As the coronavirus disease 2019 outbreak is ongoing, the number of individuals to be tested for COVID-19 is rapidly increasing. For safe and efficient screening for COVID-19, drive-through (DT) screening centers have been designed and implemented in Korea. Herein, we present the overall concept, advantages, and limitations of the COVID-19 DT screening centers. The steps of the DT centers include registration, examination, specimen collection, and instructions. The entire service takes about 10 minutes for one testee without leaving his or her cars. Increased testing capacity over 100 tests per day and prevention of cross-infection between testees in the waiting space are the major advantages, while protection of staff from the outdoor atmosphere is challenging. It could be implemented in other countries to cope with the global COVID-19 outbreak and transformed according to their own situations.A pandemic of an emerging infectious disease has similarity with bioterrorism in that both are disasters caused by infectious diseases and require safe and efficient use of resources. As of March 2020, the outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is progressing to pandemic level despite global effort for containment, involving 101 countries with more than 100,000 confirmed cases. 1 With an increasing number of suspected and/or symptomatic individuals to be tested for COVID-19, 2 there has been a need for a safe and efficient screening system. For this purpose, drive-through (DT) screening centers have been designed and implemented in Korea, based on the previous concepts of point of dispensing for bioterrorism and DT clinic for pandemic influenza. 3,4 Herein, we introduce DT screening centers for COVID-19 and share our experience with healthcare authorities and providers all over the world.

Background As the coronavirus disease 2019 (COVID-19) pandemic continues to progress, awareness about its long-term impacts has been growing. To date, studies on the long-term course of symptoms, factors associated with persistent symptoms, and quality of life after 12 months since recovery from acute COVID-19 have been limited. Methods A prospective online survey (First: September 8, 2020–September 10, 2020; Second: May 26, 2021–June 1, 2021) was conducted on recovered patients who were previously diagnosed with COVID-19 between February 13, 2020 and March 13, 2020 at Kyungpook National University Hospital. Responders aged between 17 and 70 years were included in the study. Overall, 900 and 241 responders were followed up at 6 and 12 months after recovery from COVID-19 in the first and second surveys, respectively. Clinical characteristics, self-reported persistent symptoms, and EuroQol-5-dimension (EQ5D) index score were investigated for evaluating quality of life. Results The median period from the date of the first symptom onset or COVID-19 diagnosis to the time of the survey was 454 (interquartile range [IQR] 451–458) days. The median age of the responders was 37 (IQR 26.0–51.0) years, and 164 (68.0%) responders were women. Altogether, 11 (4.6%) responders were asymptomatic, and 194 (80.5%), 30 (12.4%), and 6 (2.5%) responders had mild, moderate, and severe illness, respectively. Overall, 127 (52.7%) responders still experienced COVID-19-related persistent symptoms and 12 (5.0%) were receiving outpatient treatment for such symptoms. The main symptoms were difficulty in concentration, cognitive dysfunction, amnesia, depression, fatigue, and anxiety. Considering the EQ5D index scores, only 59.3% of the responders did not have anxiety or depression. Older age, female sex, and disease severity were identified as risk factors for persistent neuropsychiatric symptoms. Conclusion COVID-19-related persistent symptoms improved over time; however, neurological symptoms can last longer than other symptoms. Continuous careful observation of symptom improvement and multidisciplinary integrated research on recovered COVID-19 patients are required.

In addition to being the prime factor associated with amputation, diabetic foot infections (DFIs) are associated with major morbidity, increasing mortality, and reduced quality of life. The choice of appropriate antibiotics is very important in order to reduce treatment failure, antimicrobial resistance, adverse events, and costs. We reviewed articles on microbiology and antimicrobial therapy and discuss antibiotic selection in Korean patients with DFIs. Similar to Western countries, Staphylococcus aureus is the most common pathogen, with Streptococcus, Enterococcus, Enterobacteriaceae and Pseudomonas also prevalent in Korea. It is recommended that antibiotics are not prescribed for clinically uninfected wounds and that empirical antibiotics be selected based on the clinical features, disease severity, and local antimicrobial resistance patterns. Narrow-spectrum oral antibiotics can be administered for mild infections and broad-spectrum parenteral antibiotics should be administered for some moderate and severe infections. In cases with risk factors for methicillin-resistant S. aureus or Pseudomonas, empirical antibiotics to cover each pathogen should be considered. The Health Insurance Review and Assessment Service standards should also be considered when choosing empirical antibiotics. In Korea, nationwide studies need to be conducted and DFI guidelines should be developed.

Background During the coronavirus disease 2019 (COVID-19) pandemic, health care workers (HCWs) have faced multiple physical and psychological challenges while carrying out their duties. In this study, we examined the experiences of specific groups of HCWs during the pandemic. Methods From 18 November to 30 December 2020, we conducted a qualitative study using semi-structured, face-to-face interviews with four groups of 14 HCWs in three cities (Seoul, Daegu, and Gwangju) in South Korea. The HCWs who participated in the focus groups included physicians, nurses, medical practitioners, and cleaning staff who directly or indirectly cared for patients during the COVID-19 epidemic. Interviews were transcribed verbatim and analyzed using the consensual qualitative research approach. Results Our qualitative data analysis revealed four main domains: work-related struggles, personal life-related struggles, psychological stress, and health-related struggles. Health care providers were challenged by working in critical situations and were overwhelmed by heavy workloads, fear of infection, lifestyle changes, and psychological and physical struggles. Conclusion Our findings could serve as a foundation for establishing health care systems and policies that help HCWs cope with occupational stress, thus increasing their ability to adapt to the ongoing COVID-19 pandemic.

Introduction: We experienced an emergency room (ER) shutdown related to an accidental exposure to a patient with COVID-19 who had not been isolated. To prevent in-hospital transmission of the disease, we subsequently isolated patients with suspected symptoms, relevant radiographic findings, or epidemiology. The SARS-CoV-2 reverse-transcriptase polymerase chain reaction was performed in most patients requiring hospitalization. Universal mask policy and comprehensive use of personal protective equipment (PPE) were implemented. Materials and Methods: The effect of the interventions was analyzed in a 635-bed, tertiary-care hospital in Daegu, South Korea. Results: From the pre-shutdown (February 10 to 25) to the post-shutdown (February 28 to March 16, 2020) period, the mean hourly turnaround time (23:31±6:43 versus 9:27±3:41, P<0.001) was shortened, which increased the proportions of the patients tested (5.8% [N=1,037] versus 64.6% [N=690], P<0.001) and the average number of tests per day (3.8±4.3 versus 24.7±5.0, P<0.001). All 23 patients with COVID-19 in the post-shutdown period were isolated in the ER without any problematic accidental exposure or in-hospital transmission. From the pre- to the post-shutdown period, the median duration of stay in the ER among hospitalized patients (4:30 hr [2:17-9:48] versus 14:33 hr (6:55-24:50), P<0.001), rates of intensive care unit admissions (1.4% versus 2.9%, P=0.023), and mortality (0.9% versus 3.0%, P=0.001) increased. Conclusions: Problematic accidental exposure and in-hospital transmission of COVID-19 can be successfully prevented through active isolation and surveillance policy and comprehensive PPE use despite longer ER stays and the presence of more severely ill patients during an explosive COVID-19 outbreak.