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As coronavirus epidemic worsens globally, here’s how Hong Kong managed to contain it

11 Mar, 2020

UK health minister Nadine Dorries was diagnosed with coronavirus on Wednesday, 11 March, a day after France’s culture minister tested positive.

The UK now has at least 382 confirmed cases and six deaths while France has reported at least 1,784 confirmed cases and 33 deaths. The world over, at least 4,284 of 119,132 COVID-19 patients have died since the end of 2019.

As coronavirus epidemic worsens globally, here's how Hong Kong managed to contain it
Photo by Free To Use Sounds on Unsplash
60% of the world’s population could be infected

Professor Gabriel Leung, Dean of the Li Ka Shing Faculty of Medicine of the University of Hong Kong, warned in early February the coronavirus epidemic could spread to about two-thirds of the world’s population if its not controlled. About 60% of the world’s population could be infected with the virus.

Leung said his team’s mathematical model indicates the mortality rate of the new coronavirus is about 1.4 percent. It means if the epidemic is not contained, up to 50 million people could die of COVID-19.

So far, authorities have reported at least 10,149 confirmed cases in Italy, 8,042 in Iran, 7,755 in South Korea, 1,695 Spain, 1,565 in Germany and 1,037 the US. Hong Kong has 120 confirmed cases and three deaths. Its close connection with mainland China, where the coronavirus epidemic began, has put immense pressure on Hong Kong and its nearly seven million people. However, the comparatively fewer cases here would suggest Hong Kong’s prevention strategy is working.

Keiji Fukuda, director and clinical professor at the School of Public Health at HKU, helped lead the World Health Organization’s response to the West Africa Ebola outbreak. This NPR report quotes him as saying: “We see that over the past five weeks or six weeks the number of cases has remained remarkably small. So I think [Hong Kong] is a really good example where I believe that we’re seeing [that] social distancing measures, personal hygiene measures really, really work.”

Gabriel Leung
Professor Gabriel Leung, Dean of the Li Ka Shing Faculty of Medicine of the University of Hong Kong. Photo: the University of Hong Kong news
The Hong Kong experience in epidemic prevention

Experts from the University of Hong Kong were the first to isolate the SARS virus back in 2003. Chief of Virology and Professor Yuen Kwok-yung, who led the research 17 years ago, helped confirm this year the new coronavirus spreads from humans to humans.

Professor Yuen now acts as a consultant to the Hong Kong government, together with Gabriel Leung and Keiji Fukuda, professors from the Faculty of Medicine at the HKU.

HKU microbiologists, under the leadership of Professor Malik Peiris, Chief of Virology and Professor Yuen Kwok-yung, Head of Department of Microbiology together with team members including Guan Yi, Leo Poon, John Nicolas and Chan Kwok-hung, successfully identified and cultured the killer virus responsible for the outbreak of SARS. The team also developed an antibody test for the detection of SARS in infected patients.
HKU microbiologists – under the leadership of Professor Malik Peiris, Chief of Virology and Professor Yuen Kwok-yung (second from left), Head of Department of Microbiology together with team members, including Guan Yi, Leo Poon, John Nicolas and Chan Kwok-hung – successfully identified and cultured the SARS virus. The team also developed an antibody test for the detection of SARS in infected patients.

Yuen offers timely health tips and also answers questions from the public on COVID-19 here. The Faculty of Medicine also offers tips and tricks to the public, such as:

1. What are the most common symptoms of the coronavirus?

HKU researchers, including professor Yuen, extracted 1,099 COVID-19 patients data from 552 hospitals in mainland China. Data shows the two most common coronavirus symptoms are fever and cough.

Fever was present in 43.8% of the patients on admission, but developed in 88.7% during hospitalization. The second most common symptom was cough (67.8%). Diarrhoea was uncommon (3.8%). And the median incubation period was four days (interquartile range, 2 to 7).

See the full research paper here.

2. How does the virus spread?

Coronavirus is known to spread through contact, droplet and aerosol.

Droplet transmission: when a carrier or patient sneezes or coughs, large particles in their respiratory droplets will be expelled in large amounts.

These large droplets fall to the ground quickly, so the transmission of viruses in these larger droplets is usually limited to a short distance.

There are about 100,000 viruses in a drop of saliva, and wearing a mask can help not only decrease the virus transmission but also protect you.

Contact transmission: touching your eyes, ears or nose after:

  • Shaking hands with a carrier or patient whose hands are contaminated by respiratory droplets (direct contact).
  • Improper removal of face masks, resulting in your hands being contaminated by the virus (indirect contact).

Aerosol transmission: Through fine particles within the respiratory droplets of a carrier or patient, usually expelled in large amounts when they sneeze or cough. Smaller particle size allows them to remain suspended in the air for a longer period, increasing the likelihood of the viruses traveling long distances.

Patients may get infected through the inhalation of infectious particles in both close proximity and long distances.

3. What are some activities in our daily life that would increase our exposure to bio-aerosols?

If there are no carriers or patients, or no contaminated objects or surfaces nearby, there should not be an increased risk of disease transmission via bio-aerosols. 

Moreover, compared to bacteria that can survive independently in the environment, viruses can only survive and replicate by infecting other cells. As such, using a steam iron for example in an environment where viruses may be present in dust particles is still relatively safe, as the survival chances of viruses in the environment and subsequent likelihood of transmission through aerosols are both relatively low.

On the other hand, since it is believed that flushing toilets would generate aerosols, together with current data which suggests diarrhoea as a possible symptom of SARS-CoV-2 and a small number of patients having the virus detected in their feces; it is recommended to close the toilet lid before flushing to avoid spreading the virus in the form of bio-aerosols. 

Here’s a complete guide from the Faculty of Medicine at the University of Hong Kong.

4. What precaution should I take other than wearing masks?

Professor Yuen says prevention can only be effective when we perform all the necessary preventive measures at the same time. That means we not only have to wear masks, but also observe proper hand hygiene, and wear masks correctly. Try to maintain a social distance of six tiles, or a distance of one to two meters.

Here’s the full video.

5. How to wear the mask properly?

Here is a complete guide on wearing surgical masks: HKU Faculty of Medicine: FAQs about surgical masks

6. Someone in the building where I live has the coronavirus. What should I do?

Yuen Kwok-yung says you should keep calm and carry on wearing masks, washing hands frequently, and minimising social contact. At home, regularly pour water into drain outlets (U-traps) to prevent the virus from spreading through the building’s pipes and ventilation system.

Full video on this question here.

More health tips:

https://fightcovid19.hku.hk/health-tips/

 

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