2020년 10월 23일 금요일

Swimming in the pool with COVID-19

The office setup was simple. Other than desks and chairs, all that was in the room was a water purifier and a box of instant coffee. It seemed like not many things were needed for a temporary office. A low divider was set up between desks on which a monitor was placed. At first glance, the office looked like a call center, but a large monitor mounted on the wall at the back of the office hinted that this was not a typical call center. The status board listed occupied room numbers, patients names, and their ages. This ward was different from other hospitals where as most of the rooms were designed for one patient, not a group. Also, the patient rooms were 112 miles from the main office of the medical team.

The facility called “Life Treatment Center” which is located in Mungyeong, Geongsangbuk-do Province, was designed for mild patients who do not need to be hospitalized. Except for a few family rooms, all the rooms were prepared for a single patient with the purpose of quarantine in mind. The original purpose of the building was for the hospitals employee training, so I had also stayed in the building a few times to attend workshops. Staring at the status board, I remembered the structure of the room that I was familiar with. Two single beds, a desk, a small wall mounted TV, a refrigerator, and a bathroom with a shower. It was a tiny room that could be found in any cheap resort. One of two beds must be empty at all times because only one patient can stay in each room at any given time. Every patient was usually required to stay in the room for at least 2 weeks.

After patients in Mungyeong check body temperature themselves twice a day and record symptoms, a medical team based in Seoul reviews the records and provides medical consultation. Some cases need treatment from the division of infectious diseases and Psychiatry. All consultations and treatments are provided remotely through a video call from the central monitoring center in Seoul. Another medical team dispatched to Mungeyong performs tests including a blood test, a corona virus PCR, and a chest X-ray and handles problems that happen to the patients. The field team works closely with the medical team in Seoul to decide who can check out and who needs further treatment.

Two doctors and ten nurses resided in the central monitoring center in our hospital. Everyone is given a combination of their job title and a unique number like Doctor 1 or Nurse 5 to use on the messenger app downloaded on their work phone. The combinations are taken by different people as various departments take turns working at the center. I was entitled “Doctor 1” four days ago, but this afternoon I’m “Doctor 2”. In the earlier stages, all medical teams found it challenging to adapt to the new setup but it has gotten much easier as a month has passed and the number of confirmed cases has decreased. According to the status board, today’s total inpatient number was 63. There was no appointment scheduled for Doctor 2 in the afternoon so I was supposed to stay in my seat answering inquiries that come in occasionally. 

“Oh no, that must be frustrating.”

It sounded like someone in the nurse room was comforting a child. Probably a patient was complaining during the afternoon regular consultation. Being stuck in a tiny room for two weeks or more can’t be an easy thing. Being quarantined in the tiny room alone can give people a headache that they have never experienced, or even a single dry cough can frighten them. Therefore, it is equally important for a medical team to understand the anxiety patients can experience and to empathize with them to help them stay calm and not panic. Some patients who experience serious anxiety and depression get psychological counseling as well. Even if the process of identifying patients' condition through a video call or a phone call was challenging, all our nurses were doing a great job.

“Doctor, I heard the test result of positive this morning. When is the next test?”

It was towards the end of my shift when I got the inquiry from a patient. I checked the name on the messenger and checked the medical history. It was a young lady. She was admitted on the first day of opening the center so it has been more than a month. Patients regularly get a PCR test and they can check out only if they test negative twice in a row. The patient tested negative in mid March but after four days she tested positive so her check-out was postponed. The next test was negative but after that, the latest test turned out positive again. She got that result this morning. I messaged her that the next test will be in four days, and she replied quickly with thank you. The brief message made my heart heavy. She had been tested ten times by now. It is probably very depressing to get tested positive from negative twice. She was probably thinking that she can go back home soon, sit around the table with her family and eat dinner, and walk on the street with her friends with coffee in one hand.

I had reminded me of the time when I learned to swim for the first time. I felt like I’m the only one remaining in the same spot when everyone else in the pool was moving forward. In order to pass the beginner class I had to be able to swim to the end of the lane without stopping but once I was in the water that seemed impossible. I estimated the remaining distance floating in the water looking down the blue tiles at the bottom of the pool. I could reach the end after three drains. Passing the first drain was easy, the second was tough, and I got out of breath before reaching the third drain and gave up. Even if I kicked as hard as I could until I got a cramp, my body didn’t move as I had intended. The patient was smiling in the profile photo of the messenger. For the past month, she might have been feeling the same as I did in the pool. Probably hopes crumbled as test results turn out to be the opposite of what she wanted. Spring has arrived but the world is moving on as if her existence is completed removed.

The central monitoring center was closed after 36 days of operations. Total 118 patients stayed at the center during that period. A few patients who have to remain will be soon relocated to another center. When the center was closed, even if I worked there only a handful of times, I wanted to check the list of patients who remained. Her name was there. I just hoped that she can reach the end of the lane not too far from now. I was hoping that she doesn’t stop kicking until then.


(Telemedicine is illegal in Korea, but it is temporarily allowed during the covid-19 epidemic. It was March, 2020 when the Seoul National University Hospital operated the Life Treatment Center in Mungeyong. The number of patients in Korea decreased over time and the daily cases stayed around 50 for four months. However, since August, new confirmed cases started increasing drastically and we opened two new centers in the suburbs of Seoul. We haven’t reached the end of the lane yet.)