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In the opening days and weeks of the novel coronavirus outbreak in China, the criteria used for testing suspect cases outside of Mainland China has required recent travel to the affected area or close contact with a known case.
Test kits have been in short supply, and this narrow criteria would likely catch most cases.But in the past week or so, Hong Kong, Taiwan, Japan, and Singapore have detected a growing number of locally acquired cases - some of whom were seen at clinics, or hospitalized for a week or longer, before being identified.
When you add in the large number of mild or moderate illnesses - and asymptomatic cases - reported with this virus, the odds increase that a community cases are being missed by the current surveillance and testing system.Last week the CDC has announced plans to `cast a wider net' in 5 major cities (see CDC/HHS To Phase In Wider Surveillance For COVID-19), and today Hong Kong's Hospital Authority has announced plans to test out-patients being treated at clinics for fever, respiratory infections, and/or pneumonia by sending patients home with a sample cup and instructions on how to collect a sputum sample and have it tested.
Strengthening the monitoring mechanism for new types of pneumonia
February 18, 2020
The Government has strengthened the monitoring mechanism for new coronaviruses from inpatients in public hospitals to emergency departments and general out-patients. From tomorrow, if these two types of patients have relevant symptoms, they will need to take their own deep saliva samples for a new coronavirus test.
Speaking at a press conference today, the Deputy Secretary for Food and Health, Mr Xu Deyi, said that he had noted that some cases of new coronavirus infection, particularly those with milder symptoms, had been referred to patients in different places and were eventually diagnosed in public hospitals.
In response to the latest developments, the Scientific Committee on New Discoveries and Animal Infectious Diseases and the Scientific Committee on Infection Control of the Centre for Health Protection of the Department of Health met yesterday to review the latest situation and prevention and control strategies for new coronavirus infections in Hong Kong and to recommend that the monitoring mechanism be strengthened.
Mr Tsui pointed out that in order to further strengthen the prevention and control strategy, the Government had decided to broaden the scope of the laboratory surveillance programme to allow for early diagnosis and better understanding of the epidemiological situation of the virus.
The Chief Administrative Manager of the Hospital Authority (Quality and Standards), Mr Lau Jiaxuan, said that from tomorrow, patients aged 18 and over who had visited the emergency department sancatorium or general clinic of a public hospital, had symptoms of fever, respiratory infection or pneumonia, and if clinically diagnosed as not requiring admission, the emergency department or outpatient clinic would provide them with a sample bottle. When the patient gets up the next day, he takes a deep saliva sample on his own with a sample bottle and returns the sample to an emergency department or outpatient clinic for a new coronavirus test.
Patients do not have to stay in hospital to await the test results and the HA will send the samples to the Department of Health for testing, which is expected to be completed in two to three working days. If the results are negative, the HA will notify the patient by telephone message and if the results are positive, the CHP will call the patient and arrange for the patient to be admitted to hospital for isolation treatment.
