The fifth wave of the COVID-19 outbreak in Hong Kong has brought the local healthcare system to the verge of collapse and put the lives of the public at risk. President Xi Jinping has given important instructions to Hong Kong on combating the pandemic, stressing that the overriding task now is to contain the pandemic quickly. Hong Kong had been successful in combating the first four waves of the outbreak. Why have we failed this time? It is because, unlike the first four waves, during which the transmission was mainly through droplets, the new omicron variant is now airborne, transmitted through the air. It is highly contagious, and the number of new infections doubles every three days.
The question now is: Is it still containable? Taking references of the recent Winter Olympics in Beijing, and the quick eradication of the small outbreaks, including those spilled over from Hong Kong to various cities in the Chinese mainland, the answer is yes, provided that we adopt new strategies to achieve four objectives; namely, significantly raising the vaccination rate, identifying all sources of infection, severing the transmission chains, and treating the infected individuals effectively.
We should not tolerate the death of a large number of elderly due to COVID-19 infections, and “living with the virus” is not an option for us. We need to fight the virus and strive for the “zero infection” goal
1) Consider mandatory vaccination to protect everyone, especially the elderly and the young.
It has been proved that the vaccine can reduce severe syndromes, mortality and infection rates, and create a “barrier” against the virus, which is one of the keys to help interrupt the transmission chains of the virus. We need to increase the vaccination rate in Hong Kong, especially for the elderly and the young. The mortality rate is particularly high for these two age groups. The special administrative region government may have to think about “universal mandatory vaccinations”, exempting those with medical reasons.
2) Implement immediate universal rapid antigen testing (RAT) to identify those with a high viral level, followed by PCR nucleic acid testing to ensure zero cases in Hong Kong.
PCR nucleic acid testing and rapid antigen testing are the two most commonly used methods to identify positive cases. The PCR method is the international gold standard for diagnosis, with high accuracy and the ability to detect cases with a low viral level, but is limited by laboratory facilities and a long testing time. The RAT method is fast and convenient, not limited by time or place, and the results have been recognized by many Western countries. RAT is effective in identifying positive cases with high viral levels, but false negatives can occur when the viral level is low. To achieve zero COVID-19 cases for Hong Kong, universal RAT and PCR screenings would nicely complement each other. It is recommended that the government provide all Hong Kong residents 14 free RAT sets to test for at least 14 days continuously. It is highly likely that over 95 percent of positive cases will be identified within this two-week period. With the cases substantially reduced, we will then proceed to the universal PCR screening to identify all COVID-19 cases, including asymptomatic cases and those with low viral level. Once we confirm that the community is indeed clean, the resumption of quarantine-free travel with the Chinese mainland will become possible.
3) Home quarantine and universal masking with high-performance KN95/N95 masks are key measures for effective isolation of the virus and severance of the transmission chains.
It is estimated that Hong Kong has over 100,000 positive and 300,000 close-contact cases now. The best approach is to have serious, mild, and close-contact cases isolated in the Hospital Authority hospitals, mobile cabin centers, and isolation hotels or centers respectively. But the available facilities are grossly inadequate to accommodate the huge need for isolation. Therefore, home isolation is still needed as a stopgap measure that can be discontinued when enough mobile cabin hospitals and isolation centers are built and ready for use.
The other equally important measure is to implement universal masking of high-performance masks that reduces the spreading of the virus. A new study by the American Conference of Governmental Industrial Hygienists showed that N95 masks can significantly reduce the risk of virus transmission. A person wearing a regular surgical mask facing an omicron patient, who is also wearing a regular surgical mask, will be infected in just one hour; however, if both people are wearing N95 masks, the healthy one can be protected for more than 24 hours. Therefore, it is hoped that the authorities will amend the law promptly to require the public to uniformly enforce the “mask order” outside the home, including offices and workplaces, and to wear high-performance masks, which must be worn continuously for at least four weeks, in order to effectively interrupt the transmission chain.
4) Combine Chinese and Western medicine to achieve the best results for COVID-19 patients.
For serious cases, Western medicine plays a key role in treating the patients. However, accumulated experience and evidence have proved the role of traditional Chinese medicine (TCM) in treating mild and convalescent COVID-19 cases. The latest version of “The Coronavirus Infection Diagnosis and Treatment Scheme”, published by the Chinese government, has recommended the “Three Medicines and Three Herb Formulations” as treatments for mild and convalescent COVID-19 patients. The Chinese and Western medicine can complement each other at all stages of a coronavirus infection to achieve better overall outcomes.
“In the struggle between human and virus, the most important human right is the right to life and health.” We should not tolerate the death of a large number of elderly due to COVID-19 infections, and “living with the virus” is not an option for us. We need to fight the virus and strive for the “zero infection” goal. I believe that if the above measures are implemented, Hong Kong will have the chance to get rid of the virus even without a citywide shutdown.
(Declaration of interest: The author’s company is engaged in RAT and PCR testing.)
The author is a deputy to the National People’s Congress and a member of the Hong Kong Legislative Council.
The views do not necessarily reflect those of China Daily.