Updates on COVID-19 in Republic of Korea

20 June, 2020

□ As of 0:00, 20 June 2020, the total number of confirmed cases is 12,373 (including 1,427 imported cases), of which 10,856 cases have been discharged from isolation. Newly confirmed cases are 67 in total.

* Figures may change based on findings from ongoing local epidemiological investigation efforts.

○ As of 0:00 20 June, there are 31 imported cases, of which 3 are from Americas, 28 are from Asia excluding China (16 from Pakistan, 7 from Bangladesh, 2 from Indonesia, 1 from the Philippines, 1 from Kazakhstan, and 1 from India).

□ As of 12:00 20 June, confirmed cases and their chain of transmissions are as below.

* Figures may differ from table 1 due to difference in data collection time.

○ Related to Richway in Gwangak-gu, Seoul, 6 additional cases were confirmed. The new cases were contacts under quarantine. In total, 193* cases have been confirmed.

* Visitors = 41; Contacts = 152 / Seoul = 107; Gyeonggi = 56; Incheon = 24; Gangwon = 3; Chungnam = 3

○ Related to the sport facility in Yangcheon-gu, Seoul, 1 additional case was confirmed. The new case was a contact under self-quarantine. In total, 70* cases have been confirmed.

* Table tennis facility related = 41; Yongin Big Tree church related = 29

○ Related to Sungsim Day Care Center in Dobong-gu, Seoul, 2 additional cases were confirmed under contact management. In total, 42* cases have been confirmed.

* Users = 24; Staff/workers = 5; Family and others = 13

○ Related to Great Nature Korea located in Guro-gu, Seoul, 4 additional cases were additionally confirmed as a result of epidemiological investigation which was linked to a case confirmed on 9 June. This confirmed case visited Great Nature Korea. Investigation on chain of transmission and contact testing are underway.

○ Related to a rice polishing machinery company at Geomchun-gu, Seoul, 4 additional cases were confirmed as a result of epidemiological investigation. In total, 13 cases were confirmed.

○ Related to Lotte Confectionery Logistics at Uiwang-si, Gyeonggi Province, 10 additional cases were confirmed who were under contact management. In total, 15* cases were confirmed.

○ Related to door-to-door sales* in Goejeong-dong, Seo-gu, Daejeon City, 16 additional cases were confirmed. In total, 40** cases have been confirmed.

□ As a result of recent increase of imported cases, KCDC participated in a meeting with relevant authorities today (20 June) in order to put together a strategy to strengthen special entry measures for inbound travelers.

□ KCDC also stated that the last 2 weeks of chain of transmission showed the spread of COVID-19 into non-metropolitan areas such as Daejeon city and Jeonbuk province through various routes such as restaurants, religious groups, and door-to-door sales. As the situation is getting worse with a possibility of national outbreak, KCDC asked the public to take special attention during the weekend.

(exclu. imported cases)>

* Figures may change based on findings from ongoing local epidemiological investigation efforts.

○ As a result of epidemiological investigations of a confirmed case from Jeonju Girls' High School, Jeonju city, Jeollabuk Province, it was confirmed that the routes overlap at the restaurant in Jeonju on the 12 June with two confirmed cases related to door-to-door sales from Daejeon city. Taking into the consideration of transmission within a restaurant in the past cases*, investigation is underway with the possibility of a transmission.

* A case which 6 out of 7 people being confirmed after dining together as 2 groups sitting next to each other at a pub located in Gangnam-gu, Seoul (Daedong House, Bongeunsa-ro, Gangnam-gu), around 22:00~24:00 on the 5 June

- KCDC asked everyone to observe the distancing in daily life guidelines such as reducing unnecessary meetings and refrain from using restaurants when symptoms occur, since the risk of transmission is high within the restaurants due to its nature which makes people eat and talk without wearing facemasks in a dense and confined environment.

○ As a result of analyzing the cases of patients in Daejeon area, from mid-June to this week, middle-aged businessmen spread COVID-19 to acquaintances and general users through meetings at business briefings, cafeterias, cafes, churches, beauty salons, and saunas. By region, it spread into Daejeon, Sejong, Gyeryong, Gongju, Nonsan, Chungju, Jeonju, and Seoul Metropolitan Area. As the risk of transmission is high,

- KCDC encouraged everyone to keep the distancing in daily life guidelines when using crowded facilities, and for the citizens of Daejeon and Chungcheong Province, KCDC urged for them to visit screening clinics if there have fever and respiratory symptoms and used a facility which was visited by confirmed cases.

- Particularly over the weekend, KCDC asked people to hold religious gatherings non-face-to-face methods and cancel or postpone small group gatherings as they are often in a concentrated place and having conversations, singing hymns, sharing meals, can cause the droplets to spread the virus.

- If on-site workship in Inevitable, KCDC asked to reduce the size of participants to maintain the distance, check fever and suspicious symptoms, make people wash hands and wear facemasks. KCDC also asked not to provide meals and conducting of activities that may cause splashes of droplets (singing, shouting, etc.).

○ Although the percentage of elderly confirmed cases aged 60 years and above have decreased (40.2%→ 31.9%, ▴8.3%p), from the last week (6.7~6.13), it still remains as a high proportion. Therefore, KCDC especially asked senior citizens to take precautions as a high-risk group that is likely to lead to severe cases when confirmed.

< Age distribution of confirmed cases in the last 4 weeks >

- They should avoid meetings in places without windows or with poor ventilation, and refrain from going out or to a meeting as much as possible.

- If such an occasion is unavoidable, activities which causes droplets to splash such as eating and singing should be refrained. Masks should be worn and frequent hand washing or sanitizing should be practiced.

- KCDC advised elderly people to take good care their chronic medical conditions. They are encouraged to utilize over-the-phone consultations for not to miss necessary consultations, to take prescribed pills, and to wear a facemask when visiting a clinic or a hospital.

- They are also asked to take regular exercises, including light home exercises and stretching as well as taking a walk regularly at places and times with less foot traffic outside.

○ Since COVID-19 outbreak can occur in any confined, crowded, and close-contact environment, KCDC asked citizens to postpone gatherings such as social club meetings and religious small groups, and refrain from visiting nightlife facilities, bars, karaoke, and PC cafes. KCDC also asked people to practice hand washing, mask wearing, and 2 meter distancing.

□ The Korea National Institute of Health have identified the causes of vulnerability for patients with stroke, diabetes and smokers which led to severe cases once confirmed with COVID-19.

○ Since COVID-19 virus binds its spike protein to Angiotensin-Converting Enzyme (ACE2*) and penetrates into cells and proliferates, patients with more ACE2 can be at a higher risk than those who do not.

- In addition, the ACE2 on the cell surface decreases during the intercellular infiltration process of the COVID-19 virus, which increases the angiotensin 2 and leads to an increase in blood pressure, which then increases the likelihood of progression to severe symptoms.

- Cigarette smoke, stroke, and diabetes cause an increase in ACE2, the receptor of COVID-19 in a cell, which increases the likelihood of severe progression of a person with above underlying illness when infected with COVID-19.

- Therefore, smokers and people with underlying diseases such as diabetes and stroke need to take extra precautions to preventive measures such as stop smoking, and practicing social distancing guidelines to prevent COVID-19.

[Figure 3: Daily new confirmed cases by chain of transmission]

TOTAL

Seoul City

Incheon City

Gyeonggi Province

Gyeongbuk Province

[Table 5: Age distribution of severe cases]

[Figure 4: New cases (for last 2 weeks) by chain of transmission]