In Age of COVID-19, HK Innovates To Test And Quarantine Thousands

25-Feb-2020 Intellasia | NPR | 6:02 AM Print This Post

Hong Kong is fighting an epic battle to keep the new coronavirus from exploding in its territory.

As of Sunday, the city of 7.5 million had only 70 confirmed cases. But with thousands of cases being reported just across its border posts in mainland China, the threat of this virus is forcing Hong Kong health officials to work frantically to try to keep the disease at bay.

Thousands of people who may have had contact with patients or who have recently visited China are confined to their homes under mandatory quarantine orders. The government is requiring anyone who enters from China to remain inside their homes or hotel rooms for 14 days. Hundreds more are locked in quarantine facilities under police guard. Doctors are determining who to test for the new virus, who to isolate and who to order to stay at home. Hospitals have dedicated entire wards to tending to suspect and confirmed COVID-19 cases. And in this battle, Hong Kong is constantly having to innovate and improvise.

The city has converted a newly built public housing complex into a quarantine facility. The complex, called the Chun Yeung Estate, is a cluster of 40-story high-rises spread over five blocks. The complex when finished will have nearly 5,000 apartments. None of the apartments have been rented out yet but now it’s being turned in to one of the largest quarantine facilities in Hong Kong, capable of holding thousands of people.

Buses under heavy police escort arrived at Chun Yeung bringing passengers off the Diamond Princess cruise ship from Japan; they’ll be confined for 14 days. Police have set up barricades around the entire complex and not just to keep the quarantined passengers in. A few weeks ago protestors set fire to another high-rise that Hong Kong had been planning to use as a quarantine facility, fearing that the virus could spread in their neighbourhood.

But Carrie Lam, the chief executive of Hong Kong, has stood firm with the plan to use Chun Yeung Estate as a quarantine centre. “Hong Kong cannot afford to not have this centre,” she said at a press conference. The Chun Yueng housing estate, she said, is the city’s only viable option for quarantining the nearly 300 people coming from the cruise ship. There is no plan B, she said.

“We will do all we can to protect this estate,” Lam said of the police barricades and checkpoints that now surround the complex. “And I hope residents [of the neighbourhood] will accept this arrangement, which is of benefit to the whole society.”

Testing people for the virus is another area where the city has had to find new ways to respond. Hong Kong’s public health system currently runs 700 to 800 laboratory tests a day for the new coronavirus. To ease the burden on doctors, clinics and laboratories, Dr Lau Ka-hin, the Hospital Authority’s chief manager for quality and standards, announced that hospitals are launching a new outpatient testing programme for suspected COVID-19 cases.

The outpatient programme is for individuals “age 18 with fever, upper respiratory tract infection or pneumonia,” Lau said. “And if the clinical diagnosis is that they don’t need to be hospitalised, then the accident and emergency department will give a specimen tube to the patient.”

The patient is instructed to take the tube home, then first thing in the morning spit into the vial and return the sample to the lab. There is a possibility that patients will not take the sample correctly, Lau said. And of the first 300 specimen tubes sent home, only about 250 were returned. Still, Lau sees advantages in this new initiative.

“The patient does not have to stay in the hospital to wait for the test results,” Lau said, unlike the current procedure.

The vast majority of people test negative, so this new procedure will also keep those patients out of the health-care system and away from patients who may actually be infected with the virus.

“After a patient sends in a specimen it will take about two to three working days to complete the test on the virus,” Lau said. “If the test result is negative, we will inform the patient by text message. But if [the] test is positive, then the department of health will call the patient and arrange for the patient to go into hospital for treatment in isolation.”

In addition to setting up new testing programmes for the virus, Hong Kong’s health department is also attempting to track down hundreds of people who may have been in contact with confirmed cases.

Dr Chuang Shuk-kwan, the head of the communicable disease branch for the health department, said the primary focus is on getting in touch with close family members as they tend to be at highest risk.

“But for other contacts, sometimes it’s very difficult,” Chuang said. She said airlines and trains often don’t have the phone number or other contacts for passengers, and it’s impossible to track them down after they’ve disembarked. Sometimes the passengers are no longer even in Hong Kong.

For instance, the city was notified that 36 Hong Kong residents were aboard the MS Westerdam cruise ship, where a passenger tested positive after disembarking in Cambodia. The health department was able to connect with 24 of them but is still trying to track down the other 12.

The outpatient programme is for individuals “age 18 with fever, upper respiratory tract infection or pneumonia,” Lau said. “And if the clinical diagnosis is that they don’t need to be hospitalised, then the accident and emergency department will give a specimen tube to the patient.”

The patient is instructed to take the tube home, then first thing in the morning spit into the vial and return the sample to the lab. There is a possibility that patients will not take the sample correctly, Lau said. And of the first 300 specimen tubes sent home, only about 250 were returned. Still, Lau sees advantages in this new initiative.

“The patient does not have to stay in the hospital to wait for the test results,” Lau said, unlike the current procedure.

The vast majority of people test negative, so this new procedure will also keep those patients out of the health-care system and away from patients who may actually be infected with the virus.

“After a patient sends in a specimen it will take about two to three working days to complete the test on the virus,” Lau said. “If the test result is negative, we will inform the patient by text message. But if [the] test is positive, then the department of health will call the patient and arrange for the patient to go into hospital for treatment in isolation.”

In addition to setting up new testing programmes for the virus, Hong Kong’s health department is also attempting to track down hundreds of people who may have been in contact with confirmed cases.

Dr Chuang Shuk-kwan, the head of the communicable disease branch for the health department, said the primary focus is on getting in touch with close family members as they tend to be at highest risk.

“But for other contacts, sometimes it’s very difficult,” Chuang said. She said airlines and trains often don’t have the phone number or other contacts for passengers, and it’s impossible to track them down after they’ve disembarked. Sometimes the passengers are no longer even in Hong Kong.

For instance, the city was notified that 36 Hong Kong residents were aboard the MS Westerdam cruise ship, where a passenger tested positive after disembarking in Cambodia. The health department was able to connect with 24 of them but is still trying to track down the other 12.

https://www.npr.org/sections/goatsandsoda/2020/02/23/808290390/in-age-of-covid-19-hong-kong-innovates-to-test-and-quarantine-thousands

 


Category: Hong Kong

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