Although South Korea’s response to COVID-19 has received international praise, the nation’s public health policy raises numerous privacy concerns, with a growing number of civil society groups joining the conversation. Following changes to public health law in 2015 in response to the MERS (Middle Eastern Respiratory Syndrome) crisis, South Korea’s KCDC (Center for Disease Control) reconfigured its enforcement practice with measures tied to the movements of infected patients. New laws allow for the use of information communications technology and personal data (cell phone, CCTV, credit card transactions) to track patients, thereby identifying the possible routes of transmission for disease. Through mid-April 2020, this system received extensive praise, but more recently, with the “Itaewon Cluster,” centered in a popular nightclub district, citizens are starting to raise concerns. Itaewon is associated with prostitution due to its legacy of proximity to an American military base, and by extension, the presence of foreigners in general, including LGBT clubs. While contact tracing promises to preserve the anonymity of data, the significant rise in case numbers since May 2020 has resulted in calls for targeting these groups—foreigners, LGBT, English teachers—suggesting that xenophobia and social stigma continue to represent powerful forces.
1 Embracing the Data (2020)
Although considerable debate remains as to the etiology of the COVID-19 outbreak, there has been a fair degree of consensus regarding the approaches taken by certain nations with respect to treatment policy, with positive attention associated primarily with the nations of East (Taiwan, South Korea) and Southeast Asia (Vietnam). Regrettably, many of the accounts appearing early in 2020 tended to rely on broad cultural explanations—including generic labels such as “Confucian,” “authoritarian,” and “conformity”—to explain a diverse set of complicated historical developments, specific to regions and nation-states with distinct historical trajectories (Escobar 2020).1 As time has passed, these accounts have provided room for more measured takes, and more importantly, for raising a set of critical questions, seeking to understand matters at a deeper level.
This brief intervention will take up the case of South Korea, and while recognizing the extensive praise the nation has received to date, I offer a series of questions to juxtapose against this perceived success, arguing that the majority of English-language accounts fail to capture the complex social tensions present within Korean society—whether in terms of region, class, religious affiliation, or sexual orientation. With its reliance on extensive “contact tracing,” South Korea has indeed achieved results worthy of praise in containing COVID-19, but it has done so while raising a cluster of privacy concerns that have yet to be addressed. Specifically, recent changes to Korean public health law took effect in 2015, and the present situation has been the first context to emerge as a field trial. The Korean public health system derives its core practices from the period of nation building (1948–present), along with participation in the Korean (1950–53) and Vietnam Wars (1964–73), and has been extending medical aid to its partners since the late 1960s (DiMoia 2013).2
2 The MERS Precedent (May–June 2015)
The MERS (Middle East Respiratory Syndrome) outbreak (Fig. 1) provided South Korea with its immediate source of motivation, unlike SARS (Severe Acute Respiratory Syndrome), which was arguably far more important for a number of East and Southeast Asian neighbors (Hong Kong, Singapore, Taiwan).3 The largest outbreak of MERS outside its original context, the Korean MERS outbreak began in the late spring and early summer of 2015, roughly three years after the original set of cases (Choe 2015b). Linked to a small set of business travelers returning home from the Middle East, the critical development relates to the movement of these individuals, especially their activities upon entering health care facilities.
The first set of patients had vaguely defined symptoms, and experienced difficulty getting treatment, as Korean doctors and nurses had not previously observed such cases. There was no formal quarantine regime at this time, although there were some informal protocols, especially for those with symptoms such as a fever/high temperature. Seeking better advice, those included among the first group of patients tended to consult with several different health care facilities within a short time, especially with prominent sites such as the Samsung Medical Center (SMC) (Choe 2015b). While understandable, this behavior likely spread the virus throughout these facilities, and this problem—specifically, that of infected hospitals along with health care workers—came to characterize the outbreak, which peaked in June with 185 cases, and 39 deaths, a high rate of mortality.
Much of the coverage, whether domestic or international, tended to focus on the administration of President Park Geun-hye, already unpopular, and later to be removed from office in 2017, following a series of popular demonstrations (Choe 2015a). Failure to address the MERS crisis, and even more importantly, to communicate effectively with the public, brought unwanted attention to a state apparatus known for its conservatism, especially with regard to withholding information. In the aftermath, one of the major proposed changes to public health laws dealt specifically with the use of patient medical data, and how this form of information might be used to communicate and track individuals according to specific points associated with their behaviors, including personal medical data, CCTV recordings, credit card transactions, and mobile phone use. Although there are privacy issues associated with such sensitive information, the rationale behind this move appealed to public health motives and circumstances of extreme exigency, where the sharing of data might be justified on utilitarian grounds, thereby establishing a more effective quarantine regime.
In late 2015, South Korea therefore adopted these changes in the form of new provisions added to existing law, taking the form of the Infectious Disease Prevention and Control Act of 2015. With the MERS case as its formative context, the law aimed at using the ROK’s extensive information communications technology networks to prevent a repeat of MERS, meaning specifically, a case where an infected patient, whether knowingly or asymptomatic, moves easily between health facilities, thereby spreading an infectious disease. Since its introduction in the 1980s, South Korea’s internet penetration ranks among the highest in the world, and similar observations can be made for smart phone usage, with extremely high rates for adoption and frequency of usage (Kang 2016).4 The public health system, in other words, took advantage of a highly mobile, technologically-oriented society in which it is safe to assume that the majority of citizens own and regularly carry a mobile device, thereby allowing for tracking. South Koreans regularly use their phones for any number of transactions, including various civic responsibilities and transactions, and this extensive cache of data has provided a baseline to begin the contact tracing process that would become much better known during COVID-19.
3 COVID-19: Contact Tracing, Data, and Privacy Concerns
Almost since its introduction in the early 1990s, the Korean version of the internet has been plagued with identity issues, as Korean netizens have been permitted to assume roles / names distinct from their real world equivalent. In a country undergoing a transformation from nearly forty years of military rule (1961–87), many Koreans, especially those in younger cohorts, found the space of online communities enormously liberating as a place in which to experiment. At the same time, Korean net communities have become well-known for their extreme behavior, with celebrities often complaining about the comments directed at them in forums, and with some suicides attributed to this form of public shaming, or cyberbullying (National 2020). This type of activity, along with the use of internet groups to organize political activity, especially demonstrations, has resulted in the government in turn requesting that individuals register themselves in accordance with their real world identity when using e-mail, chat rooms, or comparable forms of online activity (Kang 2016).5 In response, many Korean prefer to preserve their anonymity for a wide range of motivations, and this issue has become critical during the COVID-19 crisis.
3.1 Daegu Cluster (February–March 2020)
In fact, this very issue ties directly into the circumstances leading to the outbreak of COVID-19. In mid-February 2020, a cluster was discovered in Daegu, with a large number of the patients connected to their church membership. Prior to this, the number of cases in South Korea had remained low, and there was confidence that matters were under control. The Shincheonji Church of Jesus holds a controversial reputation among many Koreans owing to its millennial beliefs, thereby alienating a number of mainstream Protestant denominations (Choe 2020c). When the ROK government requested a list of church members on public health grounds, the church initially declined, arguing that it membership rolls should remain private, as many wished to avoid being ostracized for their participation. Along with this issue, there has been steady opposition to the government from the region in question (Daegu, the Southeast), and the Shincheonji church in particular, with many members—typically older, and more conservative—portraying President Moon Jae-in as an illegitimate leader, unjustly inheriting his positon from former President Park Geun-hye.
As the government exerted pressure, the church decided to comply, given the powerful combination of state and public opinion. As it turns out, members not only sought to keep their church activities quiet but also their missionary work in China. A number of members had traveled to Wuhan in late 2019 (November, December), seeking to recruit and to organize membership drives. With this link uncovered, the Korean government believed that it had established the means of transmission, and for much of February and March, the Daegu cluster remained the greatest proportion of the outbreak, with numbers remaining low in the rest of the country. The church head publicly apologized in a televised appearance, and the government made every effort to avoid the appearance of targeting an opposition group, especially during a crisis. During this time, prior to the national elections in mid-April, the government continued to receive criticism for leaving the border open with China, and for its handling of the affair with the church.
Through the perceived success of its efforts, and with the vast majority of Korean cases restricted to Daegu—the government mobilized behind the public health campaigns, holding elections as scheduled in mid-April 2020 (Choe 2020b ). The ruling party won a strong majority, earning nearly two-thirds of the vote, offering a convenient form of narrative closure. The report issued to coincide with the electoral triumph, provided in English-language and Korean-language versions, explained the success of contact tracing precisely in terms of South Korea’s existing information communications technology strengths, and the consent of Koreans to allow this infrastructure to be put to use (Hana 2020). The religious, regional, and class tensions of February and March received scarcely a mention, as this idealized vision of reliance on technology remains consistent with language previously circulated. The current Korean government has been extremely fond of the “Fourth Industrial Revolution,” a technocratic vision deriving from European visions of the present and near future (Schwab 2017). This strategy, along with the institutional practices and metrics favored by social scientists, offered the appearance of control.
With numbers holding steady, the government decided to ease its social distancing in early May, and this is when things become interesting. A six-day holiday preceded the official close to distancing, and this development, along with spring weather, brought a large number of citizens back into the streets, raising concerns about possible spread. In fact, the numbers began to creep up again almost immediately, this time associated with the Itaewon area, a nightclub and entertainment district in central Seoul, long popular with young people and American GIs, given its proximity to Yongsan base. In this case, the press coverage associated with the new cluster took on an ugly tone almost immediately, with online forums speculating about the identity of the individuals concerned. Itaewon is known not only for its dense clusters of bars and nightclubs catering to the young but also specifically for catering to the Korean LGBT population, where preserving anonymity remains a legitimate concern (이태원 유명 클럽 / “Itaewon Club” 2020).6
4 Itaewon Cluster (May 2020–Present): Constructing the “New” Normal
Although newspapers and media outlets were generally cautious with the language they employed, the renewed outbreak—broadly referred to as the “Itaewon Cluster”—tended to be associated with several intersecting groups: young people, frequent club-goers, foreigners, and members of the LGBT population. In a highly conservative society, with a strong degree of homogeneity, these tend to be groups with a marginal political voice, especially the last two. Online forums were far less circumspect, and there were numerous posts seeking to identify those deemed responsible for this new development, especially when the ROK had appeared to be on the verge of handling the virus. At the same time, the government, through CCTV footage and phone records, knew the identity of several individuals suspected of causing the spread. This development might be problematic on its own, but furthermore, in calling for those who visited the same clubs on the nights in question to come in for testing, the state created the perception that it was targeting these subgroups. In particular, the strongest resistance came from those who felt that the public health rationale was being used as a device to target LGBT members, and / or, their foreign partners, especially when the calls for follow-up testing named specific venues and times (“Itaewon Club” 2020; Kukmin Ilbo 2020).
While these new clusters have been largely contained, the ongoing issues of privacy and data protection continue to circulate in a variety of ways. In the case of Itaewon, some teachers in the English-language industry were asked to confirm their whereabouts and sexual identity by Korean employers. As of early June, the government has adopted a new policy regarding foreign travel, requiring a health certificate for both departure and reentry, with failure to comply resulting in a forfeiture of visa status. For the existing period of two-week self-quarantine, a measure already in practice, enforcement came with much harsher results, with several individuals penalized. In other words, the anonymity claimed for contact tracing through data has started to break down, and while there have been no formal leaks to date, the knowledge that the data is available has led to new kinds of social pressures and public shaming. A number of Korean celebrities who attended club activities in early May, suspecting that they appeared in camera footage, made public apologies to preclude any further criticism (“Stars Apologize” 2020).
4.1 Managing Space, Logistics
In the weeks following early May, the numbers have continued to rise at a moderate pace, linked in part to relaxed social distancing in a range of venues (Fig. 2). Coupang, the package delivery service in South Korea, identified a cluster at its logistics center in the outskirts of Seoul (Bucheon), and this site has drawn attention, given the heavy reliance on online shopping throughout much of the crisis. As with the case of the Shincheonji church and Daegu, this cluster, along with the type of work performed at the site—sorting, carrying, and delivering packages—suggests the possibility of a much closer look at regional and class dynamics in a nation still tied to its industrial strengths and rigorous work habits. In this case, there have been reports that the firm did not allow employees to take sick days, and did not properly enforce policies regarding the wearing of masks (Chae 2020).7 Again, these remarks should not detract from the overall effectiveness of Korean COVID policy, but there are numerous fissures and gaps emerging in recent weeks, especially when juxtaposed against the success narrative constructed during April.
As the virus numbers remain a cause for concern, the most recent measure (June 2020) involves requiring the use of a QR code uploaded to one’s phone for entry at “high risk” sites, again raising the challenging question of privacy, particularly when a specific region of the city (Itaewon), an individual firm (Coupang), or even a specific restaurant (King Club) or ethnicity (Chinese) is named by authorities, thereby associating its patrons with disease (COVID-19), social stigma, and by extension, an extended set of assumptions about personal behavior. This new QR policy will hold for bars, clubs, religious facilities, and hospitals, with possible expansion to include a similar list of high frequency venues.
More broadly, measures to be adopted as a form of governance directed against the growing case numbers will rely primarily on data-driven and/or technological approaches. As with the case of Singapore—see Stevens and Haines 2020—South Korea has debated the use of wearable bracelets as a supplemental form of contact tracing. This approach, while still not in place, seeks to augment the use of cell phones, as regulators have learned that savvy young people are generally uploading the apps/codes as requested, and then “accidentally” misplacing or leaving their phones behind. The bracelets would be locked in place, with a notice sent to authorities if the connection is severed or removed. Most likely, the bracelets would be used primarily to target those already in quarantine, especially with international travel expected to increase during the summer months.
Other possibilities include a heavy blend of the traditional, such as increased phone calls to those in quarantine, and a higher volume of random visits, again, seeking to keep the inspection regime in place. In this respect, despite its high-tech trappings, the Korean program ultimately echoes a great deal of previous history, when quarantine relied on physical confinement and close, frequent watching. In a recent article in the Korea Times, Matt Van Volkenberg has pointed to Itaewon’s much longer history with various forms of infectious disease, here suggesting some hybrid combination of the old and the new (Van Volkenberg 2020). Again, given the presence of the American military, he notes that the first clinics for STD (Sexually Transmitted Disease) in Seoul were situated in the area. In the mid to late 1980s, AIDS brought unwanted attention to the district, resulting in numerous editorials and campaigns, a point also made by historian Todd Henry in a recent NPR (National Public Radio) interview (Henry 2020) and by Timothy Gitzen of HKU (Gitzen 2020). With many claims for the current circumstances as “unprecedented,” the Itaewon cluster has stirred up uncomfortable memories of the colonial past (Japan), the military period (US, ROK government), and the dense layers of intersection between public health practice and various forms of policing (Choe 2020a; Choe et al. 2020).
A much-needed counterpoint to this trend can be found in Park 2020.
South Korea sent medical teams to Vietnam as early as 1964 and to African nations beginning in 1968.
SARS motivated South Korea to create its KCDC (Korea Center for Disease Control) in 2004, with post-MERS (2016) resulting in a vice ministry–level promotion. With COVID-19, the KCDC will soon move to stand-alone status to enhance its freedom of action in a crisis. KCDC has undergone a recent name change and reorganization and is now known as KDCA (Korea Disease Control and Prevention Agency).
South Korea chose to connect to ARPANET in the early 1980s.
See Kang’s chapter 2, “The Birth of the Internet Youth Protest.”
See also “Over 24,000 Linked to Itaewon Cluster Tested: Seoul Mayor,” Yonhap News, 14 May 2020.
Coupang has since established a fund to compensate workers.