? Especially when the vice-minister position is pretty much a fake one? Here’s a question for Dr. Park Hongjoon.

31:39 - It can be said that the voluntary assistance from the medical staff played a decisive role in calming down the situation in Korea. Now, the medical practitioners and hospitals probably faced some serious economic losses because of this. Were there any talks from the government about how it can supplement this? Or was this all purely voluntary? Talks with the government is currently ongoing. There’s always a temperature different between the government’s point of view and those of the medical practitioners, and it is questionable whether any such support will be effective at all. But what comes before all this is the deep-rooted instinct doctors have.

32:29 - When we think that the people’s health is in great danger, many doctors will actually run to the field without a moment’s thought. When an outbreak occured in Seoul, in Itaewon, the doctors in each district went there voluntarily, even if they face terrible losses should they get infected, so that they could help out in this difficult situation. This crisis showed us that, of course, public health care is important, but private health care can also help overcome this difficult situation when we coordinate well with public health authorities. We need to promote this more, because this was the first wave, and we are expecting the second wave soon, and are preparing for it in many ways, right? It is in these times that the government and the private medical industry, that is, the KMA, should forge a better partnership and coordinate strategies to build a more proactive response system. They say that infectious diseases emerge every 4 or 5 years, and I think this can be a good way to prepare our nation. Thank you. Here’s a question for Dr. Jeong.

33:56 - Records show that about 9,000 people were treated at the Mungyeong live-in treatment center. How many medical personnel were actually dispatched to the Mungyeong center? And how much manpower do you think you would have needed if you didn’t use this remote examination system? Actually, remote examination doesn’t really help that much with reducing the number of staff. It helps us save the resources that go into coming and going. In fact, I think we put in more time, and more hours of work put in by doctors and the medical staff. Two medical specialists have been dispatched to Mungyeong to stay there full-time, We received two public health doctors initially, which was later reduced to one.

34:49 - There is always more than one person in the monitoring room at the SNU Hospital in Seoul, and we needed to provide a lot of psychological and mental support to the patients. A lot of young patients come to the center, isolated alone, so psychiatrists were there to support them. So this system is more geared toward improving patients’ accessibility rather than improving the efficiency of the hospital. It doesn’t seem like the hospital saves resources and gains efficiency. Got it. We have some questions from our online viewers. Please show them on the screen. Let’s take a look at the questions.

35:43 - A lot of COVID-19 tests are being done – how do we manage the costs? Are there any medical resources to prepare in advance for the next wave? Are mathematical prediction models helpful or not? This third question can maybe be dealt with next time, since, in fact, Seoul National University is working on various data- driven prediction models. So, let’s focus on the first two questions. How are we managing the costs? According to the Infectious Disease Prevention Act, for Type 4 infectious diseases, which are no Class 1, the government must cover the costs. Because the government enforced measures to get people tested based on its judgement, most of the cost burden falls on the government. However, the copayment part is covered by the government, and by insurance.

36:53 - So, in fact, most of the tests are paid for by the government and insurance without copayment. To add to this, the National Health Insurance is responsible for 60%, and the Disaster Fund for 40%. That is, individuals don’t need to pay the costs. The second question is a bit ambiguous, and I’m not sure whether this is asking about the system or some method, but I think it’s asking whether we have a system prepared to deal with a sudden increase of patients? Since the Biological Terrorism Act of 2000, the government has been stockpiling necessary drugs in preparation. So, we have stockpiled Tamiflu and various antibiotics, and after MERS, we have stockpile for PPE.

38:08 - Other than that, we haven’t been stockpiling ventilators and such like the US, but I think we are moving in the direction of doing so in case of emergencies. Let’s go to the next slide. The most important factor behind Taiwan’s success in this pandemic, Sweden’s collective immunity strategy, and whether we have any other method than social distancing in the absence of vaccines or cures. I think the first question has already been dealt with a lot, and for the second question, Sweden says that they did try to build collective immunity even though this is what is happening. Would anyone like to talk about this? Well, as you know, we won over influenza through collective immunity in 2009 to 2010. The R0 value was 1.45 to 1.5, so the goal was to vaccinate 30-33% of the population, and after considering efficiency, 24 million vaccines were prepared and administered to toddlers first to eradicate influenza.

39:35 - Collective immunity is a strategy used when immune antibodies are reported to have clearly generated, but we are yet unsure whether we can realize collective immunity for COVID-19. Even if collective immunity is formed, the problem remains that it is difficult to protect people selectively. The reason why we see Sweden’s case as a failure is that infections spread at elderly welfare facilities or nursing homes which led to a lot of fatalities. Actually, considering Korea has not enforced a shut down, what we are doing additionally and with success is probably contact tracking and isolation, and I don’t think we’re much different in the level of social distancing, etc. It is still very dangerous to try and form collective immunity for this disease.

40:41 - We don’t know who will get infected, and we can’t decide, and there is a possibility that a lot of people will get infected. 20% will show severe symptoms and 5% will be critical, and as I see it, there will be too many patients than we can cope with. So, the current contact tracking and isolation measures are the most effective at this time, but the concern is whether it is sustainable or not, and how long we can and should continue this. We need to put a lot of thought into this. In the situation where there is no cure and vaccine, we need to consider how long and at what scale this can be carried out and, in the process, establish a new normal and social distancing, or new model.

41:38 - If we are able to establish a new model, I think our current method is a little safer than relying on herd immnunity. The third question asks whether there any other method besides being vigilant about personal hygiene or social distancing, but there doesn’t seem to be a clear solution as of yet. Let me expand this question a bit to ask how long it will take for a vaccine or cure to be developed. Dr. Jung or Dr. Jee, any predictions? In the US, Dr. Anthony Fauci has expressed optimism that something will be developed within the year, but even if everything goes smoothly and something is developed, the time it takes to get approved and actually used… Everyone in the world needs it, but how evenly will it be distributed? We have the development stage issues, and then in the production and distribution stages, We have the development stage issues, and then in the production and distribution stages, Because it’s another thing to get to the distribution stage and have everyone benefit equally. I think it’s a very difficult problem, so right now, in fact, what is most important is for Korea to development something ourselves.

43:21 - But we haven’t made a lot of progress in this area yet, so it’s hard to be optimistic. But there are a lot of options in terms vaccines as well as treatments, and developers are repositioning them and trying different things, and I think these efforts will help us to treat patients better pretty soon. Dr. Jung, any thoughts? Okay, then let’s move on to the next questions. Would it cause a human rights issue if the Korean model becomes an international standard? I think this will be covered in the second session, so it would be a good idea to ask this then. What are our main achievements that the world should know about? The people and the medical staff are becoming tired as the situation prolongs, and the viewer is curious as to what kind of discussion is taking place. Dr. Park or Dr.

Jeong? 44:35 - The medical industry is suffering overall, in primary care, secondary care, and even hospital levels. Yesterday and today, we keep hearing news about new cases at high- level comprehensive hospitals. I don’t think this is a problem that the medical community itself can solve, but something that society, the whole country, and the people as a whole should take interest and cooperate. The KMA is also discussing about this problem, how we cannot let a nationwide pandemic to collapse our medical industry, and what we should do in the fall and winter when all of this can start over again. What should the medical community do for patients with continuous respiratory symptoms and fever? Should all we can do be telling them to stay home for 3-4 days if they have a fever? We are discussing this both realistically and from the medical perspective.

45:47 - To this end, we created several committees, and sending out messages to the citizens. We are working hard with the government to come up with a good plan as soon as possible. Dr. Jeong? Well, exhaustion and such are actually pretty well-accepted by doctors and medical staff, because they have a responsibility and a high sense of duty to society. I think this pandemic has significantly increased the public trust, etc. in medical practitioners. And at our hospital also, we received a lot of donations, such as presents for our medical staff and employees, and we receive quite a lot of support and encouragement.

46:44 - We hope to work harder to deal with what awaits us. The question in the middle: what did we do well that you want the world to know about? Can anyone answer this in 30 seconds? Yes… I think everyone here will agree with me here. The fact that we quickly established a diagnostic system. We worked with the Ministry of Food and Drugs to expedite the emergency usage approval and to produce the kits quickly, which helped us to build a nationwide network for screening and testing at an early stage. People are saying that the US is testing more people than us now, but the fact is that it’s already too late.

47:50 - In my view, establishing this system early on was the key to our success. There are many more questions from the audience and viewers, to which I am sure our experts can provide insightful answers, but since we need to end this forum on time, we will end Session 1 here. .