Joint statement on HK local healthcare system’s response to COVID-19

The third wave of COVID-19 outbreak emerged in July, and the epidemic situation is more severe compared with the second wave. There have been more than 100 confirmed cases every day. The medical sector understands the citizens’ concerns including whether the daily number of viral tests, isolation facilities, hospital beds and healthcare manpower are enough to tackle the menacing pandemic. In fact, more than 100 patients with COVID-19 are still waiting for admission. This is obviously undesirable [1]. Below are our thoughts and suggestions:

   

(1) Insufficient hospital beds

Hospital Authority Chief Manager (Clinical Effectiveness & Technology Management) Dr. Linda Yu said that the main problem is insufficient hospital beds. Non-emergency and non-essential services have been reduced freeing up hospital beds and allowing the redeployment of manpower to treat COVID-19 patients.[2] According to the Hospital Authority (HA), 1207 first-tier isolation beds and 650 isolation wards were in use, reaching 69.8% and 76.5% of full occupancy respectively while the occupancy for negative pressure intensive care unit beds was 53.5% [3]. We still have some rooms before hitting 100% occupancy.

The HA has said that it will increase the number of isolation beds to 1,400 within 72 hours [4, 5], including 350 units at Lei Yue Mun Park for isolation use [6], while the new makeshift hospital at the AsiaWorld-Expo can house 2000 beds [7]. These isolation facilities are ready for use. We hope that the government can implement its plan when needed and not repeat similar mistakes like failing to provide enough personal protective equipment in February 2020.

   

(2) Mis-allocation of manpower

During the COVID-19 pandemic, citizens have reduced visits to hospitals. Meanwhile hospitals have reduced non-emergency and non-essential services to redeploy personnel to treat COVID-19 patients [2]. The HA has 6,429 doctors in total [8], with about 200 of them working in isolation wards. Chief Executive of HA Dr Tony Ko Pat-sing said that there are multi-pronged arrangements on manpower deployment [9]. There are more than 14,000 Hong Kong doctors in the public and private sectors [10]. We believe that many of them are willing to be assigned to take care of citizens in critical times. If we have no other choice but import doctors from mainland China in future, the HA can adhere to existing mechanisms and applicants need to be evaluated and approved by the Medical Council of Hong Kong.

   

(3) Asymptomatic COVID-19 patients

Some confirmed cases are asymptomatic. They do not need to use isolation beds in hospitals. If the outbreak persists, we should explore the use of community isolation facilities and the feasibility of using telemedicine to ease the burden on hospitals.

   

(4) Help

Regarding the providing of assistance by the Central People’s Government to Hong Kong such as supplies, facilities and nucleic acid testing, Dr Tony Ko Pat-sing has said that if the number of confirmed cases rises exponentially, we may need to purchase hospital beds from mainland China [9]. The Hong Kong government has also commissioned two institutions in mainland for COVID-19 nucleic acid testing [11]. Chief Secretary for Administration Matthew Cheung Kin-chung pointed out that the Hong Kong Chief Executive has requested the mainland to help step up the capacity of mass testing but will not ask mainland healthcare workers to practice in Hong Kong [12].

  

(5) Coronavirus tests

The inadequate number of daily viral tests has been criticized by the general public as being far behind Singapore and Macau. The Hong Kong government should enhance the testing capability of the Department of Health, and should further increase the daily number of viral tests through private-public partnership. We hope it can increase testing capacity and shorten the reporting time of the results.

To prevent the pandemic from getting worse, the government has tightened curbs on social gatherings, such as imposing restrictions on restaurant dining, supermarkets and wet markets, and mandatory mask-wearing in public places. But health experts pointed out that the third wave outbreak is possibly caused by the exemption of seafarers and aircrew from COVID-19 quarantine rules [13-15]. The government denied it at first [16]. It made an announcement a week later suspending crew change arrangement for passenger vessels and goods vessels without cargo operation in Hong Kong [17-18]. Other exempted arrangements from quarantine requirements will also be tightened.

We suggest that the government should reduce unnecessary exemptions and increase coronavirus testing for anyone entering Hong Kong. Some newspapers reported that there have been quarantined persons with wristbands going everywhere. The government needs to enhance its monitoring system and increase prosecution. We call on our citizens to display a rigorous self-discipline like we did in February, such as wearing face masks, washing hands frequently, boosting personal hygiene and environmental hygiene, and staying home to curb the spread of coronavirus.

We sincerely hope that we can minimize the adverse impact of the third wave of the pandemic.

(This article is English version of original Chinese joint statement. 有關本地醫療系統如何應對疫情的聯合聲明 2020-08-01.  In case of any discrepancy between the Chinese version and the English translation, the Chinese version shall prevail. )

   

References

[1] 逾百患者仍等候入院，醫管局認不理想。港台新聞 2020-7-26
[2] 被問是否要內地醫護協助，醫管局：主要是病床不足。港台新聞 2020-7-25
[3] 昨增7危殆至29人 20確診者入院一度要等，鯉魚門營最快周五收輕症確診者。明報 2020-7-22
[4] 醫管局：可於72小時內將隔離病床增至1400張。RTHK 2020-1-7
[5] 1400隔離病牀何來，一加一減數字遊戲，近千牀屬普通房。頭條日報 2020-1-14
[6] 有醫生相信鯉魚門社區隔離設施短期內足夠應付疫情。Now TV 新聞 2020-7-24
[7] 林鄭月娥找國家協助亞博館建方艙醫院，將提供2000床位。香港01，2020-7-27
[8] 醫院管理局 2018-2019 年報，202頁 (2019 年 3 月 31 日數字)
[9] 李立業︰亞博館規模似醫院，高拔陞︰或須向內地買病床。港台新聞 2020-7-25
[10] 香港統計年刊。政府統計處 2019 年版
[11] 政府億元聘兩內地機構助檢測，先驗4高危群組40萬人，防疫基金支付。明報 2020-7-14
[12] 張建宗：特首請求中央增本港檢測能力，惟不會要求內地醫護來港。Now 新聞 2020-7-27
[13] 袁國勇：第三波疫情源於邊境檢疫漏洞，估計零號個案是接載旅客的士司機。有線新聞2020-07-14
[14] 許樹昌估計第三波疫情源於豁免檢疫海外入境者。香港電台 2020-7-18
[15] 何栢良批評船員豁免如無掩雞籠，促立即取消政策。香港電台 2020-7-24
[16] 政府澄清豁免強制檢疫安排屬必要。政府新聞公報 2020-7-19
[17] 陳肇始：第三波疫情源頭來自豁免檢疫人士有實證支持，會嚴肅跟進。2020-7-28
[18] 政府收緊豁免人士檢測和檢疫安排。政府新聞網 2020-7-26

Aug 2020