Hotel quarantine in Hong Kong – a personal and medical perspective

By Dr Ray SH Ng

At the time of writing this article, it has been 4 weeks since I left my 14-day hotel quarantine. I realise there are readers who are experiencing the prolonged 21 days of quarantine due to the changes made in the government directives since the middle of December. I was very fortunate to have missed that by just a few days.

To provide some background, I have been living out of my suitcase in three different hotels so it would be fair to say that I had not been able to lead my normal life for up to three weeks.

I am writing this from the perspective of a General Practitioner with an interest in Sports Medicine. As a result, I will be focusing on the health issues I faced whilst going through my quarantine. I will also discuss the mental aspects and the issues I had with my diet during the quarantine.

This is my personal account of the quarantine period and hopefully you may be able to glean something from reading this – whether if you are in quarantine or in preparation to undergo one.

First night of quarantine

It had been an arduous journey from Scotland to Hong Kong, which had involved two planes and a necessitated stay at Heathrow airport for 12 hours. Throughout this journey, I had been wearing the same clothes for more than 24 hours.

Luckily it was not too hot in Hong Kong in December. I dread to think what I would have smelled like if it had been the height of summer.

The first thing I wanted as soon as I arrived was to have a warm shower. Unfortunately for me, as I turned on the water and started pushing furiously on the soap dispenser, I realised that it was devoid of any shower gel.

A quick call to the reception and 5 minutes later, a member of staff brought up a paper cup with white liquid inside. I had a sudden flashback of the patient who once brought in his semen sample to my clinic for testing and had simply thrust it gleefully into my reluctant hand.

This experience marked the first night I spent in the government assigned hotel room. As I was waiting for my COVID-19 test result, I started thinking about how I was going to spend the next two weeks of hotel quarantine. I wondered if it was going to be a total breeze or a complete torture. At the end of my experience, I would say it was somewhere in between.

Sleeping and mental wellness

In my first week, I suffered from jetlag. With the enforced confinement, I also found my energy levels were more depleted than usual. Initially, I tried to meditate everyday with my sessions usually lasting around 15 mins. However, due to low energy, these invariably became naps that lasted one to two hours during the afternoon. This further exacerbated the jetlag as I could not sleep at night as a result.

I wouldn’t say that I felt stressed but it was more akin to boredom. I was fortunate enough that I was able to do some work with the company laptop and arrange some teleconsultations. This helped me with a routine which ensured that I got up relatively early (e.g., 8:30 am) and stopped me from staying in bed for too long.

For mental stimulation, I also worked on my Mandarin with my teachers via Skype.

Outside of work and my Mandarin lessons, I spent my time reading and watching some dramas online. Once or twice, I also had time to follow the Spurs, my football team, during their live matches which was a rare luxury as games were normally played in the middle of the night in Hong Kong.

Diet and food

The hardest part of the quarantine for me wasn’t the inability to go outdoors and leave the hotel room but rather the unsuitability of the food. I had decided to book my hotel stay to include 3 meals per day. I must give them credit for trying to provide some variety as they offered a different menu each day. However, the hotel menu involved a lot of carbohydrates. As a result, I found myself eating a lot more rice, bread, noodles and fries in the two weeks than I have been accustomed to eating in the previous 3-month period. I personally do not like consuming carbohydrates as I knew it would lead to fat accumulation around the waist and inevitably weight gain.

In the second week, I decided to eat mainly the protein and vegetables provided by the hotel kitchen but also ordered food delivery where there were healthier options which suited my taste. Due to sheer boredom I also decided to order a bottle of whisky. I only had a glass or two each night but it certainly made the time pass more quickly!

Exercising in quarantine

I tried to replicate my usual home routine by doing a combination of cardiovascular, resistance training and core exercises. I was aiming to do cardiovascular exercises daily. I knew I was going to use the jump rope for my daily routine and I purposefully chose a hotel room that was large enough (mine was 240 – 260 sq ft) to provide floor space for my training. I also checked the room had carpeting to soften the noise and would be less harsh on my rope.

I used the 1lb Crossrope which is much heavier than normal ropes. This helped me to work some of my upper body muscles particularly the forearms, shoulders and the lower body muscles (e.g., calves).

In general, below is my exercise routine during the 2 weeks of quarantine.

Warming up

Jump rope for 15 minutes session in the morning before lunch and then another 15 minutes session before dinner. This is my warm up routine. I also have a ½ lb rope which I use less often. For variety, I also did around 150 Jumping Jacks in 2 to 3 mins as an alternate warm up session.

Resistance body weight training

• Standard Pushups: As many as possible for one minute and then a break followed by more sets until I reach 100 pushups in total. For variety, I would also do pushup burpees.
• Pushup Burpees: This is a good way of training both the cardiovascular aspect and resistance type exercises.
• Plank: Hold for 1 to 3 minutes to work the core abdominal muscles.

Itchy foot?

Towards the latter stages of my quarantine, I noticed the upper parts of my right foot had started itching (as you may have surmised, I do try to shower regularly!).

As I had been living on the road for 3 weeks, I had not packed enough sports socks and had resorted to reusing them for a few days. This might have led to a mild fungal infection even though there was no rash. Rather than wait for the situation to worsen, I applied an anti-fungal ointment and stopped wearing any old socks. This helped to resolve the situation relatively quickly.

Lesson to be learned is pack more socks!

Aftermath

I had kept records of my weight before and after the quarantine. By the end of it, I had gained 2kg and my waist circumference had also increased by 2cm.

I had previously been able to do 100 pushup burpees in 10 minutes but in the week after returning home, this had reduced significantly to only managing 60 which meant a 40% drop off.

Undergoing hotel quarantine was an interesting experience but certainly one that I wouldn’t want to repeat unless it was absolutely necessary.

I had fun sharing my experiences a week after leaving quarantine though, there's nothing quite like regaling it among wine and pizza with a friend. It sounds bizarre but I was feeling far less guilty eating carbs again once I was in a more relaxed environment.

What I did correctly

• Stuck to a routine of getting up reasonably early rather than staying in bed until late. A good friend gave me this advice and I felt the day became more productive as a result.
• Packing the correct training equipments and supplements:
  
  • Jump rope: as mentioned above. If you are interested in replicating my exercise regime, you can take a look at the Crossrope here. I have no affiliation with this company and having used this for 6 months, I have been happy with the durability and uniqueness of this equipment. I brought the ½ lb and 1 lb ropes with me during my travels. It’s also the only rope I am aware of that has a weighted rope as opposed to weights at the handles. I bought a much cheaper rope and the outer casing started tearing after 1 month.
  • Trainers - essential for working out. Even if you forgot your exercise clothes and have to train in your underpants it doesn't matter as nobody would know, but you can’t train without proper shoes.
  • Vitamin D tablets – as there is no direct sunlight exposure, my level is bound to drop so it’s worth bringing some. I was taking 2000iu per day myself but this dose may be too high for some people. 1000iu may be more appropriate especially if you have not had your Vitamin D levels checked previously.
  • Anti-fungal cream and emollients for the skin – remember to bring a skin moisturiser if you are prone to eczema as air conditioning or radiators (in colder climates) can wreak havoc with the skin barrier. You may want to obtain an anti-fungal cream such as Clotrimazole or Canestan as well.
  • Probiotics – in case of diarrhoea. Fortunately I did not need to use them.
• Eat fruit and vegetables daily as this helps to prevent constipation.
• If the hotel is not serving suitable food, then consider using your preferred food delivery service to supplement what you think is deficient in your diet.

What I could have improved on

• Not packing a shake blender - I packed enough whey protein powder to consume every other day but in the end only managed to consume 2 days’ worth of powder. I was a bit put off drinking the powder without a blender handy and the lack of protein certainly contributed to the significant muscle loss on my body.
• Resistance bands - I would not have suffered as much muscle wasting if I had brought these with me for additional resistance workouts.
• Not bringing enough sports socks!

Ultimately, remember to relax during your quarantine. Try to think of it as a positive experience where you can have time to yourself and enjoy a period of self-reflection without being physically disturbed. For some people, you may want to set a goal to achieve something over the 2 - 3 week period, such as learning a certain number of new words of a foreign language or reading that book you always thought about completing but never had the time. If you don't manage to achieve any goals, it's also fine - just chill and binge watch an entire series of your favourite show.

To learn more about the expectations of Hong Kong's fourth COVID-19 wave and the outlook of immunization, click here to listen to our podcast.