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Dr Gabriel Choi Kin, president of the Hong Kong Medical Association

2020-08-09

Dr Gabriel Choi Kin, president of the Hong Kong Medical Association

2020-08-09
 
Good Morning.
As Covid-19 continues to rampage in Hong Kong and came back as a third wave with vengeance in July 2020, with infected number over 100 for 10 consecutive days, citizens grew tired and panicky.  As of 5 August this year, Hong Kong has 3755 confirmed cases, 2314 recoveries and 43 deaths.  The first case in Hong Kong was identified at 23 January 2020, 5 months 25 days ago.  Due to our experience with SARS, our diligence with masking, social distancing and hand washing, we came out of the first wave fairly intact.  The second wave took place in late March with 48 new cases on 20 March 2020.  This was attributed to residents returning to Hong Kong from Europe without compulsory testing.  Things quiet down a bit after tighter control till early July when the third wave hit us.  The experts attributed this to over 20 categories of exempted persons numbering over 200000 who arrived into Hong Kong without testing.  Experts tied the source of infection to air crew members, sea farers and domestic helpers. 
In July this year, the Health Department opened up free deep throat saliva testing without the need to see a doctor, resulting in further anxiety for the citizens as testified by the long queues outside the public clinics from 4 am to compete for a saliva bottles.  Public laboratory service, however, was stretched to the limit and the public laboratory was dealing with samples from July 16 when I phoned in and asked them about my specimens on 30 July, a delay of nearly 2 weeks in reporting.   The Centre for Health Protection, in their letters to doctors and on the media, requested doctors to test only those with mild symptoms.  This inconsistency in testing policy posed a dilemma for doctors – indiscriminate testing or only those with symptoms, albeit mild. 
Citizens working in construction site, sanitation business and as security guards and who live in the neighbourhood of an infected person have been asked by their employer to produce a certificate of negative Covid-19 test result before they are allowed to return to work.  If they do not want to wait the wait, they have to foot the bill of near $1500 to have the test done in a private laboratory.  More recently, Mainland authority and Macau immigration have requested that travellers from Hong Kong produce a valid Covid-19 negative test result within 3 days before travellers are allowed entry into their territory.  My colleague in the Medical Association had suggested in a prior press conference that government provide a health coupon for citizens to support them to get themselves tested in the private sector if there is a time constraint.  I further suggested that the coupon could be used to treat Covid-19 related illness such as anxiety depression, panic attack, social phobia, breathing difficulty, facial mask dermatitis, acne, and so on. 
Unfortunately, what we said in the press conference was twisted into an evil plan to enrich doctors through testing which can result in billions of dollars of revenue from the government.  However, 99.9% of doctors are not proprietors or share owners of private laboratories or on the board of directors of private hospital.  If testing were to be done, it is because of the need and doctors will not benefit from the testing fees.  As pointed out earlier, there are other related illness and stress that needed to be managed and the condition reassured.  The health coupon would be helpful to those in these difficult times when many are out of a job.
It is now settled that government has invited Mainland experts to help out with our epidemic.  Up till yesterday, the Medical, Nursing and Medical technologist profession have no clue about what they will be doing in Hong Kong, what kind of experts they are, whether they will submit the CV for registration to practice in Hong Kong, where they will work and what kind of work they will do.  In the Medical Association press conference, the news of Mainland expert arriving had not been confirmed, and I commented that it may be chaotic when the local doctors and Mainlanders had to work together because of difference in language and record keeping.  If the Mainland experts are to be working by themselves and taking charge of the AsiaWorld Expo makeshift hospital, this would be a possible solution.  I made it clear in the Press Conference that I would not be using strong remarks to oppose Mainlanders working in Hong Kong to assist us.
Already there is report that the Mainland experts will be setting up Universal testing of up to 200000 tests a day with the aim of screening the whole population and finding out the occult carriers.  Unless a curfew is posed to keep all these tested indoor to wait for the whole population screening is completed, it would be difficult to prevent reinfection.  The last three days saw the number of infection daily dropping down to two figures, making the need for universal testing a valid question.  However, if the test from Mainland cost $15 an examination, as some KOL on the internet claim, and if it is opened to the public, this would solve the problem of expensive testing for some of our citizens who needed the test quick and cheap.
Our local experts have located the source of the third wave to aircrew and seafarers from overseas who were exempted from testing prior to the third wave.  There were over 200000 people coming into Hong Kong untested and brought on the third wave.  This loophole is closed but there are still over 20 groups of people who are exempted from testing and this may continue to pose a threat.  Government seems reluctant to permanently close this gate.
The creation of temporary hospital in AsiaWorld Expo site and at Penny’s Bay aims to relief the congestion in the public hospital.  Public hospitals do not have enough isolation beds and rooms for Covid-19 patients.  The rationale of the temporary hospitals is to pool those with mild illness together on the assumption that they are already infected and it would not matter if they are grouped together.  However, doctors are stressed and even infected.  Uninfected patients have been brought to stay with infected patients in the same room or in the temporary hospital.  A re-distribution of manpower has to be arranged.  Doctors from the dirty team could not even get a hotel room to stay to rest themselves and avoid contaminating their own family.  Private sector doctors have not been asked to share the work of the public service.    With over 6000 doctors with potential to contribute, when is the Health authority going to tap this resource?
I have confidence that Hongkongers will pull through this stage of the epidemic.  We need to be resilient and keep our masks on, our hands washed, social distancing kept and remain at home with our family unless we are forced to go out.  Government has to learn from mistakes and balance the risk and well-being of citizens and made correction as soon as possible such as banning lunch and breakfast in restaurants and forcing the labourers to eat on the street with their mask down and sitting side by side on the road.  God bless Hong Kong. 
 
 

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