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Legislator Ip Kin Yuen

2019-01-27
In view of the present Seasonal Influenza situation, the Government announced on last Thursday that all kindergartens, including kindergarten-cum-child care centres and special child care centres, will start their Chinese New Year holidays from January 26 till the end of the original scheduled, about a week earlier than planned, in order to help prevent the further spread of flu. I think the early kindergarten closures were justified. However, the situation also shows that the government hasn't done enough against flu, since it is already the second consecutive year the holiday has been brought forward for flu prevention.
 
The government officials said the flu outbreak among children aged under 6 this year is "serious" compared to the past couple of years. According to The Centre for Health Protection (CHP)'s weekly influenza surveillance reports, from 30 December 2018 to 17 January 2019, that is shortly before the first call for suspension of classes, more than 275 outbreak cases were recorded involving almost 2,000 people and 70% of them were from kindergartens. Media reported since the start of the winter flu season in December, 13 children have contracted flu classed as severe, eight of them were aged five or younger.
 
Before the Thursday announcement was made, CHP recommended that kindergartens recording 3 cases of flu within 4 days be suspended for 7 days. This affected some 372 kindergartens, more than one third of the total, which had suspended classes before last Thursday. While this ‘unusual' measure came out all of a sudden, for the sake of students' health, I believe that kindergartens are willing to act accordingly, though this may cause confusion to the schools.
 
However, workload on kindergartens arising from class suspension is not insignificant, especially in kindergartens with limited staff resources. On January 18, the government announced that 208 kindergartens would suspend classes on the next school day, without providing a list of affected kindergartens to the public. Many kindergartens reported that they had to handle a barrage of phone enquiries rushing in, issue notifications, cancel school bus services, step up cleaning activities, etc, all of a sudden. Taken together, these are no simple tasks. I therefore requested the Government to issue a full list of kindergartens required to suspend classes in a centralized manner. Not only would this approach reduce the number of phone enquiries continuously coming in from parents to kindergartens, it would also enable the kindergartens to focus on other crucial and urgent works. Readily acceding to my request, the Government issued online on the night of the same day a full list of kindergarten suspensions. This rapid response should be welcome.
 
About this ‘unusual' measure, that is, kindergartens recording 3 cases of flu within 4 days be suspended for 7 days, there exist some doubts in kindergartens. For example, under the existing Guidelines on Prevention of Communicable Diseases in Schools, kindergartens are required to consider ‘school-based' suspension only when specific conditions are met: (a) Any death of healthy children in the school due to influenza, (b) Two or more children required intensive care unit admission due to influenza, or (c) Influenza-like illness attack rate among children is 20% or more.
 
The Government should let the public know how this extra criterion of ‘3 cases within 4 days' has been arrived at, and whether this year's epidemic situation has become more acute following the ‘optimization' measures introduced by the Government and whether the existing Guidelines are no longer adequate in handling the current situation. It is necessary for the Government to review the situation and explain the need for change to kindergartens and members of the public, so as to remove their doubts and worries.
 
Looking back at the winter flu outbreaks last year, both kindergartens and primary schools were seriously hit disaster areas. As many as 73% of the cases came from schools. Of the 20 serious cases, only one student had been vaccinated. The Education Bureau announced the suspension of classes before the Lunar New Year suddenly, followed by chaos and widespread complaints. As remedial measure, the Food and Health Bureau launched a pilot scheme for vaccination in schools coordinated by the Department of Health. However, the scheme covers only primary schools and involves less than 200 of them.
 
Influenza outbreaks this year have concentrated on kindergartens. In addition to young children being relatively less able to take care of themselves and their immunity system being not yet mature, it deserves a careful study whether there exist any gaps in the prevention and control of flu outbreaks in kindergartens. For example, is there a direct correlation between the high infection rate in kindergartens and their relatively low vaccination rate of 30%? Even though the Government had simplified the tendering procedures for last year's ‘Outreach Vaccination Scheme' – under which private doctors were invited to come to kindergartens to provide vaccination service – the participation rate was still less than 20%. Was this an indication that the scheme failed to match the real needs of ‘users'? The pilot scheme introduced by the Department of Health in primary schools in the 2018/19 school year got a good response and proved effective. Could the Government be more proactive and extend the pilot scheme to kindergartens so as to enhance the protection of this high-risk group?
 
Seasonal flu outbreaks occur regularly every year and the Government has introduced various preventive measures and vaccination schemes. However, public hospitals still find themselves in a ‘critically desperate' situation every year and gaps continue to exist in the protection network for school children.
 
If the Government does a good job in flu prevention leading to less people being infected or requiring hospital admission, the resources saved may be greater than the annual expenditures on the purchase and distribution of vaccines, the medical staff may not have to suffer every year and school campuses need not become heavily hit disaster areas year after year.
 
Therefore, responsibility falls on the Government to comprehensively review the effectiveness of the various vaccination schemes and set targets, including making reference to the medical sector's recommendation to increase the vaccination rate of kindergarten and primary school children to 70% and to formulate corresponding measures so as to facilitate the Government's estimation of the quantities of vaccines required and the amount of staff resources needed to administer the vaccination work. The Budget should also increase funding provisions to ensure sufficient financial resources and manpower to deal with flu attacks.
 
At the same time, schools and parents have to take up their part of responsibilities as well. Apart from vaccination, there are a lot of things that can be done. Just to give one example, young kids should be given more time to engage in physical exercise every day. As the Chinese New Year is drawing near, may I wish all of our young kids will be healthy and strong! 

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