Background: The Democratic People’s Republic of Korea (North Korea) had successfully suppressed the coronavirus disease 2019 (COVID-19) epidemic via border closures. However, a rapid surge in incidence was reported due to the spread of the omicron variant (B.1.1.529), leading to a national emergency declaration in May 2022. Moreover, with the lack of vaccine accessibility and medical facilities, it is unclear how the disease burden may be exacerbated. Despite the limited epidemiological data, we aimed to project the COVID-19 transmissions in North Korea and quantify the potential impact of nationwide vaccination, comparing epidemiological outcomes via scenario analysis. Methods: A discrete-time deterministic compartmental model was used. The parameters were calibrated using empirical data. Numerical simulations incorporated nationwide COVID-19 vaccination into the proposed model with various asymptomatic proportions. Results: Our model suggested that the stringent public health and social measures (PHSMs) reduced the severe acute respiratory syndrome coronavirus 2 transmissibility by more than 80% in North Korea. Projections that explicitly incorporated vaccination indicated that nationwide vaccination would be necessary to suppress a huge resurgence in both COVID-19 cases and hospitalizations after the stringent PHSMs are eased. Moreover, vaccinating more than 80% of the population with two doses may keep the peak prevalence of hospitalizations below 1,500, averting more than 40,000 hospitalizations across all scenarios. Conclusion Nationwide vaccination would be essential to suppress the prevalence of COVID-19 hospitalizations in North Korea after the stringent PHSMs are lifted, especially in the case of a small asymptomatic proportion.

The formation of herd immunity through vaccination is a key point in overcoming the coronavirus disease 2019 (COVID-19) pandemic. To acquire herd immunity, a high vaccination rate is required, which is necessary to instill confidence in the public regarding the effectiveness and safety of the vaccine. In the real-world setting, thorough preparation of components, such as priority setting, vaccine delivery, logistics, and side-effect monitoring is necessary to overcome vaccine hesitancy. Each country prioritizes vaccination since healthcare workers, nursing facility residents, and the elderly population, and similar trends are found between countries. Vaccination is performed at large centers and medical institutions operated by the country, and variations are dependent on the environment of each country. The transport of mRNA vaccines is a challenging task, and to this end, each government is striving for safe distribution. In addition, each authority operates a surveillance system to monitor the safety of vaccines, and Korea needs to produce evidence for monitoring effects and side effects with expertise. Even after the acquisition of herd immunity, COVID-19 is highly likely to remain an endemic infectious disease, and a higher immunity level may be required because of variants of the virus. If the spread of variants of concern continues, a booster vaccination may be required. Therefore, non-pharmaceutical interventions, such as social distancing, wearing a mask, and epidemiological investigation should be maintained.

The formation of herd immunity through vaccination is a key point in overcoming the coronavirus disease 2019 (COVID-19) pandemic. To acquire herd immunity, a high vaccination rate is required, which is necessary to instill confidence in the public regarding the effectiveness and safety of the vaccine. In the real-world setting, thorough preparation of components, such as priority setting, vaccine delivery, logistics, and side-effect monitoring is necessary to overcome vaccine hesitancy. Each country prioritizes vaccination since healthcare workers, nursing facility residents, and the elderly population, and similar trends are found between countries. Vaccination is performed at large centers and medical institutions operated by the country, and variations are dependent on the environment of each country. The transport of mRNA vaccines is a challenging task, and to this end, each government is striving for safe distribution. In addition, each authority operates a surveillance system to monitor the safety of vaccines, and Korea needs to produce evidence for monitoring effects and side effects with expertise. Even after the acquisition of herd immunity, COVID-19 is highly likely to remain an endemic infectious disease, and a higher immunity level may be required because of variants of the virus. If the spread of variants of concern continues, a booster vaccination may be required. Therefore, non-pharmaceutical interventions, such as social distancing, wearing a mask, and epidemiological investigation should be maintained.

South Korea’s rapid economic growth over the past 50 years has significantly improved healthcare outcomes, with life expectancy rising from 62.3 years in the 1970s to 82.7 years in 2022. However, the sustainability of its high-performing healthcare system is increasingly uncertain. Healthcare expenditure as a percentage of GDP reached 9.7% in 2022, surpassing the OECD average, while the fertility rate dropped to 0.72, undermining the system’s demographic foundation. Challenges include freezing health insurance premiums despite rising costs, short-term fiscal injections without thorough evaluation, and expanding the physician workforce without accounting for demographic changes. These policies risk overburdening future generations and escalating systemic financial pressures. To ensure sustainability, a shift in healthcare policy is necessary; from expanding services to managing limited resources and controlling demand. South Korea must adopt a strategic, long-term framework that balances current needs with future sustainability, ensuring its healthcare system remains equitable and resilient.

South Korea’s rapid economic growth over the past 50 years has significantly improved healthcare outcomes, with life expectancy rising from 62.3 years in the 1970s to 82.7 years in 2022. However, the sustainability of its high-performing healthcare system is increasingly uncertain. Healthcare expenditure as a percentage of GDP reached 9.7% in 2022, surpassing the OECD average, while the fertility rate dropped to 0.72, undermining the system’s demographic foundation. Challenges include freezing health insurance premiums despite rising costs, short-term fiscal injections without thorough evaluation, and expanding the physician workforce without accounting for demographic changes. These policies risk overburdening future generations and escalating systemic financial pressures. To ensure sustainability, a shift in healthcare policy is necessary; from expanding services to managing limited resources and controlling demand. South Korea must adopt a strategic, long-term framework that balances current needs with future sustainability, ensuring its healthcare system remains equitable and resilient.

Background: The coronavirus disease 2019 (COVID-19) pandemic has altered daily behavioral patterns based on government healthcare policies, including consumption and movement patterns. We aimed to examine the extent to which changes in the government's healthcare policy have affected people's lives, primarily focusing on changes in consumption and population movements. Methods: We collected consumption data using weekly credit card transaction data from the Hana Card Corporation and population mobility data using mobile phone data from SK Telecom in Seoul, South Korea. Interrupted time-series analysis was used to calculate the relative risk ratio and perform the intervention effects when government healthcare policy changes. Results: We found that leisure and outside movements were the most immediately affected by changes in government healthcare policies. It took over 2 years and 11 months, respectively, for these sectors to return to their pre-COVID-19 routines. Conclusion Enhancing healthcare policies presents advantages and disadvantages.Although such policies help prevent the spread of COVID-19, they also reduce consumption and mobility, extending the time needed to return to pre-COVID-19 levels. Government healthcare policymakers should consider not only disease prevention but also the impact of these policies on social behaviors, economic activity, and mobility.

Background: The coronavirus disease 2019 (COVID-19) pandemic has altered daily behavioral patterns based on government healthcare policies, including consumption and movement patterns. We aimed to examine the extent to which changes in the government's healthcare policy have affected people's lives, primarily focusing on changes in consumption and population movements. Methods: We collected consumption data using weekly credit card transaction data from the Hana Card Corporation and population mobility data using mobile phone data from SK Telecom in Seoul, South Korea. Interrupted time-series analysis was used to calculate the relative risk ratio and perform the intervention effects when government healthcare policy changes. Results: We found that leisure and outside movements were the most immediately affected by changes in government healthcare policies. It took over 2 years and 11 months, respectively, for these sectors to return to their pre-COVID-19 routines. Conclusion Enhancing healthcare policies presents advantages and disadvantages.Although such policies help prevent the spread of COVID-19, they also reduce consumption and mobility, extending the time needed to return to pre-COVID-19 levels. Government healthcare policymakers should consider not only disease prevention but also the impact of these policies on social behaviors, economic activity, and mobility.