Friday, May 07, 2021

Hong Kong Hospital Authority Ramps Up Procedures For New COVID Variants


 Hong Kong CHP COVID Dashboard

#15,944

Hong Kong, with a population of roughly 7 million, has managed to keep their daily COVID numbers in the double digits for months, and has one of the lowest death rates (28 per million) in the world.  By contrast, the death rate per capita in Hungary (2936 per million) is more than 100 times higher. 

Part of this is due to their early, and coordinated response to the COVID pandemic (see A Tale of Two Outbreaks: Hong Kong & Italy), a culture that already embraced mask wearing (see HK CDW: Surgical Masks For Respiratory Protection), and the dominance of the original, milder, `asian' lineage of COVID for much of 2020. 

As an international city - even with a strict 14-day quarantine policy for arriving visitors - there remains the potential for the introduction and spread of newer, possibly more dangerous, variants which could undermine Hong Kong's success to date. 

On Tuesday, May 4th, the CHP announced the detection of a local COVID case with the 501Y mutation, raising concerns of community spread. 

Among the newly reported cases announced, three are imported cases and one is a possibly local case with unknown sources.

The possibly local case with unknown sources is a 48-year-old woman (case number: 11791) involving N501Y mutant strain. As N501Y mutant strain is with high transmissibility, the CHP decided to carry out prudent measures on infection control and prevention to stop the potential risk of spread of N501Y mutant strain.
The CHP will, in accordance with the Prevention and Control of Disease Regulation (Cap. 599A), transfer asymptomatic residents of all units on all floors of the building (involving over 220 units) where the patient resided (Block R, Allway Gardens, Tsuen Wan) to quarantine centres ; symptomatic residents will be sent to the hospital for treatment. They will undergo compulsory quarantine for 21 days.

The normal quarantine period of 14 days has been extended by 50% to 21 days out of an abundance of caution. Today Hong Kong's Health Authority has announced enhanced measures to deal with this new threat. 

Hospital Authority heightens vigilance towards mutant strains

The following is issued on behalf of the Hospital Authority:

In light of the latest global epidemic situation and the emergence of local cases with mutant strains, the Hospital Authority (HA) today (May 7) reminded hospital clusters to prepare for deploying adequate single isolation facilities to dovetail with the stepped-up patient isolation arrangement, while the regular staff testing arrangement will be further extended to reduce the risk of nosocomial transmission of COVID-19 to safeguard patients and staff.

"Single isolation will be arranged for all patients confirmed with COVID-19 infection upon their admission, with gene sequencing tests arranged immediately. Patients of imported cases will be kept in single isolation until they are discharged upon recovery, while patients of local cases will also be kept in single isolation until discharge, unless they test negative for mutant strains through gene sequencing tests," the HA spokesperson said.

In addition, the HA will arrange regular COVID-19 testing for around 65 000 front-line staff who have direct patient contact, starting from next week.

"Upon consultation with infection control experts and making reference to the regular testing arrangements of overseas and local healthcare institutions and other professions, the HA decided to extend the staff testing arrangement next week," the HA spokesperson said.

"The staff concerned will be provided with rapid antigen test kits for conducting self-testing regularly every week. Upon completion of a test, staff members can report their test results through a mobile app designated for HA staff, or save a photo record by themselves. Staff who have received two doses of a COVID-19 vaccine for more than 14 days can indicate their preference for participation in the regular testing exercise."

Since January 2021, the HA has introduced pilot COVID-19 regular testing for about 5 000 staff members caring for vulnerable patients and patients with end-stage illness. Rapid antigen testing was later introduced in mid-March. The testing and the reporting workflow have been smooth so far, while feedback from participating staff has been positive. No confirmed case has been identified during the period.

The HA spokesperson reiterated that regular testing and vaccination are types of stepped-up measures. Front-line staff still need to comply with infection control measures and wear appropriate personal protective equipment as stipulated in the guidelines when taking care of patients.

The HA thanks staff members for their co-operation in the testing arrangement and urges members of the public and staff to get vaccinated early so as to reduce their own risk of COVID-19 infection and to prevent the resurgence of a large-scale community outbreak.

Ends/Friday, May 7, 2021
Issued at HKT 17:00

While no one factor can be credited with the success (when graded on the curve) that many Asian nations have had in curbing community transmission of COVID-19, not having to deal often with more transmissible variants like B.1.1.7, B.1.351, and P.1  has been certainly helped. 

Mainland China has been very vocal about the need to prevent entry of the `foreign' variants, and last December their CDC published a paper (see CCDC Weekly: Models Suggest D614G Spike Protein Mutation Accelerates Transmission of COVID-19) with the following map showing the relative lack of the `European' variant in Asia.



The ability to keep the rising tide of COVID variants at bay - even with strict travel policies and quarantines - becomes increasingly difficult over time, and today's announcement from Hong Kong reflects that reality.