Hong Kong 16.04.2020 Corona Virus Management Practices in Kong

The first confirmed case of the COVID-19 in was announced on 23 January 2020. Hong Kong was relatively unaffected by the Covid-19 outbreak and had a flatter epidemic curve than most other places, which observers consider remarkable given its status as an international transport hub. Its closeness to mainland China and its millions of mainland visitors annually would make it vulnerable. Experts now believe the habit of wearing masks in public since the SARS epidemic of 2003 has helped keep its casualty numbers down with four deaths in the beginning of April.

Taiwan is not being reported by WHO daily updates (Daily Report/Sitrep)

Few of the important landmarks:

The HK government on 4 January declared a "serious response level" to the virus outbreak.

As of 2 March, Hong Kong had reached 100 confirmed cases.

Hong Kong government on 25 January declared the viral outbreak as an "emergency", the highest warning tier. The city's largest amusement parks, Resort, , and Madame Tussauds Hong Kong closed from 26 January, until further notice.

Hong Kong's first death was reported on 4 February.

Hong Kong closed its border to all incoming non-residents arriving from overseas on 25 March. Transiting through Hong Kong is no longer allowed either. All returning residents, regardless of point of departure, are subject to the Compulsory Quarantine Order, which requires all to stay at a reported quarantine premise (either home or hotel) for 14 days. Tracking devices are employed to enforce the order. All returning residents from the United States, the UK, and continental Europe are required to go through enhanced screening and submit saliva sample for COVID- 19 testing.

At the retail level, masks and hand sanitizer were in short supply by the end of January. Queue to buy face masks in Hong Kong, January 30, 2020. Everybody in the line is already wearing a disposable mask. In addition to toilet paper, flour became oversold as citizens took up home baking.

Government announced support for local private mask production by subsidising each production line with grants, help in identifying suitable premises, as well as placing orders to sustain their operations. An increase in mask production by Correctional Services Industries from 1.8 million to 2.5 million units a month is planned.

In view of the coronavirus outbreak, the Education Bureau closed all kindergartens, primary schools, secondary schools, and special schools until 20 April. The disruption raised concerns over the situation of students due to take examinations at the end of the year, especially in light of the protest-related disruption that happened in 2019.

On 5 February, flag carrier Cathay Pacific requested its 27,000 employees to voluntarily take three weeks of unpaid leave by the end of June. The airline had previously reduced flights to mainland China by 90% and overall flights by 30%.

As a preventive measure Hong Kong recommended wearing a surgical mask when taking public transport or staying in crowded places.

Social Protection Measures and Jobs Responses to COVID-19:A Real-Time Review of Country Measures based on “Living paper” version 3 (April 3, 2020) by Ugo Gentilini (World Bank), Mohamed Almenfi (World Bank) and Ian Orton (ILO) is given in the following table:

Hong Social Cash transfer An extra 1-month allowance is Kong assistance One-off universal cash planned for CSSA payment, Old transfer Age Allowance, Old Age Living Utility and financial Allowance, or Disability obligations support Allowance. Similar arrangements (waiver/postponement) will apply to the Work Incentive Transport Subsidy.1 A one-off transfer of HK$10,000 ($1,280) is planned for permanent residents over the age of 18. This measure, which involves a cost of about $71 billion, is expected to benefit about 7 million people2. The government will cover one month of rent for lower-income tenants living in public rental units3.

Analysis

In Hong Kong, the outbreak of the corona virus evoked bitter memories of SARS epidemic in 2003, when over 1,700 people contracted the virus and almost 300 people died locally.

Honk Kong was affected by Severe Acute Respiratory Syndrome (SARS) in 2003 exposing its vulnerability to new and emerging infectious diseases. It also exposed Hong Kong’s public health inadequacies in surveillance for early detection and in rapid responses to threats.

In the aftermath of the epidemic, a government-commissioned SARS expert committee made recommendations to enhance Hong Kong’s public health capabilities. Supplies, facilities and staff training for infection control were enhanced, isolation rooms and wards were upgraded and increased in 14 hospitals,

1 https://www.info.gov.hk/gia/general/202001/03/P2020010300231.htm 2 https://www.info.gov.hk/gia/general/202002/26/P2020022600420.htm 3 https://www.budget.gov.hk/2020/eng/nt.html and public health resources were significantly increased with the creation of the Centre for Health Protection, whose mission is “to achieve effective prevention and control of diseases”.

Hong Kong has a very strong public health system, good resources, and deep experience in managing epidemics. Hong Kong is one of the best health care facilities places in . When COVID-19 emerged, there was already an epidemic management plan in place that just had to be activated.

Hongkongers are particularly compliant with public health measures because the 2002-2003 SARS outbreak, which claimed almost 300 lives in the territory, is still fresh in many people’s minds.

Experiences gained during SARS, Hong Kong’s health department used its police’s Major Incident Investigation and Disaster Support System to contact tracing and this improved the timeliness and effectiveness of such work, enabled the early detection of infection clusters, and led to immediate interventions.

Hong Kong has more draconian travel restrictions that have since been imposed as a result of the outbreak of COVID-19. And just before Hong Kong implemented drastic restrictions that have allowed it to weather the coronavirus crisis while recording limited number of deaths so far.

The city has been in partial lockdown from the middle of January, with schools and universities shut, employees encouraged to work from home, sports facilities and museums closed down, and people told to avoid crowds. Hong Kong residents have accepted these restrictions, since. The partial lockdown is neither easy nor cost- free, but it largely seems to have controlled incidence of the disease, without paralysing Hong Kong. The city is close to mainland China and has extensive economic and other ties. But so far, it has recorded only limited number of deaths.

There has been extensive testing for the coronavirus in Hong Kong – which is free. This allows public health authorities to track the spread of the disease, and see that victims get treated properly and promptly.

Testing has been ramped up gradually. Initially they just added testing of all pneumonia patients, regardless of epidemiological link. The testing of all mildly symptomatic patients with no epidemiologic link is relatively new. A few weeks ago they started offering it in the public hospital and public outpatient clinics. Then have extended it to all private clinics.

People, in Hong Kong, are being told to get tested if you think you have been exposed, and/or are symptomatic. Anyone with a fever or respiratory symptoms is tested as a matter of course, upon recommendation of a doctor.

Honk Kong used triage at the door technique to identify people with high-risk travel history. Such people have to go directly to government hospital if symptomatic; or if just for routine care, wait 14 days after return (all of which must be healthy). Low risk people with symptoms were isolated immediately; they never enter the main clinic. Doctors have to wear personal protective equipment to check them. Hong Kong has made it a criminal offence to lie to a health care provider about one’s travel or exposure history. Honk Kong has a culture of wearing masks make it easily acceptable to wear mask.

Select References: 1. Ugo Gentilini (World Bank), Mohamed Almenfi (World Bank) and Ian Orton (ILO); Social Protection Measures and Jobs Responses to COVID-19:A Real- Time Review of Country Measures based on “Living paper” version 3 (April 3, 2020). 2. WHO, Coronavirus disease 2019 (COVID-19) Situation Report – 76, April 6, 2020 3. Promfret, James (4 October 2019). "Explainer: Hong Kong's controversial anti- mask ban and emergency regulations". Reuters. Archived from the original on 4 October 2019. Retrieved 7 October 2019. 4. "Hong Kong activates 'serious response level' for infectious diseases as Wuhan pneumonia outbreak escalates | ". Scmp.com. Retrieved 8 April 2020. 5. Siu, Phila (6 January 2020). "Hong Kong to add mystery Wuhan pneumonia to list of notifiable infectious diseases, giving authorities power to quarantine patients". South China Morning Post. Archived from the original on 14 January 2020. Retrieved 8 February 2020. 6. Cheung, Elizabeth (22 January 2020). "China coronavirus: death toll almost doubles in one day as Hong Kong reports its first two cases". South China Morning Post. 7. "Lunar New Year carnival canceled". The Standard. 23 January 2020. Retrieved 24 January 2020. 8. Chan, Kin-wa (25 January 2020). "Hong Kong declares Wuhan virus outbreak 'emergency' – the highest warning tier". Hong Kong Free Press. Archived from the original on 28 January 2020. Retrieved 29 January 2020. 9. Chan, Thomas (26 January 2020). "China coronavirus forces temporary closure of Hong Kong Disneyland, Ocean Park for indefinite period". South China Morning Post. Archived from the original on 26 January 2020. Retrieved 26 January 2020. 10. "Hong Kong reports first death from coronavirus". The Straits Times. 4 February 2020. Archived from the original on 4 February 2020. Retrieved 4 February 2020. 11. "Hong Kong imposes new quarantine rules over virus". BBC. 7 February 2020. Archived from the original on 8 February 2020. Retrieved 8 February 2020. 12. "Hong Kong reaches 100 coronavirus cases as two more infections confirmed". South China Morning Post. 2 March 2020. Retrieved 2 March 2020. 13. "Government announces enhancements to anti-epidemic measures in four aspectsdate=2020-03-24". The Government of the Hong Kong Special Administrative Region. Retrieved 27 March 2020. 14. "Are Hong Kong's coronavirus measures too little, too late?". South China Morning Post. 29 January 2020. 15. "Hundreds queue for masks amid virus crisis, with some in line at 7 am". South China Morning Post. 29 January 2020. Archived from the original on 30 January 2020. Retrieved 31 January 2020. 16. "Flour latest item to grow scarce during coronavirus outbreak". South China Morning Post. 11 April 2020. 17. "Hong Kong mask production to ramp up, though firms seek logistics help". South China Morning Post. 15 February 2020. 18. "Prevention of Coronavirus Disease 2019 (COVID-19)" (PDF). Centre for Health Protection. Retrieved 22 March 2020. Riley, Charles (5 February 2020). "Cathay Pacific asks workers to take 3 weeks off without pay as the coronavirus decimates travel". CNN. Archived from the original on 6 February 2020. Retrieved 7 February 2020

06.04.2020 Hong Kong Despite having close proximity to China, till date, there are positive corona cases of 862 with only 4 deaths in Hongkong. How, it has managed to control the disease may be seen by their efforts listed as below:- Self-Restraint; The Hong Kong resident ventures outside only by necessity. People walk to and from work and go to grocery shop once in a week. If not necessary, they do not leave their apartments for weeks. People are quite cautious now when they face a major outbreak of an infection. The precautions have been so effective. These gains come despite mistrust of the government, which runs deep after nine months of often violent street demonstrations. But faith in the public health system—one of the world’s best—remains intact. People don’t want to get sick and they are actually compliant with public health measures even though they don’t like the government. Experience: It learnt hard lessons from the 2003 SARS epidemic. SARS or severe acute respiratory syndrome, killed 299 in Hong Kong at that time. Hongkong took it as dress rehearsal and better systems were put in place for future crisis. Hong Kong has been hailed for using those hard-won lessons to combat the new coronavirus. Epidemic preparedness starts years before an outbreak. Following SARS in 2003, Hongkong was well prepared, making rapid response possible. Act quickly:- For Hong Kong, the story could easily have been one of catastrophe. The novel coronavirus emerged just in time for Lunar New Year, when millions travel to Hongkong in the world’s largest annual human migration. Hongkong is also closely interconnected with mainland China, with direct flights to Wuhan, the outbreak’s epicenter. Key to its success so far has been the decision to respond aggressively from the outset. By Feb. 1, Hong Kong had proactively implemented travel restrictions on passengers coming from the mainland, contravening the World Health Organization’s [WHO] insistence that travel bans were not necessary. The precautions came at a significant economic cost to Hongkong which relies on mainland China as their biggest trading partner and source of tourists. Hongkong quickly compiled list of action points including border controls, school and work policies, public communication plans and resource assessments of hospitals etc. to deal with the epidemic. Rigorous detection and strict quarantine:- It was decided early on to test all influenza-like and pneumonia cases. They have also spared no pains in hunting down every possible contact of those infected. The process, which operates 24/7, starts with patient interviews, and has also involved police, flight manifests and a locally developed a test for antibodies, which linger even after an infection clears. Government advertisements carried on the front page of daily newspaper urge readers with even mild symptoms to see a doctor and refrain from going to school or work. Social distancing and banning mass gatherings:- Perched just across the border from the mainland’s health crisis, Hong Kong quickly put social distancing into practice. Schools remain closed through Easter. Normally bustling shopping streets, in some of the world’s most densely packed districts, are largely devoid of foot traffic as residents voluntarily stay sequestered at home. Many businesses have either shuttered or asked employees to work from home. Movie theaters, churches and basketball courts sit empty. Mass gatherings are canceled.The measures appear to be working. Effective communication:- To ensure people remain vigilant, but don’t panic, experts say a government’s communication with the public is vital.Hongkong is doing it in a better way. Senior political leaders have had dialogues/risk communication with public for not creating hue and cry over food, medicine, shelter shortages. The example stands out amid a series of blunders in coronavirus messaging in other parts of the Globe. In order to be trusted you need to be open and honest and transparent. You need to demonstrate your competence, and you need to show people that you actually care.