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Somewhat unexpectedly, Hong Kong's administrator Carrie Lam and their Department of Health have announced a major tightening of the discharge criteria for COVID patients and - starting today - will institute a strict 14-day isolation policy for anyone `discharged' from the hospital.
Additionally, past quarantine exemptions granted to arrivals deemed vital to city’s economy and daily operations - Diplomats, company directors and scientific experts - will no longer be granted, bringing Hong Kong's policies more in line with Mainland China.
In a statement published by News.gov.hk, Carrie Lam is quoted as saying:
Mrs Lam explained that if Hong Kong decided to resume quarantine-free travel with the Mainland, the city’s anti-pandemic practices would have to be more in line with the Mainland’s in order to give Mainland authorities confidence to enable Hong Kong people to travel to the motherland without being subject to a 14-day quarantine plus seven days of health monitoring.
“If Hong Kong was to loosen the boundary controls for people arriving from overseas or adopt what other countries have done - so called live with the COVID-19 virus - then the chances of resuming travel with the Mainland would be reduced.”
The Chief Executive stressed that in Hong Kong’s anti-COVID-19 strategy, controlling the importation of possible cases is a very important part of that plan of action.
Outside of China, and now Hong Kong, the trend over the past year has been towards reducing the amount of time required for isolation/quarantine as more has been learned about the disease. The CDC's criteria for when isolation and/or quarantine can end follows:
- For most children and adults with symptomatic SARS-CoV-2, the virus that causes COVID-19, infection, isolation, and precautions can be discontinued 10 days after symptom onset and after resolution of fever for at least 24 hours and improvement of other symptoms.
- For people who are severely ill (i.e., those requiring hospitalization, intensive care, or ventilation support) or severely immunocompromised, extending the duration of isolation and precautions up to 20 days after symptom onset and after resolution of fever and improvement of other symptoms may be warranted.
- For people who are infected but asymptomatic (never develop symptoms), isolation and precautions can be discontinued 10 days after the first positive test.
- Patients who have recovered from COVID-19 can continue to have detectable SARS-CoV-2 RNA in upper respiratory specimens for up to 3 months after illness onset. However, replication-competent virus has not been reliably recovered and infectiousness is unlikely.
Hong Kong's statement on post-discharge isolation (at a prescribed facility) follows.
Isolation discharge criteria revised
October 26, 2021
The Government announced that from tomorrow, the criteria for releasing COVID-19 patients from isolation will be updated and the discharge criteria will be tightened.
The revised discharge criteria for symptomatic patients includes no fever for at least three days, having significantly improved respiratory symptoms and significant improvement in lung infiltrates in chest imaging.
These patients also have to meet designated laboratory criteria. They need to have two clinical specimens of the same type that tested negative for nucleic acid of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) taken at least 24 hours apart.
For patients with stool specimen(s) that tested positive, the laboratory criteria are two negative stool specimens collected 24 hours apart before release from isolation.
There should also be 10 days that have passed since the onset of illness for these patients.
For patients who did not develop any COVID-19 compatible symptoms all along, the laboratory criteria are two clinical specimens of the same type that tested negative for nucleic acid of SARS-CoV-2 by RT-PCR taken at least 24 hours apart.
Those whose stool specimen(s) tested positive, the laboratory criteria are two negative stool specimens collected 24 hours apart before release from isolation.
There should also be 10 days that have passed after the first positive RT-PCR for SARS-CoV-2 for these patients.
Patients fulfilling the discharge criteria will immediately be arranged by point-to-point transfer to designated isolation facilities to undergo 14-day isolation and health monitoring through closed-loop management.
The arrangement is to ensure they do not bring the virus into the community. The North Lantau Hospital Hong Kong Infection Control Centre is designated as the isolation facility.
The Department of Health will extend the isolation orders of patients who meet the discharge criteria pursuant to the power under the Prevention & Control of Disease Regulation until 14 days after discharge.
These new rules are receiving a good deal of criticism, not the least of which comes from well known Epidemiologist Benjamin Cowling from the University of Hong Kong's School of Public Health, who is interviewed in the following RTHK report.
2021-10-27 HKT 09:20
Epidemiologist Benjamin Cowling on Wednesday said requiring recovered Covid patients to spend an extra two weeks in hospital before being allowed to go home will waste public resources.
The infectious diseases expert from the University of Hong Kong's School of Public Health, said there were no cases known around the world where a recovered, or even a re-positive case, had triggered a community outbreak.
While these policies may be feasible now, when the number of daily cases in Hong Kong are running in the single digits - it will become much more difficult if they see another wave of infections like they did last winter.
