When Precarity Encounters COVID-19: A Critical Analysis of Korean Policy Responses

In the acute phase of the COVID-19 pandemic, Korea was considered a successful case of containment of infection. However, the employment protection response has not been as successful as the health response. Although the Korean Government has taken unprecedented fiscal measures, the hardest-hit groups including workers in non-standard employment are still least protected. The pandemic has found countries with widespread precarious employment at their most vulnerable. Since the 1997 Asian financial crisis, the Government has promoted the deregulation of capital and the flexibilization of labour, with precarious work becoming ‘normal'. COVID-19 shows that workers excluded from labour protection before the crisis are the most vulnerable in the current crisis. Dependent contractors are not protected from termination of contract or loss of income, while employees in a comparable situation may be supported by job retention schemes and unemployment benefits. This means employers using dependent contractors can avoid employer liability in a normal situation as well as in times of crisis. While the Government attempts to expand unemployment insurance to certain groups of dependent contractors, debates over who should bear the financial burden are underway. Employers refuse to contribute to unemployment insurance for dependent contractors, arguing that they are not the employers of these workers. This article analyses how flexibilization in Korea has affected vulnerability and the segmentation of labour protection. It argues that the ‘protection gap' among workers resulted from political choices and the strategy of capital to transfer cost-and-risks onto workers and society as a whole. These pre-pandemic political choices undermine the chances of a fair recovery. This article argues that establishing employer responsibility is essential for a humancentred recovery. © 2022 Kluwer Law International BV, The Netherlands

Plasmapheresis and Rituximab for Prevention of Focal Segmental Glomerulosclerosis Recurrence Post-Kidney Transplantation

Purpose: Primary focal segmental glomerulosclerosis (FSGS) recurs after kidney transplantation (KT) in 30-50% of recipients with a median time of 1.5 months post- KT. Recurrence is associated with early graft loss in 60% of cases. The aim of this study is to assess the efficacy of pre-emptive therapeutic plasma exchange (TPE) and rituximab for the prevention of FSGS recurrence post-KT. Method(s): This single-center, retrospective study included patients receiving KT for primary FSGS between May 2016 and August 2021. Living-donor KT recipients received three sessions of TPE prior to scheduled transplant. Recipients of both living and deceased donor KT received 3 postoperative sessions of TPE followed by one dose of 375 mg/m2 rituximab with or without intravenous immune globulin (IVIG) 0.5 g/kg. Recipients underwent protocol biopsy at one month to screen for FSGS recurrence. The primary endpoint was a composite for disease recurrence including proteinuria (>=1 g/day) or/and biopsy-proven FSGS within one month. Result(s): 54 patients received KT for FSGS during the study period using the TPE/ rituximab protocol. 5 patients (9%) experienced FSGS recurrence within one month of transplant. A total of 10 patients (19%) were found to have disease recurrence within a year, with median (IQR) time to recurrence of 37 days (27-66). White race and history of hypertension were independent risk factors for recurrence, whereas African American race and diabetes were associated with a reduced risk of recurrence. 31 patients (57%) also received IVIG prior to discharge due to concerns for hypogammaglobulinemia. There were 18 documented infections in 13 patients (24%) within 3 months of transplant. Patients who received IVIG had significantly fewer cases of infection (3 cases: 1 viral and 2 COVID-19) compared to patients who did not receive IVIG (15 cases: 4 bacterial, 9 viral, 1 fungal, and 1 COVID-19), p<0.001. At one year, 9 patients (19%) had biopsy-proven rejection (5 acute cellular rejection, 1 antibody-mediated rejection, and 3 mixed rejection). There were no instances of graft loss or mortality observed at one year. Conclusion(s): The utilization of plasma exchange and rituximab may prevent early disease recurrence of FSGS without significant rates of infection, graft loss, or mortality.

Communication and Cooperation Between the Medical Academy, Medical Association, and Local Government: Health Counseling Program After Recovery From Coronavirus Disease 2019 (COVID-19) in Daegu.

We are currently experiencing the disaster of the COVID-19 pandemic. Since the first case of Coronavirus disease 2019 (COVID-19) was confirmed in South Korea on January 20, the number of COVID-19 cases in South Korea has been rapidly increasing until early March due to a local spread in Daegu, which is one of the eight metropolitan cities in South Korea with a population of 2.5 million. As the medical academy has social accountability as professionals, Daegu-Gyeongbuk branch of the Korean Academy of Family Medicine (Daegu-Gyeongbuk branch) developed the health counseling program for discharged COVID-19 patients. The Daegu-Gyeongbuk branch communicated with Daegu Medical Association and Daegu city for this program and incorporated available resources and capabilities as a leader of this program. This newly developed counseling program consists of medical consultations, sending healthcare brochures and medical supplies, and the appraisal at the end of the program. Not only COVID-19 related symptoms but also other psychological problems are also dealt with during consultations. This program started on March 18, and over 1,700 recovered patients have been receiving counseling as of April 28. Communication and cooperation between the medical academy, medical association, and government are essential to overcome the COVID-19 pandemic. Besides, we expect to apply this health counseling program and our model of setting this program cooperating with medical association and government to different infectious pandemic crisis.

Diagnosis of Coronavirus Disease 2019

The first massive outbreak of coronavirus disease 2019 (COVID-19) in Korea was controlled by fast diagnosis, isolation and triage systems. The development of therapeutic agents and vaccinations are going on, but many studies clarified the nature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this review, we will discuss the characteristics and spreading of SARS-CoV-2, and prognostic factors and diagnosis of COVID-19.