MASS TESTING MAY BE DELAYED TO GIVE ELDERLY CARE PRIORITY
Exercise would be ‘useless’ with so many cases emerging and a lack of isolation facilities, insiders say
Hong Kong could postpone its Covid-19 mass testing to next month to focus instead on reducing severe coronavirus infections and deaths among the elderly, the Post has learned, as epidemiologists estimated the fifth wave peaked late last week.
As part of the shift in emphasis, Chief Executive Carrie Lam Cheng Yuet-ngor would likely give an update today on how hospital resources in public and private sectors would be allocated for epidemic control, a source familiar with the matter said.
The source revealed top officials were considering the shift in strategy as a result of the alarming number of fatalities among the old, saying: “Now the priority is to reduce the death rate and care for the elderly.”
Lam had said some form of mass testing could take place in March, but the source said: “The Hong Kong government only put March as a planning parameter. The central government has never set a time frame.”
The chief executive met representatives of the Hong Kong Private Hospitals Association yesterday on their role in supporting the fight against Covid-19 and they were scheduled to hold talks with health minister Sophia Chan Siu-chee today, the insider said.
Private hospitals are under pressure to take up a greater role in treating patients after VicePremier Han Zheng, who oversees the city’s affairs, criticised them for their alleged reluctance in handling some of the overflow from public hospitals.
To better cope with the backlog of patients, Queen Elizabeth Hospital will dedicate its resources, including its estimated 2,000 beds, to exclusively treating cases, becoming the third public facility to do so, according to another source.
Authorities also announced that hair salons, which were ordered to close on February 10, would be allowed to reopen tomorrow. But other existing social-distancing measures, including a ban on public gatherings of more than two people and private gatherings involving more than two households, would remain in place until March 23.
On the internal discussions to delay universal testing, insiders told the Post that carrying out the exercise with so many cases emerging every day would be “useless”, given the city still did not have an adequate number of isolation facilities.
Sources had previously said the exercise could begin on March 26, though the exact timing and details of a lockdown had yet to be finalised. But the insider said authorities were still considering whether testing should begin in late March or late April, adding: “Both options are still open.”
The government on Monday launched an online portal for residents who test positive using rapid kits to log the results and drew 17,236 people, according to Dr Albert Au Ka-wing from the Centre for Health Protection.
Of those, 14,715 were new cases while the rest were infections previously known to health authorities through nucleic acid tests or they mistakenly entered their information repeatedly. But only 2,018 residents completed the reporting process and were issued with isolation orders.
They were added to the 28,475 infections discovered through PCR tests, for an overall tally of 30,493 cases yesterday.
“There was a time about 200,000 people were queuing at the platform last night. This number covers those who only came to browse the website as well,” Au said, adding that those who had tested positive via rapid tests between February 26 and March 5 were given one week to upload their results.
Au explained that self-reporting positive RAT results was voluntary but highly encouraged because the information meant authorities could keep track of case numbers, which could have implications for policymaking.
Logging the cases also allowed health authorities to certify infections and issue or update relevant documents to patients, including medical records that could affect their vaccination schedules.
“There will be legal implications after submission of the documents … They will be classified as a confirmed Covid-19 case under our system and we will issue an isolation order to them under the Cap 599A regulation and issue quarantine orders for their household contacts,” Au said. “So it is necessary for them to provide their identity card and rapid antigen test image so we can verify their information … and issue those orders.”
Health authorities will randomly select people who registered a positive RAT result on the government platform to undergo compulsory nucleic acid testing.
A courier will deliver a test kit to the person, and they are required to return a sample within 20 minutes.
The fine for noncompliance is HK$10,000 and the person will also receive a compulsory testing order. Failure to comply with the order will result in a fine of HK$25,000 and up to six months in jail.
The tally of confirmed cases since the start of the pandemic stands at 527,260. The Hospital Authority recorded 160 fatalities in the 24 hours to yesterday, involving patients aged four to 105. Of those, 116 had no vaccination records.
Another 127 people, aged 56 to 102, died earlier but the cases were only reported yesterday due to a backlog. Four chronically ill patients aged 32 to 85 who had not been admitted to hospital also died earlier. The number of Covidrelated fatalities stands at 2,578.
According to modelling by the University of Hong Kong, led by government pandemic adviser and its medical dean Professor Gabriel Leung, daily cases peaked on March 4. The number is expected to drop below 1,000 on April 23 and fall into double digits by mid-May.
But Professor David Hui Shucheong, another adviser, cautioned uncertainties remained.
“Many people have been using RAT in the past few weeks. Some of them have not reported their test results, and some might never report them,” Hui said.
The government needed to monitor overall cases for another two weeks to get a better idea of where the infection trend was heading, he said.
The development came as Dr Liang Wannian, leader of the National Health Commission’s Covid Response Expert Team, urged elderly care facilities to adopt a “closed-loop” approach with restrictions on staff movement to reduce deaths.
Since arriving in the city last week, Liang has urged the government to concentrate on “four focuses”, with the main goal being to reduce deaths.
“Care workers at the nursing homes are not under closed-loop management currently. Can [Hong Kong] consider implementing it to cut transmission links?” he said in an interview with Xinhua on Monday.
On the mainland, staff at hospitals treating Covid-19 patients work in closed loops, living on site without going home on rotations that last up to two months.
As of Tuesday, more than 86 per cent of Hong Kong’s elderly care homes, or 690 in total, had logged coronavirus cases during the fifth wave, with 16,200 residents and 4,470 workers infected. More than two-thirds of homes for the disabled, or 230 facilities, have also had cases, with 4,800 residents and 1,710 staff infected.
Au said the death rate of people who had received two or more doses of a Covid-19 vaccine was 0.06 per cent, and 1.52 per cent for those who were unvaccinated or had taken only one jab. For those aged 80 or above, the death rate was 2.12 per cent and 10.32 per cen, respectively.
The vaccination rate among the elderly lags far behind that of the general population. In a Facebook post on Monday night, civil service chief Patrick Nip Takkuen said authorities aimed to vaccinate all suitable seniors in care homes with at least one shot within two weeks via outreach services, with the long-term goal of providing three doses.
In his interview, Liang reiterated that the government should focus on isolating residents who tested positive, pooling resources, consolidating expert advice and improving treatments.
The universal testing plan, he said, was a piece of “system engineering” that involved careful planning on how to conduct screenings, collect and transport specimens, and manage those who tested positive, along with their close contacts.
Medical experts have suggested that the government defer compulsory universal testing until late April, arguing a lack of quarantine and treatment facilities will render the exercise ineffective if conducted in the middle of a fifth wave of infections.
Granted, the government should keep ramping up quarantine and treatment capacity but universal testing should be conducted expeditiously as a matter of principle. The number of Omicron-induced fatalities has surpassed 1,000. Hong Kong’s seven-day rolling average of Covid-19 deaths per million is currently the highest in the world.
Worse still, while extant research finds three doses of vaccination as the key to protection against Omicron, fewer than 30 per cent of Hongkongers aged 12 or above have received the booster shot. Only 47.7 per cent of children under 12 and just 52.9 per cent of elderly aged 80 or above have received the first jab, although they have proven to be the more vulnerable groups.
In light of the foreseeable surge in Covid-related deaths, we have every reason to support measures that can help cut community transmission chains speedily. Time is of the essence in our efforts to save lives. Deliberately delaying compulsory testing is tantamount to agreeing to the epidemic continuing to claim Hongkongers’ lives.
Mass testing should be conducted as soon as Hong Kong has maximised its quarantine and treatment capacity, not necessarily only when case numbers have dropped. Although early testing will not guarantee a return to “dynamic zero infection”, it is a step towards limiting the number of potential infections and deaths.
Of course, early testing should only be part of a multipronged strategy to fight the epidemic. Apart from boosting the vaccination rate and constructing more isolation and treatment facilities, the government must strengthen support for patients who are suited or compelled to isolate at home. Relevant measures could include opening more hotlines and mobilising more civil servants to distribute tracking wristbands, daily necessities and medication to people undergoing home isolation.
Meanwhile, members of the public should play their part by getting vaccinated and reducing social gatherings. It is through proactive action and public cooperation that we can win the battle against the virus.
Roy Tsang Churn, Sha Tin