When COVID-19 broke out in Wuhan, it took 76 days of lockdowns to clear the city for reopening, with its thriving economy unaffected. Its success hinges on the resilience of the citizens as well as the help of experts and resources from all over China. Notably, they built 16 modular/portable Fangcang hospitals, which lasted for 35 days, admitting 12,000 mild cases, equivalent to 25 percent of newly diagnosed cases. They were supported by 94 teams comprising more than 8,000 doctors and nurses from different parts of China.
Now in Hong Kong, the public health and hospital system has succumbed under the hyper-infectious omicron. How can we suppress the fifth wave? Vaccination of the young and elderly, together with the third dose of the vaccine, has been put into high gear. We are getting the support of supplies and manpower from the Chinese mainland.
The special administrative region government has 3,500 beds at Penny’s Bay and 350 at Lei Yue Mun Park & Holiday Village, in addition to 500 at AsiaWorld-Expo, currently fully occupied. For almost immediate use, we have 3,000 units in three housing estates, 20,000 hotel rooms, and 1,000 beds from the refurbished Kai Tak Terminal Cruise Building. Fangcang hospitals will be built in Kai Tak Cruise Terminal and Penny’s Bay Phase 2, providing 10,000 beds. There are other sites offering 50,000 additional beds. With a grand total of over 92,200 new beds, it is still not enough to take in the tens of thousands of confirmed cases every day.
If the SAR government so requests, there could be major enterprises and philanthropists offering to support this movement to significantly alleviate the current unprecedented high disease burden and related burdens on our healthcare system
With the compulsory universal testing delayed for a few weeks, we may detect hundreds of thousands of asymptomatic COVID-19 carriers or spreaders. Where are we going to isolate them? What about all the cruisers that are lying fallow? Are there more hotel rooms or guesthouses? What about the recreational homes and community activity centers run by church groups and NGOs? What about the mega cultural and sports stadiums, such as the Hung Hom Coliseum and Queen Elizabeth Stadium? What about the various Leisure and Cultural Services Department’s cultural and sports centers? We need exclusive use of them for just a week, which is critical in cutting the stealthy transmission.
When citizens are asked to isolate at home, we need a professional assessment of the site and the occupants to find out whether it poses a high risk for cross-infection. The availability of a separate room and toilet would be desirable. LegCo member Stephen Wong Yuen-shan wrote on Feb 27 in China Daily on the “health and social vulnerabilities” in setting priorities. I agree with him that we could emulate the “Home Recovery Program” with 24/7 telemedicine support and the buddy support system as practiced in Singapore.
Who is going to do this? It is obvious that collaboration between the Department of Health (DH) and the Social Welfare Department (SWD) is needed. The DH runs 142 clinics covering treatments concerning the elderly, maternal and child health, chest, social hygiene, etc. These nurses and doctors could be redeployed to work with social workers of NGOs funded by the SWD. Together, they could support the home testing, isolation education, and medical observation, with volunteer “buddies” to support healthy eating and home exercise to improve mental health. This is where the district health centers should play an active role.
Some doctors in private practice have indicated their willingness to help. The general practitioners in each district are well-positioned to conduct 24/7 telemedicine on a roster system. In case of uncertain deterioration, they could offer support on-site, with access to the patient’s clinical records with the Hospital Authority (HA) via an electronic Health Records system. For the support of residential care homes for the elderly (RCHEs), a few groups of traditional Chinese medicine practitioners (CMPs) have organized telemedicine with online/offline services. However, it would be much more effective if the Community Geriatric Assessment Team from the HA could work with the Chinese Medicine Department (CMD) to develop integrated care, since the CMD of the HA has offered a general hotline service and is working with CMPs to help the elderly patients in RCHEs.
Then the Fangcang hospitals could deal with mild to moderate cases. There may be 10 percent of HA staff on sick leave for isolation or rehabilitation. The solution would be the invitation of experienced expert teams from the Chinese mainland to run the Fangcang hospitals. They can be granted temporary registration to practice in Hong Kong. But their treatment guidelines are different from those in Hong Kong. It would be highly beneficial for our medical service, in both the immediate and long-term basis, if the three renowned teams for integrative medicine for COVID-19 from Shanghai, Tianjin and Guangzhou are invited to lead the Fangcang services.
In Wuhan, they had one Fangcang hospital that was entirely run as a Chinese-medicine hospital (CMH). Since our CMPs have already embarked on treating COVID-19 cases and we have a team of experts in Baptist University working on our first CMH and they have established a working relationship with Guangdong provincial CMHs, it would be very appropriate for us to invite the Guangdong province CMHs to help Hong Kong as they did in 2003 during the SARS crisis. The effectiveness of integrative medicine was reviewed by Professor Derrick Au in a chapter titled “Challenges of SARS”, published by Saunders Elsevier in 2006.
Regarding evidence-based medicine (EBM), researchers at the University of Hong Kong and Hong Kong Baptist University have published four turnkey articles in the American Journal of Chinese Medicine (AJCM) over the past four years. Internationally, the editor of Ethnopharmacology, Professor Thomas Efferth, wrote “Traditional Chinese herbal medicine at the forefront battle against COVID-19: clinical experience and scientific basis”, analyzing the use of herbal medicine in their prevention, treatment and rehabilitation. He also analyzed 15 herbs and gave a summary of their effects on the immune system. Professor Tommy Cheng of the Department of Pharmacology, Yale University, wrote in Frontiers in Pharmacology, “Prospective evolution of Chinese medicine to treat COVID-19 patients in China”. He analyzed the “three formulae and three medicines” used in the national guidelines for COVID-19 and discussed the link between immunological reactions with the Chinese medicine theory of “elimination of heat”. In November 2021, Evidence-based Complementary and Alternative Medicine published a randomized control trial of a renowned over-the-counter medicine, showing that close contacts under quarantine in the treatment group had significantly fewer individuals becoming positive for COVID-19. This agrees with other studies in which the PCR tests turned negative faster when the individuals are treated by traditional Chinese medicine.
Thus, scientific evidence showed that we could reduce the COVID-19 disease burden by giving TCM in its prevention and early treatment. Our HKU team published in AJCM a review of 53 clinical trials to show that there are three formulas that could reduce the severity of disease, the length of stay in the hospital, and the number of deaths. While we are running out of beds for isolation and treatment, we should consider using TCM for all contacts and all patients immediately after diagnosis, to reduce the viral load and, in turn, reduce the use of isolation services and hospital beds.
In the final analysis, we are saving lives. This is the ultimate goal of all our efforts. If the SAR government so requests, there could be major enterprises and philanthropists offering to support this movement to significantly alleviate the current unprecedented high disease burden and related burdens on our healthcare system.
The author is a former chief executive of Hospital Authority; HCE of Queen Mary Hospital; and Hon Professor, School of Chinese Medicine, HKU.
The views do not necessarily reflect those of China Daily.