Impact of imported COVID-19 cases on South Korea’s response: variant transitions and regional patterns (2020-2023).

Publication date: Jul 01, 2025

The global spread of infectious diseases like COVID-19, accelerated by globalization and frequent international interactions, poses a serious threat to public health. Robust epidemiological data on imported cases is essential for managing cross-border disease transmission, enabling targeted public health responses through international cooperation and enhanced surveillance. This study investigates the impact of imported COVID-19 cases on South Korea’s pandemic response from January 2020 to May 2023. We analyzed 78,495 imported COVID-19 cases reported by the Korea Disease Control and Prevention Agency (KDCA) from January 2020 to May 2023. The dataset included demographic information, countries of origin, entry points, and information on dominant viral variants during the specified period. Temporal and spatial analyses examined how variant transitions, particularly from Delta to Omicron, and quarantine policy changes influenced imported case patterns. We calculated the “confirmation lag,” the time between entry and confirmation, and applied Kernel Density Estimation (KDE) to evaluate how detection speed was affected by policy shifts and variant changes. In addition, least squares regression was used to explore the relationship between regional population size and the number of imported cases. The findings reveal a significant increase in imported cases during the transition from the Delta to Omicron variants, highlighting the increased transmissibility of Omicron and its impact on imported case numbers. Consequently, testing strategies were improved for faster detection and quarantine adaptability, which was confirmed by the observed reduction in confirmation lag. Regions with major entry points, such as Incheon, had higher imported case ratios. Population size was the strongest predictor, followed by first importation timing. This trend underscores the importance of tailored measures, such as region-based surveillance and country-targeted entry policies, to effectively manage virus importation. By systematically analyzing a large-scale dataset of imported COVID-19 cases, we demonstrate that targeted border measures-accounting for travelers’ countries of origin and regional vulnerabilities-are essential for effective containment. Our findings underscore the value of variant-specific strategies, reinforced by real-time surveillance of imported cases, as a critical component of South Korea’s public health infrastructure. This approach not only enhances current response capacity but also strengthens preparedness for future cross-border infectious disease threats.

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Concepts Keywords
Accounting Border control
Korea Communicable Diseases, Imported
Pandemic Confirmation lag
Viral Coronavirus disease 2019 (COVID-19)
COVID-19
Entry policies
Humans
Imported cases
Public Health
Quarantine
Republic of Korea
SARS-CoV-2
South Korea
Travel
Travel restrictions

Semantics

Type Source Name
disease MESH COVID-19
disease MESH infectious diseases
disease MESH border disease
disease IDO country
pathway REACTOME Infectious disease
disease IDO infectious disease
pathway REACTOME Reproduction
disease MESH community transmission
disease MESH unemployment
disease MESH depression
disease MESH anxiety
disease MESH infections
disease MESH imported infectious diseases
disease IDO symptom
drug DRUGBANK Nonoxynol-9
drug DRUGBANK Trestolone
disease IDO process
disease MESH tics
disease IDO infectivity
drug DRUGBANK Ilex paraguariensis leaf
drug DRUGBANK Albendazole
drug DRUGBANK Isoxaflutole
drug DRUGBANK Fenamole
drug DRUGBANK Medical air
disease MESH aids
drug DRUGBANK L-Valine
drug DRUGBANK Coenzyme M
disease IDO role
drug DRUGBANK Cyclic Adenosine Monophosphate
disease IDO intervention
disease MESH emerging infectious diseases
drug DRUGBANK Etodolac
drug DRUGBANK (S)-Des-Me-Ampa
disease MESH dengue
drug DRUGBANK Alpha-1-proteinase inhibitor
disease IDO infection
disease IDO communicability

Original Article

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