Institutional preparedness for infectious diseases and improving care

The experience of the 2015 Middle East respiratory syndrome outbreak in the Republic of Korea showed greater impact on healthcare institutions as compared to the previous epidemic in the Middle East in 2012. However, the Middle East respiratory syndrome coronavirus was biologically identical to that of 2012, without evidence of a mutation that would account for increased transmissibility. Due to the higher population density of Korea and lower medical costs, Korean hospitals are usually crowded with high numbers of both inpatients and outpatients, who function as a reservoir for intra-hospital transmission. The fact that the patient referral system between smaller and larger hospitals is very active and efficient in Korea was one reason for high inter-hospital propagation of the Middle East respiratory syndrome outbreak. To prepare for a future epidemic in Korea, an improved contact tracing policy, improved public hospital facilities for critical care of severe infections, and pre-emptive isolation for unknown respiratory infections should be emphasized.