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1Department of Public Health, Kyungpook National University Hospital, Daegu, Korea
2Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
3Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
©2021, Korean Society of Epidemiology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
The authors have no conflicts of interest to declare for this study
FUNDING
This work was funded by the Research Program funded by the Korea Centers for Disease Control and Prevention (2020-ER5308-00).
AUTHOR CONTRIBUTIONS
Conceptualization: JYK, YML, SWK. Data curation: JWK, YML. Formal analysis: YML. Funding acquisition: SWK. Project administration: SWK. Visualization: YML. Writing – original draft: JYK, YML, JWK. Writing – review & editing: SWK, HL.
Date in 2020 |
Cumulative no. of confirmed cases1 |
Key countermeasures | |
---|---|---|---|
Members of the S religious group | Total | ||
Feb 18 | 7 | 10 | Index case (case #31 in Korea) confirmed |
Forced closure of church and 24 related facilities of the S religious group | |||
Feb 19 | 42 | 51 | Securing a list of members |
Telephone survey of symptoms from worship attendees (n=1,001) | |||
Request of self-quarantine and screening test for 90 symptomatic persons | |||
Feb 20 | 90 | 108 | Telephone survey of symptoms from all members (n=9,336) |
Decision of self-quarantine for all members | |||
Feb 21 | 226 | 255 | Start of COVID-19 screening test for 1,261 symptomatic persons |
Feb 23 | 494 | 565 | Designation of a self-isolation monitoring officer |
Feb 25 | 962 | 1,130 | Start of COVID-19 screening test for non-symptomatic persons |
A message sent for self-quarantine to all members | |||
Feb 26 | 1,241 | 1,480 | Executive order for church-related facilities closure |
Securing additional list of members | |||
Feb 29 | 2,292 | 2,856 | Securing the list of disciples |
Extension of the period of self-quarantine to the unexamined members | |||
Mar 2 | 3,035 | 3,834 | Opening of the first therapeutic living center |
Mar 4 | 3,603 | 4,676 | Outbreak in the H apartment buildings where members resided in groups |
Mar 7 | 4,124 | 5,547 | Executive order to screen unexamined members |
Mar 10 | 4,254 | 5,932 | Decision to force all confirmed patients in homes to be admitted to a facility |
Mar 11 | 4,267 | 6,001 | Completion of the screening test for all members |
Jun 30 | 4,309 | 7,008 | Overall, 7,008 COVID-19 cases were confirmed |
Characteristics |
Membership in the S religious group |
p-value1 | |
---|---|---|---|
Non-members (n=2,699) | Members (n=4,309) | ||
Sex | |||
Male | 1,235 (45.8) | 1,453 (33.7) | <0.001 |
Female | 1,464 (54.2) | 2,856 (66.3) | |
Nationality | |||
Korean | 2,656 (98.4) | 4,281 (99.4) | <0.001 |
Foreign | 43 (1.6) | 28 (0.7) | |
Place of residence | |||
Daegu | 2,687 (99.6) | 4,309 (100) | <0.001 |
Gyeongsangbuk-do | 3 (0.1) | 0 (0.0) | |
Others/unknown | 9 (0.3) | 0 (0.0) | |
Age (yr) | |||
Mean±SD | 53.7±20.5 | 38.7±16.9 | <0.001 |
0-9 | 56 (2.1) | 21 (0.5) | <0.001 |
10-19 | 120 (4.5) | 255 (5.9) | |
20-29 | 267 (9.9) | 1,652 (38.3) | |
30-39 | 198 (7.3) | 465 (10.8) | |
40-49 | 343 (12.7) | 574 (13.3) | |
50-59 | 564 (20.9) | 758 (17.6) | |
60-69 | 518 (19.2) | 412 (9.6) | |
70-79 | 367 (13.6) | 146 (3.4) | |
≥80 | 266 (9.9) | 26 (0.6) | |
Comorbidity | |||
Hypertension | 258 (9.6) | 182 (4.2) | <0.001 |
Diabetes mellitus | 165 (6.1) | 100 (2.3) | <0.001 |
Cancer | 44 (1.6) | 27 (0.6) | <0.001 |
Chronic renal failure | 11 (0.4) | 1 (0.0) | <0.001 |
COPD | 5 (0.2) | 0 (0.0) | 0.009 |
Asthma | 29 (1.1) | 31 (0.7) | 0.116 |
Heart disease | 60 (2.2) | 31 (0.7) | <0.001 |
Stroke | 32 (1.2) | 18 (0.4) | <0.001 |
Dementia | 31 (1.1) | 3 (0.1) | <0.001 |
Symptoms |
Membership in the S religious group |
p-value1 | |
---|---|---|---|
Non-members (n=2,699) | Members (n=4,309) | ||
Presence of symptoms | |||
Asymptomatic | 639 (23.7) | 1,669 (38.7) | <0.001 |
Symptomatic | 2,060 (76.3) | 2,640 (61.3) | |
Symptoms | |||
Fever/febrile sense | 957 (35.5) | 691 (16.0) | <0.001 |
Cough | 910 (33.7) | 1,111 (25.8) | <0.001 |
Myalgia | 571 (21.2) | 631 (14.6) | <0.001 |
Sputum | 516 (19.1) | 663 (15.4) | <0.001 |
Sore throat | 511 (18.9) | 585 (13.6) | <0.001 |
Chills | 391 (14.5) | 377 (8.8) | <0.001 |
Dyspnea | 205 (7.6) | 149 (3.5) | <0.001 |
Headache | 196 (7.3) | 296 (6.9) | 0.531 |
General weakness/general ache | 175 (6.5) | 231 (5.4) | 0.050 |
Rhinorrhea | 158 (5.9) | 358 (8.3) | <0.001 |
Diarrhea | 62 (2.3) | 48 (1.1) | <0.001 |
Chest pain/chest discomfort | 41 (1.5) | 41 (1.0) | 0.032 |
Decreased sense of smell | 32 (1.2) | 67 (1.6) | 0.202 |
Decreased sense of taste | 27 (1.0) | 37 (0.9) | 0.544 |
Dizziness | 21 (0.8) | 25 (0.6) | 0.318 |
Vomiting | 20 (0.7) | 5 (0.1) | <0.001 |
Nausea | 17 (0.6) | 15 (0.3) | 0.089 |
Other | 102 (3.8) | 70 (1.6) | <0.001 |
Characteristics |
Membership in the S religious group |
p-value1 | Korea2(n=81,487) | |||
---|---|---|---|---|---|---|
Non-members (n=2,699) |
Members (n=4,309) |
|
||||
No. of deaths/cases | Case-fatality rate, % | No. of deaths/cases | Case-fatality rate, % | Case-fatality rate, % | ||
Total | 173/2,699 | 6.4 | 12/4,309 | 0.3 | <0.001 | 1.82 |
Sex | ||||||
Male | 87/1,235 | 7.0 | 9/1,453 | 0.6 | <0.001 | 1.84 |
Female | 86/1,464 | 5.9 | 3/2,856 | 0.1 | <0.001 | 1.80 |
p-value | 0.216 | 0.004 | ||||
Age (yr) | ||||||
0-9 | 0/56 | 0.0 | 0/21 | 0.0 | NA | 0.00 |
10-19 | 0/120 | 0.0 | 0/255 | 0.0 | NA | 0.00 |
20-29 | 0/267 | 0.0 | 0/1,652 | 0.0 | NA | 0.00 |
30-39 | 1/198 | 0.5 | 0/465 | 0.0 | 0.299 | 0.06 |
40-49 | 1/343 | 0.3 | 0/574 | 0.0 | 0.374 | 0.10 |
50-59 | 5/564 | 0.9 | 4/758 | 0.5 | 0.508 | 0.32 |
60-69 | 28/518 | 5.4 | 1/412 | 0.2 | <0.001 | 1.33 |
70-79 | 55/367 | 15.0 | 5/146 | 3.4 | <0.001 | 6.47 |
≥80 | 83/266 | 31.2 | 2/26 | 7.7 | 0.012 | 20.74 |
p-value | <0.001 | <0.001 |
COVID-19, coronavirus disease 2019; NA, not applicable.
1 Chi-square test or Fisher exact test for a difference between groups.
2 Source from: Korea Centers for Disease Control and Prevention. Updates on COVID-19 in Republic of Korea [11].
Date in 2020 | Cumulative no. of confirmed cases |
Key countermeasures | |
---|---|---|---|
Members of the S religious group | Total | ||
Feb 18 | 7 | 10 | Index case (case #31 in Korea) confirmed |
Forced closure of church and 24 related facilities of the S religious group | |||
Feb 19 | 42 | 51 | Securing a list of members |
Telephone survey of symptoms from worship attendees (n=1,001) | |||
Request of self-quarantine and screening test for 90 symptomatic persons | |||
Feb 20 | 90 | 108 | Telephone survey of symptoms from all members (n=9,336) |
Decision of self-quarantine for all members | |||
Feb 21 | 226 | 255 | Start of COVID-19 screening test for 1,261 symptomatic persons |
Feb 23 | 494 | 565 | Designation of a self-isolation monitoring officer |
Feb 25 | 962 | 1,130 | Start of COVID-19 screening test for non-symptomatic persons |
A message sent for self-quarantine to all members | |||
Feb 26 | 1,241 | 1,480 | Executive order for church-related facilities closure |
Securing additional list of members | |||
Feb 29 | 2,292 | 2,856 | Securing the list of disciples |
Extension of the period of self-quarantine to the unexamined members | |||
Mar 2 | 3,035 | 3,834 | Opening of the first therapeutic living center |
Mar 4 | 3,603 | 4,676 | Outbreak in the H apartment buildings where members resided in groups |
Mar 7 | 4,124 | 5,547 | Executive order to screen unexamined members |
Mar 10 | 4,254 | 5,932 | Decision to force all confirmed patients in homes to be admitted to a facility |
Mar 11 | 4,267 | 6,001 | Completion of the screening test for all members |
Jun 30 | 4,309 | 7,008 | Overall, 7,008 COVID-19 cases were confirmed |
Mode of transmission | n (%) |
---|---|
Member of the S religious group | 4,309 (61.5) |
Cohabitation with a member of the S religious group | 354 (5.1) |
Contact with a member of the S religious group | 104 (1.5) |
Contact with a confirmed case | 1,355 (19.3) |
Overseas | 61 (0.9) |
Unknown | 825 (11.8) |
Characteristics | Membership in the S religious group |
p-value |
|
---|---|---|---|
Non-members (n=2,699) | Members (n=4,309) | ||
Sex | |||
Male | 1,235 (45.8) | 1,453 (33.7) | <0.001 |
Female | 1,464 (54.2) | 2,856 (66.3) | |
Nationality | |||
Korean | 2,656 (98.4) | 4,281 (99.4) | <0.001 |
Foreign | 43 (1.6) | 28 (0.7) | |
Place of residence | |||
Daegu | 2,687 (99.6) | 4,309 (100) | <0.001 |
Gyeongsangbuk-do | 3 (0.1) | 0 (0.0) | |
Others/unknown | 9 (0.3) | 0 (0.0) | |
Age (yr) | |||
Mean±SD | 53.7±20.5 | 38.7±16.9 | <0.001 |
0-9 | 56 (2.1) | 21 (0.5) | <0.001 |
10-19 | 120 (4.5) | 255 (5.9) | |
20-29 | 267 (9.9) | 1,652 (38.3) | |
30-39 | 198 (7.3) | 465 (10.8) | |
40-49 | 343 (12.7) | 574 (13.3) | |
50-59 | 564 (20.9) | 758 (17.6) | |
60-69 | 518 (19.2) | 412 (9.6) | |
70-79 | 367 (13.6) | 146 (3.4) | |
≥80 | 266 (9.9) | 26 (0.6) | |
Comorbidity | |||
Hypertension | 258 (9.6) | 182 (4.2) | <0.001 |
Diabetes mellitus | 165 (6.1) | 100 (2.3) | <0.001 |
Cancer | 44 (1.6) | 27 (0.6) | <0.001 |
Chronic renal failure | 11 (0.4) | 1 (0.0) | <0.001 |
COPD | 5 (0.2) | 0 (0.0) | 0.009 |
Asthma | 29 (1.1) | 31 (0.7) | 0.116 |
Heart disease | 60 (2.2) | 31 (0.7) | <0.001 |
Stroke | 32 (1.2) | 18 (0.4) | <0.001 |
Dementia | 31 (1.1) | 3 (0.1) | <0.001 |
Symptoms | Membership in the S religious group |
p-value |
|
---|---|---|---|
Non-members (n=2,699) | Members (n=4,309) | ||
Presence of symptoms | |||
Asymptomatic | 639 (23.7) | 1,669 (38.7) | <0.001 |
Symptomatic | 2,060 (76.3) | 2,640 (61.3) | |
Symptoms | |||
Fever/febrile sense | 957 (35.5) | 691 (16.0) | <0.001 |
Cough | 910 (33.7) | 1,111 (25.8) | <0.001 |
Myalgia | 571 (21.2) | 631 (14.6) | <0.001 |
Sputum | 516 (19.1) | 663 (15.4) | <0.001 |
Sore throat | 511 (18.9) | 585 (13.6) | <0.001 |
Chills | 391 (14.5) | 377 (8.8) | <0.001 |
Dyspnea | 205 (7.6) | 149 (3.5) | <0.001 |
Headache | 196 (7.3) | 296 (6.9) | 0.531 |
General weakness/general ache | 175 (6.5) | 231 (5.4) | 0.050 |
Rhinorrhea | 158 (5.9) | 358 (8.3) | <0.001 |
Diarrhea | 62 (2.3) | 48 (1.1) | <0.001 |
Chest pain/chest discomfort | 41 (1.5) | 41 (1.0) | 0.032 |
Decreased sense of smell | 32 (1.2) | 67 (1.6) | 0.202 |
Decreased sense of taste | 27 (1.0) | 37 (0.9) | 0.544 |
Dizziness | 21 (0.8) | 25 (0.6) | 0.318 |
Vomiting | 20 (0.7) | 5 (0.1) | <0.001 |
Nausea | 17 (0.6) | 15 (0.3) | 0.089 |
Other | 102 (3.8) | 70 (1.6) | <0.001 |
Characteristics | Membership in the S religious group |
p-value |
Korea |
|||
---|---|---|---|---|---|---|
Non-members (n=2,699) |
Members (n=4,309) |
|||||
No. of deaths/cases | Case-fatality rate, % | No. of deaths/cases | Case-fatality rate, % | Case-fatality rate, % | ||
Total | 173/2,699 | 6.4 | 12/4,309 | 0.3 | <0.001 | 1.82 |
Sex | ||||||
Male | 87/1,235 | 7.0 | 9/1,453 | 0.6 | <0.001 | 1.84 |
Female | 86/1,464 | 5.9 | 3/2,856 | 0.1 | <0.001 | 1.80 |
p-value | 0.216 | 0.004 | ||||
Age (yr) | ||||||
0-9 | 0/56 | 0.0 | 0/21 | 0.0 | NA | 0.00 |
10-19 | 0/120 | 0.0 | 0/255 | 0.0 | NA | 0.00 |
20-29 | 0/267 | 0.0 | 0/1,652 | 0.0 | NA | 0.00 |
30-39 | 1/198 | 0.5 | 0/465 | 0.0 | 0.299 | 0.06 |
40-49 | 1/343 | 0.3 | 0/574 | 0.0 | 0.374 | 0.10 |
50-59 | 5/564 | 0.9 | 4/758 | 0.5 | 0.508 | 0.32 |
60-69 | 28/518 | 5.4 | 1/412 | 0.2 | <0.001 | 1.33 |
70-79 | 55/367 | 15.0 | 5/146 | 3.4 | <0.001 | 6.47 |
≥80 | 83/266 | 31.2 | 2/26 | 7.7 | 0.012 | 20.74 |
p-value | <0.001 | <0.001 |
The figures are based on the COVID-19 confirmed date of the epidemiological investigation reports, which differed from the confirmed date officially announced by the Daegu municipal government.
Values are presented as number (%). COVID-19, coronavirus disease 2019; SD, standard deviation; COPD, chronic obstructive pulmonary disease. Chi-square test or Fisher exact test for categorical variables and independent t-test for continuous variables.
Values are presented as number (%). Chi-square test or Fisher exact test.
COVID-19, coronavirus disease 2019; NA, not applicable. Chi-square test or Fisher exact test for a difference between groups. Source from: Korea Centers for Disease Control and Prevention. Updates on COVID-19 in Republic of Korea [