COVID-19 Update
In our last email, we suggested that the declaration of a pandemic may help to consolidate a previously fragmented international response. There have certainly been dramatic, unprecedented national interventions aimed at social distancing and restriction of movement, including international travel. The WHO have emphasised the importance of learning from the experience of places with success in controlling the rate of local infections including Hong Kong, China, Singapore and Korea. The importance of testing, case identification and isolation of individuals and contacts has been emphasized by the Director General of the WHO.
We have consistently encouraged a focus on two distinct concepts. The disease and the epidemic. Information about the disease tells us about the impact on individuals. The epidemic is about the impact on populations. The recent international interventions are aimed at controlling the size of the epidemic. They are not a sign that the disease has become more serious. A disease with a low mortality can have a significant impact if it spreads widely. This illness has the potential to produce significant impact on health systems. The social distancing measures are aimed at reducing the peak of infections and taking the pressure off hospitals. They will also buy time in order to better understand strategies for control, to optimise treatments and to work on vaccine development.
International politicians have given predictions of the likely percentage of infections and the expected numbers of deaths in the population. We ask whether we can trust politicians to make accurate predictions of mortality in epidemics. The answer is probably not too surprising.
We have updated our understanding of the disease here
We have more evidence to suggest that children and young people who get the illness are more likely to experience mild symptoms. How important this is in the spread of the epidemic is not yet clear. A review in the Lancet of the Italian experience reported the mean age of fatalities in Italy as 81years with two-thirds being in smokers or individuals with other medical conditions. As we have explained previously until we have a better understanding of the number of mild and even symptomless infections we will not have an accurate assessment of the true case severity rate.
We are updating the epidemic curves regularly. Look at the rate of change in cases in different locations. The curve for Korea demonstrates the success of widespread testing and isolation. Look to see if the curve for Italy flattens. Italy introduced significant social distancing measures on March 8th. We may expect to see some benefit over the next week if the interventions have been effective. This will be an important early predictor of the relative effectiveness of social distancing in Europe in comparison to the focussed contact tracing and enforced isolation in China, Hong Kong and Singapore.
The latest update on COVID-19: The epidemic
We have been fully functional throughout this process. We are updating policies regularly. If you have travelled out of Hong Kong in the last 14 days, have been in contact with a confirmed case of COVID-19 OR you have a fever or are feeling ill, please contact our clinic and we will give advice and arrange treatment according to your needs. Please do not come to the clinic before contacting us first if you are in any of the categories above. A gentle reminder that misrepresenting your travel history in a medical setting is now a criminal offence in Hong Kong. We appreciate that this is a difficult time. We wish to emphasize that the community risk in Hong Kong remains very small and we will continue to care for all of our patients, whilst ensuring that our clinics are safe environments for patients and staff alike. Policies for OT&P appointments here.
As the Anxiety epidemic settles in Hong Kong in Europe and the US it has taken off, understandably aggravated by widespread government action. Anxiety is both more infectious and more dangerous than the disease itself. Information and education are key factors in the management of both anxiety and infectious disease. Keep calm, keep positive.
Our health information resources are now available in Chinese and French.
更新: 新型冠狀病毒
在上一篇文章提及到宣布疫情大流行將有助改善國際間不同意見的分歧。其中前所未有的全國性干預行動目標就是要保持社交距離及限制人民流動包括國際出行。世界衛生組織一再強調應該從中國，香港，新加坡，韓國等地方汲取成功經驗及再次強調: 測試，病例識別及隔離措施的重要性。世衛總幹事譚德塞在日內瓦的記者會上對疫情給全世界一個簡單訊息就是：”測試、測試、測試” 。
我們一直鼓勵大家應該分別兩個完全不同的概念 - 疾病與疫情。有關疾病的知識告訴我們，疾病是對一個人的影響，而疫情是對群眾的影響。最近國際間的干預措施就是針對控制疫情的大小，但這不代表疾病本身漸趨嚴重。因為當一個低死亡率的疾病廣泛傳播亦會造成重大影響。今次的疾病有可能對衛生系統造成重大衝擊，保持社交距離的目的是減低高峰期的傳播及減輕對醫療系統的壓力。這同樣可以為制定更好的策略，優化治療方法及研製疫苗想我爭取更多時間。
國際間的政治家已經預測了可能感染人數的百分比和死亡人數。 我們問自己可否相信這些政客對疫情死亡率做出準確的預測，答案可能不會太令人驚訝。
更新：對疾病的了解
越來越多證據顯示今次疾病在幼年及年青人身上出現較輕微病徵。目前我們還未知道今次疫情傳播的嚴重程度。>>刺胳針<< (Lancet) 的文章提及到從意大利經的平均死亡年齡幾為81歲，其中三分之二死者為吸煙人士或同時患有其他疾病。正如我們之前解釋，在我們完全掌握輕微或完全沒有病徵數目之前，我們無法對實際病例的嚴重程度進行準確的評估。
我們正在定期分析疫情的趨向並制定數據圖表，可以看到不同地區的病例：韓國展示了廣泛測試和隔離的成功。又可以看看意大利的數據圖表是否平穩下來。在3月8日，意大利政府制定了大規模的保持社交距離措施，我們可以看看在未來這幾星期，隔離措施是否得到成效。相比中國，香港及星加坡對懷疑個案追踪及強制隔離的成效，意大利的社交隔離措施對歐洲的早期預測相當重要。
更新：新型冠狀病毒疫情
我們會繼續在今次事件中提供全面服務，並會定期更新我們的政策。如果你在過去14天離開香港外遊，與確診患者接觸，發燒或感到任何不適，請聯絡繫我們診所，我們將根據您的情況提供建議並安排治療。如果你涉及上述任何一種情況，請不要在沒有聯絡我們之前直接到我們診所。溫馨提示：在香港任何人如果虛報過去的外遊史，已構成刑事罪行。我們感謝大家明白這是共同的艱難時間。我們想重申今次疫情在香港社會風險仍然是很少，我們會繼續照顧所有病人同時確保我們所有診所的醫務人員及病人在安全環境下工作及治療。
隨着流行性焦慮症已經在香港及歐洲扎根，美國亦已開始蔓延，明白到政府的大規模措施亦迅速助長這事情發生。焦慮症比疾病本身更加具有傳染性及危險，信息和教育仍然是控制焦慮症和傳染病的關鍵因素。保持冷靜，保持正面。
我們的健康信息現已提供中文和法文版本。
