Explainer: What could be behind the surge in South Korea's Covid-19 cases? A secretive sect and Patient 31

SINGAPORE — South Korea reported 334 new cases of the Covid-19 disease on Thursday (Feb 27) morning, the largest jump in the number of newly diagnosed patients in the country since its first was confirmed on Jan 20. 

Hours later on Thursday afternoon, another 171 cases were reported, raising the total tally to 1,766, the Korea Centers for Disease Control & Prevention (KCDC) said.

Up until Feb 19 last week, the number of confirmed cases hovered below 100, but it skyrocketed from Feb 20 onwards to where it is now.

Coming under the spotlight and linked closely to the outbreak in South Korea is the Shincheonji Church of Jesus, the Temple of the Tabernacle of the Testimony — a secretive sect that claims to be Christian and is based in Daegu city where around 64 per cent of the country’s infections have sprung. 

How did the coronavirus that causes severe acute respiratory symptoms such as pneumonia get out of control so quickly in South Korea, claiming 13 lives so far in the country?  

CHURCH OF ‘NEW HEAVEN AND EARTH’

At present, the bulk of the cases are from Daegu city, which is home to some 2.4 million residents — of which 1,132 have been sickened by the virus as of Thursday afternoon.

The city, located in the North Gyeongsang province, is also the base of operations for the Shincheonji church. Shincheonji means "new heaven and earth" in Korean.

American news channel CNN reported on Thursday that the South Korean authorities believe a large number of cases in the country attended a service at Shincheonji church or have been in contact with attendees.

British newspaper The Guardian reported that more than six in 10 of the people infected are linked to the church. 

PATIENT 31 AND HER MOVEMENTS

The Shincheonji cluster began with Patient 31, a 61-year-old woman who developed a fever on Feb 10 and went to at least four services in Daegu before being diagnosed, news agency AFP reported.

Several media reports said that the woman did not get herself tested for the coronavirus because she had not travelled overseas and simply thought that she had caught the common cold.

During the course of two weekends, she came into contact with more than 1,000 churchgoers.

Detailing the chronology of events involving Patient 31, Bloomberg reported that she first checked into the Saeronan Chinese Medicine Hospital on Feb 7 due to headaches after being involved in a car accident the day before.

The hospital said that at the time, she did not have any fever, cough or respiratory symptoms.

On her third day in the hospital, she developed a fever and went for a flu test, which came back negative.

KCDC said that she left the hospital on Feb 10 for two hours to attend a morning service at Shincheonji church.

South Korea’s health authorities also said that she had lunch with a friend at a hotel in eastern Daegu on Feb 15 and attended another worship service at Shincheonji on Feb 16.

It is common in South Korea for hospital patients to come and go, and they have even been seen venturing out while wearing hospital garb and wheeling intravenous drips alongside them, Bloomberg reported.

On Feb 17, Patient 31 was finally confirmed to have Covid-19. That day, her condition worsened and a scan showed she had signs of pneumonia. This prompted the doctors to test her for the coronavirus.

ILLNESS ‘NOT VALID REASON’ FOR MISSING SERVICE

A former member of the Shincheonji church told CNN that illness was “never accepted as a valid reason to miss services”.

Attendance was monitored through a roll call, and churchgoers would have to use a special card to swipe in and out of the venue.

The number of confirmed cases started multiplying exponentially shortly after Patient 31 was diagnosed and shot past 1,000 by Wednesday, which prompted the government to raise its health alert to the highest level.

Health officials in South Korea still do not know how she was infected and how she spread the virus to fellow Shincheonji members.

Professor Kim Chang-yup, who researches on health policy at Seoul National University, told Bloomberg that what made the case worse was that Patient 31 spent a considerable amount of time in a crowded areas.

Followers in the sect would sit on the floor "packed together like sardines” during services that last hours, CNN reported.

Various media reports have pointed to the church’s connection to the city of Wuhan, the epicentre of the virus outbreak in China.

Shincheonji members held meetings in Wuhan until December, stopping only when they realised that their community in South Korea had been hit by Covid-19, Hong Kong daily South China Morning Post reported.

A FUNERAL AND A HOSPITAL 

The South Korean authorities are also trying to determine whether Patient 31 is connected to an outbreak at another hospital outside Daegu, where a funeral for the brother of the sect’s leader was held earlier this month.

AFP reported that between Jan 31 and Feb 2, an unknown number of members came together for the funeral, which was said to have been held at Cheongdo Daenam Hospital.

The hospital is the second hot spot for the virus within South Korea, with at least 114 cases. More than half of the fatalities in the country are linked to the hospital.

Shincheonji members are known for proselytising in secret and not revealing their identities, which makes it hard for people to know if they have been in contact with a member, AFP reported.

However, mounting public anger has forced the church to hand over a list of 212,000 members to the authorities to enable them to be checked for Covid-19 symptoms.

Previously, the church had boasted that it had more than 240,000 members, raising doubts over the accuracy of the roster.

Despite the large number of cases in Daegu city and Cheongdo county, the South Korean government has yet to forcibly control the movement of people from these areas or ban visitors from China, the New York Times reported.

From Wednesday, Singapore has imposed restrictions on new visitors who have travelled to Cheongdo county or Daegu city in the past 14 days.

This means that travellers from the two places will not be allowed to enter or transit through Singapore.