Exploring the Experiences of Managers and Practitioners in Infectious Disease Management Organizations During the COVID-19 Response: A Qualitative Study.

Background: Even before coronavirus disease 2019 (COVID-19), unexpected new infectious diseases such as severe acute respiratory syndrome, novel influenza A and Middle East respiratory syndrome (MERS) affected the Korean healthcare systems. Nevertheless, during the COVID-19 period, we still experienced difficulties in systematic response. Especially in Ulsan Metropolitan City, which had no confirmed cases during the MERS, the response infrastructure was also very insufficient. Therefore, this study aimed to investigate in depth experiences of managers and practitioners of infectious disease management organizations with the COVID-19 response and identify areas for improvement in the response to future novel infectious diseases.

Methods: We recruited participants through targeted and snowball sampling. Data were collected between March 27 and May 2, 2023, through in-depth interviews with 15 healthcare workers from Ulsan Metropolitan City, South Korea, including civil servants, physicians, nurses, and administrative staff, all of whom had experience with the COVID-19 response.

Results: We extracted 1,496 semantic units, 16 subcategories, and 5 categories. The participants experienced confusion at being inserted into the infectious disease response without a thorough understanding of the work due to the sudden appearance of COVID-19. In the absence of precise manuals or designated consultancies, the participants' confusion was exacerbated by frequent changes to guidelines and insufficient communication, and they felt despair by others' passive attitudes, which contradicted their own feelings. They also felt bewildered that they were not supported by policy, despite having chosen to support a great cause in an emergency. Excessive workloads led to health problems. Nevertheless, the participants actively sought help, received support, made efforts to construct the response environment, and felt a sense of reward when they witnessed the results. The participants emphasized the need to build up the inadequate public healthcare system in Ulsan to prepare for future novel infectious diseases, to maintain a trained, professional workforce, and to secure a sufficient budget to provide support and compensation.

Conclusion: The findings indicate that local governments need to establish public healthcare systems and secure professionals for responding to novel infectious diseases.