2020 has been an unprecedented year. The virus continues to spread at a slow burn; occasional lockdowns are now normal.
We believe an increase in the transmission is likely to happen as the weather gets colder. COVID-19 is likely to have a seasonal oscillation leading to more winter outbreaks like many human respiratory viruses such as influenza.
Peoples' immunity are also generally lower and they are more likely to remain indoors in winter, where transmission of the virus through droplets can be a greater risk.

The common differences between Cold, Flu, or COVID-19:
However, with the winter period approaching patients may get flu-like symptoms and be worried if it is a cold, flu, or COVID-19. Some of the symptoms of flu and COVID-19 are similar, and therefore it may be hard to tell the difference between them based on symptoms alone, and testing may help confirm a diagnosis. Flu and COVID-19 share many characteristics, but there are some key differences between the two.

While more is learned every day, there is still a lot that is unknown about COVID-19 and the virus that causes it. The following table compares all 3 conditions, given the best available information to date.

• Colds

The common cold is upper respiratory tract infection (throat, nose, sinuses, upper airways). The period of a cold could be 7-10 days. Colds are a mild upper respiratory condition, with a runny, stuffy nose without a fever. There are no tests required.

• Flu (influenza)

Influenza is an upper respiratory and/or lower respiratory tract infection. The duration of the flu ranges from around 5 days to 2 weeks. Flu symptoms include mild to moderate fever, headache, cough, fatigue, and pains in the body. 
The risk of complications for healthy children is higher for flu compared to COVID-19. However, infants and children with underlying medical conditions are at increased risk for both flu and COVID-19. Doctors diagnose flu based on clinical signs and readily available laboratory tests. Flu vaccine will provide 70% protection against 4 predicated strains this year. Medication to treat flu is available.

• COVID-19 

A single-stranded, positive-sense RNA coronavirus is responsible for COVID-19. It can cause severe respiratory problems. It has an incubation time of around 2-14 days. 
If a person has COVID-19, it could take them longer to develop symptoms than if they had flu. COVID-19's main symptoms are headache, fatigue, fever and mild to severe cough.
From the current data we have we know that symptoms can be very similar to flu and there are even differences in the symptoms suffered between age groups. The standard high temperature, continuous cough and loss of taste and smell may not appear for those aged below 18 and above 65. You don't see (loss of taste and smell) in older people and in kids at all. Despite scientists around the world working at lighting speed to produce a vaccine, currently there is no vaccine to prevent COVID-19 or effective treatment for COVID-19.


COVID-19 TEST: 

A Molecular Test (Sputum test) 
The molecular test is also known as a polymerase chain reaction test (PCR). This detects the virus's genetic material that triggers COVID-19. It involves collecting an early morning sputum sample and is the most commonly performed test in Hong Kong.

A nasopharyngeal swab can also be done. Again, this is a COVID-19 PCR test however it involves swabbing the inside of your nose or throat. It is usually done in hospital where full PPE is worn.


Blood Test (Serology test)
This tests for antibodies in your blood. A few days or weeks after you are infected, they are produced in the body.  There are two different types of antibodies. One which informs us if you currently have the infection IgM and one which indicates if you've been infected in the past with conditions, COVID-19 IgG. This test has a lower accuracy rate. Commercially available test relies on picking up these antibodies in your blood.


Are there any tests to distinguish Cold, Flu or COVID-19? 
But you need not worry. If you are unwell, please call or email us at the clinic and we will offer consultation by telephone or Zoom, in the first instance. We can then arrange for you to have sputum test that can distinguish between flu, or COVID-19, and maybe some blood tests.
A doctor can usually make a diagnosis based on history taking, examination, looking at vital statistics and with some test results. We can then prescribe some medication for someone to pick up on your behalf to ease your symptoms or prescribe specific medicine for influenzas. In Hong Kong at present, all positive COVID-19 PCR tests are reported to public health department which would warrant compulsory hospital admission.
The 2020/2021 flu vaccine is now available in the clinic and with COVID-19 still in circulation - it is even more important this year to have it. There is an anticipation that there may be a worldwide shortage of flu vaccine this year as well.


In conclusion:
We conclude by reiterating a few basic safety measures again to protect you and your family:

• Clean your hands often with soap and sanitizers.
• Keep a safe distance from anyone.
• Wear a mask.
• Don’t touch your nose, eyes, or mouth.
• If you feel unwell, stay and work from home. Call or email your doctor for advice. Do not attend the clinic in person. We can offer remote consultation and arrange for  you to receive medication and COVID-19 tests without you attending the clinic.
• Get the flu vaccine, which is still avaible in the clinic. Additional vaccines sucha as penuomnia vaccine are advised for those at risk of  chest infection.
• It may be advisable for you to have a blood pressure monitor and a thermometer at home (available in the clinic). Simple devices such as Oximter which checks for oxygen levels has also been suggested.  Providing such information to the doctor during a remote consultation will be useful.
• In recent weeks , there has been news that the long awaited COVID-19 vaccine  may soon be available. However, as yet, we have had very limited information. When this will be and how many will be districtubed to Hong Kong is still not clear, however it would most likely be given to the most vulnerable patients initially due to limitations of supply. We will keep you informed.
• This year has been tough on mental health. Change has been the only constant. Maintaining good physical health will help, but reach out to us if you feel you are not coping. There is support out there for you.

​Stay safe.
​

The clinic will be closed from Friday 10th April 2020 to Monday 13th April inclusive. We will be open as usual from Tuesday 14th April 2020.

​Have a nice Easter but try and stay at home!

On March 11th 2020 the W.H.O classified the COVID-19 as a worldwide pandemic.   The situation is evolving rapidly with different guidelines being issued by respective governments around the world.
In view of this, our clinic is trying to adapt to these events by balancing the medical needs of our patients to the safety and well-being of patients in the clinic and our staff. 
 

COVID -19 Testing
We can arrange private rapid Covid -19 testing for those who require a certificate for travel, fitness to return to work or concerned about their symptoms. This can be done as a blood, nose/throat swab or saliva test. It is mandatory to have a phone consultation with one of our doctors to assess if you are suitable for this test first. Please contact the clinic for further information.

Teleconsultation
In addition, we have set up teleconsultations via Zoom
 
Teleconsults would be suitable for;
 
1-Those who have travelled anywhere in the past 14 days and present with any respiratory symptoms (sore throat, cough, runny nose) with or without a fever or anyone who has been in close contact with them. For such patient you are advised as per Centre of Health protection Hong Kong to self-isolate at home for 14 days.
 
2-We can arrange home testing of COVID-19 . This is only after a consultation with a doctor to assess if it is suitable for you. 
 
3-Those who wish to seek medical advice, but do not wish to attend the clinic due to personal circumstances.
 
4-As always skype consultations continue to be available for psychiatrist or psychologist.
 
For further information regards the above services please email info@thelondonmedicalclinic.com
 

Take a deep breath and carry on.
 
Dr Lily Wong

 

Due to the prolonged COVID-19 situation and pandemic spread we understand a lot of patients have concerns about coming in person to the clinic. They may also have come back from countries where the virus is spreading. Although we are screening our appointments we appreciate some patients would like a virtual consultation from their home or work. As such we will be rolling out the ability to have Zoom consultations with our doctors. A lot parents will be familiar with the app which is available for iOS/Android and Windows PC/Macs. Please contact us by telephone or email for more details. Consultation fees will be the same as a standard clinic appointment. 

 
February has been a challenging month for most of us. It’s been over 1 month since the Coronavirus (COVID -19) first hit Hong Kong. Being highly contagious, the mortality rate of the virus is estimated at 2% in the epicenter of the outbreak, Hubei province, but thankfully this figure is much less elsewhere. Putting this into context, SARS had a death rate of more than 10%, so although the COVID-19 might be highly contagious, it is definitely less deadly.
However, as there is no vaccine to date and with the uncertainty of when the virus will subside, or indeed where it will spread to next- it’s not surprising that many people will feel anxious about the current situation. Added to the fact that Hong Kong has seen some pretty turbulent times with the protests last year and now with the disruption caused by the virus from our daily routines, home schooling and fears over employment- it’s no wonder that some people feel emotionally distressed and drained.        
 
However, apart from the standard government advice of good hand and personal hygiene and avoiding crowded areas, there is only so much a person can do to avoid exposure to the virus.  
The best thing anyone can do in these situations is to take a step back, take a deep breath and try to look at ways to safe guard your own mental health and outlook on life to face the uncertain challenges that lie ahead. Here’s a couple of pointers that you might find useful.
 

• You will feel much better when you set up a new routine for the day, particularly if you are working from home and/or have children who are now being home schooled.
• As a parent I understand the importance of them achieving high academic grades, but as an employer I know it’s as important for children to develop interpersonal skills to equip them for their working life ahead.  These unprecedented times whilst they are off school might be the perfect opportunity to teach them such life skills such as cooking, asking them to plan a BBQ list, allowing them to plan a hiking trip etc. Also think of activities to strengthen bonding with your children. After all, they will be observing and learning from us now as to how we are handling change and uncertainties in our current lives.
• Eat healthily and sleep well.
• Try and keep up with some regular exercise twice a week.
• Download mediation apps such as CALM and Headspace. Meditation has many benefits, including reducing stress and boosting one’s immune system. Its free, easily accessible anywhere and if learnt with your child, will help them to face life’s challenges.

 

• Don’t plan too far ahead. Accept there may be changes to be made.

 

• Simple measures such as frequent vigorous hand washing, especially after touching potentially infected surfaces (like shoes, shopping trolley handles, and money), is the most important advice to reduce infection rates as well as social distancing.

 

• Epidemics bring out the best and worst in social media. Try to avoid relying on unregulated social media for information. Human behavior is such that we have a greater tendency to share emotionally evocative images and text that provokes fear and panic in us.

 

• There is still some flu vaccine available which is recommended to all from 6 months, especially this year. This does not protect you against the Coronavirus, but protects you against influenzas only. By doing so it allows your immune system to work at an optimal level to tackle any other infection you may come across, which is especially important in the current situation.

​On a side note, we will continue to implement the following preventive measures in the clinic to protect the health and safety of our patients and staff by:
 

• Screening all patients who make appointments.
• Not accepting  walk-in patients for the time being.
• Temperatures checks for all patients.
• We have also increased the frequency of disinfection of public areas in the clinic.
• Drs are always accessible by email or phone for those who are uncertain as to what to do or whether to attend the clinic for appointments.

 
Novel Coronavirus testing has just been made available to private clinics. This can be either by blood or nose and throat swab. The likelihood is that it will only be appropriate for testing of low risk patients. We will be providing our patients with more information once it becomes available.
 
In the meantime, stay calm, take sensible preventive measures and keep your self-updated with the latest information and advice via https://www.chp.gov.hk/en/index.html
 
 
Yours in Good health
Dr Lily Wong

As of February 9th,  2020, the worldwide figure for those infected with the Coronavirus is 37554, with the number of deaths at 813. Hong Kong has 28 cases resulting in one death. 
Although the influenza virus causes many deaths every year, the main reason we are scared by this novel coronavirus is that it is new and unknown. We just don’t know how bad it will get and exactly how deadly or contagious it is. Similarly there is no vaccine or effective treatment at present. What we don’t know is what frightens us.
If current figures are to be believed, it is without doubt a very contagious virus but the death rate is still low, and occurring mainly in those patients with co-existing illnesses. It is indeed an emergency in China, but numbers still remain relatively low in other parts of the world. However, the situation is constantly changing.

Be reassured though that Hong Kong also has medical facilities with high standard of care run by well trained medical professionals.

As of February 8th, Hong Kong will be enforcing a mandatory quarantine of 14 days for those arriving from China and penalties for those who violate this order. Even so a  much higher number of confirmed cases is likely in the coming weeks.
​
What we know so far about the coronavirus
The incubation period is around 14 days, which means people can show no symptoms but are still infectious. There are no real specific symptoms to identify if a patient is suffering from the coronavirus. Special swabs taken from the nose or throat and an examination of sputum samples for the virus are the current ways for detection and are only available in public hospitals.
The coronavirus spreads by droplets, which can be spread by a sick person who are visibly coughing sneezing. A distance of around 2 meters will keep you safe. Such droplets can also land on surfaces, which can then contaminate your hands and be transferred into your body by your eyes, nose or mouth. Coronavirus is not something that people can get from casual contact. The coronavirus has also been found in stool samples; therefore this can be another mode of infection and diarrhea can also be a symptom of the infection.
There are no vaccines or drugs at present that are found to be effective. Although there is suggestion that some antiviral drugs, such as those for HIV and influenza, may have a role in treatment, it is too early to say. It is not advisable for patients to stock up on these medicines as they are very potent and are not appropriate for every one. Also they can have serious side effects.
 
How can we best protect ourselves from getting infectious respiratory diseases?
The below tips are based on guidelines from the Department of Health, but also contain some practical advice that we having always advised patient to follow to prevent themselves from catching any infectious diseases - even more so in the current climate.

• Hand washing with soap, including between fingers, is still the most effective way and should be done for at least 20 seconds. If soap and water are not available, use an alcohol-based hand rub with at least 60% alcohol.
• A mask is only really useful for sick people or those dealing with sick people, working in confined spaces, public transports, doctor’s waiting rooms etc.  Masks can cause a false sense of security and increase the chances of touching one’s face when adjusting it. It is not advisable to wash and reuse a mask. Goggles and glasses are only advised for medical personnel dealing with sick patients.
• Make sure you don’t touch the outside surface of your masks and where you place your mask should you take it off. Dispose of them directly in the bin.
• One of the best ways to avoid any infectious disease is not to touch your face or those of your loved ones. Viruses and bacteria can get in to your body either by your eyes, nose or mouth. Cover your nose and mouth when you cough or sneeze. Infection does not enter the body through intact skin.
• We do advise patients to have an influenza vaccine, especially this year. This helps protect your body from seasonal flu and therefore allows your immune defense to fight any other potential infections you may acquire. Stocks are limited this year.
• For some patients it may also be appropriate to have the pneumonia vaccine; please discuss with your doctor.
• It is advisable not to bring too many companions to a medical clinic.
• Due to the incubation period, it is a good idea to avoid crowds because you do not know who might be sick.
• Close your toilet seat when flushing the toilet to prevent a contaminated aerosol column from infecting nearby objects. Also, keep personal toiletries in cupboards or covered up in the bathroom.
• Try and not share food, utensils, cups or towels.
• Avoid putting your bag/school bags on to sofas and beds.
• Clean and disinfect surfaces and objects that may be contaminated with germs, such as door handles at home and work.
• While sick, limit contact with others as much as possible, work from home, children should avoid school and playgroups. This is to avoid passing any infection to others but also to avoid others from infecting you to further burden your immune system.
• Use a tissue to touch public toilet handles and door handles.
• When travelling, avoid travelling if you are sick, wear a mask and bring some disinfectant to clean around your seating area and the TV screen. Bring your own pillows and blankets. 
• Consider changing out of your outdoor clothes when you get home, especially for young children, as it is more difficult to emphasize to them  not to touch their faces. Consider having bed covers.
• Clean electronic devices like mobile phones, iPads regularly with disinfectant.
• Social media has shown itself in the past few weeks to be useful in passing on both regulated and unregulated information, which can cause more fear and anxiety. At times like this it as important to look after ones’ mental as well as physical health. Try to control the amount of time you are on social media. For up to date regulated information it would be best to  look at official websites such as CHP https://www.chp.gov.hk/en/index.html
• As always, one of the best defenses is our own immune system. Eat a healthy balanced diet,  do  regular exercises, minimize stress levels and ensure you have a good sleeping habit.

 
How we can help
The clinic is running the full usual service, both doctors and therapists. There are measures in place to ensure we do not see any suspected cases, as all patients are screened first. For those wishing for tests to alleviate their concerns as to whether they may have the coronavirus, this test is only available in the public hospital. 

Currently we are only seeing booked appointments to allow us to screen all patients.

Seasonal flu vaccines are still currently available. 

For those patients who may need medical attention but feel they are not able to attend the clinic, please email your usual doctor and we will try and help you as best as we can.
​
In recent weeks some patients have needed letters for travel plans; please make an appointment with your usual doctor to issue these.
 
In the meantime, stay calm, safe, adhere to good personal hygiene and please email us for any additional information.
 
Dr Lily Wong
The London Medical clinic

The HKSAR government have announced that from Saturday 8th February 2020 12am - all people coming in from Mainland China will be subject to enforced quarantine for 14 days. This applies to all nationalities. In addition, if you have visited Mainland China in the past 14 days and come in from another country, you will also be subject to quarantine. Further details will announced later as to whether this will be in camps or at home with the use of GPS bracelets. We would advise all patients in China to come back to HK in the next 24hrs to avoid the quarantine measures.

This is partly in response to the new Coronavirus cases in the past 2 days in which the patients have had no previous travel to China. This would suggest that the virus is already spreading within the HK community. If this is the case then we would expect more infection cases in the next 2 weeks. 

We have made the decision that due to infection control we are unable to take walk-in patients until further notice. All patients must have an appointment before being seen. This allows the clinic to screen patients efficiently and reduce the risk of infection spread. It will also safeguard patients who visit the clinic by appointment, as well as our own staff and doctors. 

As of today there are 15 confirmed cases of the Coronavirus in HK, a majority of which have a travel history to Hubei Province. The Centre for Health Protection (CHP) has announced that there will be testing for all pneumonia cases not responding to treatment within 3 days, in the public hospital -  regardless of travel history.

All patients who have been to Mainland China in the past 14 days should stay at home if possible and wear a mask if they need to go out.

All patients who have been to Hubei Province in the past 14 days should wear a mask and contact the Department of Health on 2125 1122.

As of today there are 2 confirmed cases of Coronavirus patients in the UK. Both were tourists from Wuhan. In HK there are now 12 confirmed cases. Singapore and US have now banned all visitors coming from China and all residents who have been to China will be encouraged to stay at home for 14 days.