Wuhan Coronavirus Update

As China and indeed, other countries around the world battle to curb the spread of the Wuhan virus - a novel (new) type of coronavirus responsible for the epidemic currently spreading around the world - the need for relevant and useful information regarding the epidemic which the Director-General of the World Health Organization has referred to as a "high global risk" continues to increase. 


The Wuhan virus is a betacorona virus, currently provisionally referred to as '2019-nCoV', similar to the SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) viruses, which characteristically cause flu-like illnesses.


The virus has been identified as a new type of coronavirus and is believed to have originated from bats, and while initially thought to have spread from animal to humans, is now reported to also possibly be spreading from person-to-person. 


The typical symptoms of infection are respiratory in nature and include: 

• Dry cough
• Sore throat
• Fever
• Malaise (a general feeling of being unwell)

In severe cases, there could be:

• Shortness of breath and 
• Severe pneumonia, resulting in death in some patients. 

As of today January 28th 2020, there have been 4,682 reported cases, 106 deaths in China and 8 confirmed cases in Hong Kong, and while the situation is constantly changing, our current advice based on the information from the Centre for Health Protection, HK and practical advice from the family doctors in the clinic are as follows: 




What do we know so far about the Coronavirus?


Most current available information about the virus can be found here. 
https://www.chp.gov.hk/en/healthtopics/content/24/102466.html


How do I best protect myself?
Most coronaviruses spread through respiratory droplets, which are released when an infected person coughs, sneezes, exhales, or drips nasal mucus. 
This is why it is advised to wear face masks in high risk situations such as in crowded areas and in medical clinics. 


But because these respiratory droplets can get settled on surfaces and you can get infected indirectly when you come in contact with them, wearing face masks only are not enough. 


Viruses can enter the body via the eyes, nose, or mouth. It is important therefore, that you practise good hand hygiene:

• Ensure you wash your hands with soap regularly as per the guidelines on CHP.
• Make liberal use of alcohol-based hand sanitisers when hand washing is not feasible or convenient. 
• Try not to touch your face with your hands too often especially when you have not done the above. 

We are aware in recent days that there has been a limited supply of masks both in Hong Kong and around the world. This makes hand hygiene maintenance even more necessary. 


So far, most of the deaths associated with this virus have occurred in people of older age and in those with underlying medical illnesses. Therefore, it is important to maintain a good immune system and protect yourself against infections especially respiratory infections like the influenza against which there are available vaccines like the influenza vaccine. In the past months, we have seen a high number of cases of Influenza A in adults and children, and we would advise anyone who has not had the flu vaccine to have this while there are still some in supply. Contracting Influenza A and Coronavirus combination could lead to a more severe infection.


Avoid crowded areas especially for those who are old, young, or pregnant, and if you must move around in public places, wear a face mask and maintain good hand hygiene. Museums and theme parks are already closed to avoid large gatherings of people.


Wear protective clothing like hand gloves and winter mittens when you go out in public and take these and your outdoor clothes off as soon as you return home. 
If you are not feeling well, seek medical care immediately. 




Can I still travel?
Currently there is no official advice on travel in and out of Hong Kong, other than to Hubei province, but as you are aware, a lot of airports are on heightened alert and should you travel with a mild fever, regardless of the underlying cause, there is a chance you may be stopped and quarantined if you're coming from Hong Kong or China for interrogation. 


Currently, some boarding schools in the UK have already sent out a circular to their students informing them that any student who travels back to Hong Kong or China for the half term February period will not be allowed back to school for at least 2 weeks after returning to the UK.


Should you travel, wear masks on the plane and bring alcohol wipes to clean the seating area around you and the TV screens.


Should I cancel my hospital bookings?
At present, most private hospitals are asking patients to reschedule their hospital booking if they have any respiratory symptoms and/or have travelled to China in the last 2 weeks.


For all other patients, you can proceed with your bookings but should you have any concerns and wish to reschedule or to discuss further, please contact the nurses at [email protected].


Can I be tested for the Coronavirus?
No, this cannot be done in private practice currently. The testing for this virus is very specialised and currently only available in designated laboratories under the public health system via public hospitals' Accident and Emergency departments and therefore not available at any private clinics.


As doctors, we have been advised to report to the public health officer should any of our patients fulfil the following criteria: 

• Presenting with fever and acute respiratory illness, OR
• Pneumonia

AND;
Having had either one of the following within 14 days BEFORE ONSET OF SYMPTOMS:
(a) visited Hubei Province; OR 
(b) visited a medical hospital in mainland China; OR 
(c) had close contact with a confirmed case of the novel coronavirus infection while that patient was symptomatic.
However, such guidelines are likely to change with time.


What is the current treatment?
Since this is a new virus, there are no vaccines or specific treatments currently.
Treatment is supportive only, to relieve symptoms and prevent any complications and side effects, as well as to improve the patient's comfort and quality of life. Antibiotics are only useful for bacterial infections.


A few days ago, the Hong Kong government announced that patients placed on isolation in Hong Kong because they have, or are suspected to have the new Wuhan virus will be treated free of charge be they SAR residents, mainlanders, or foreigners.


Is the clinic still open?
Yes, the clinic would be open for full services from January 29th 2020, but we would appreciate it if patients adhered to our respiratory/cough etiquette guidelines of wearing a mask especially if you have any respiratory symptoms. Face masks will be available from the reception. 
Unfortunately, at present due to a limited supply of masks worldwide, we are not able to sell the masks and can only give them out for patients' use in the clinic.
Should you have a fever on arrival, please speak to the nurses.
The clinic has also put in place, advice from the CHP for all medical clinics. 


Should you have fever and be concerned that you may be at risk of coming in contact with the coronavirus, do not hesitate to contact us by telephone for advice instead of coming to the clinic.


We understand that there may still be some concerns and patients may require some advice specific to their own circumstances. In such cases, please email your usual family doctor for further advice.


The situation is changing fast and we will try as much as we can to give our patients current updates of the situation intermittently, but you can also keep abreast of the latest travel advisories and changes by monitoring news and advice websites such as the Hong Kong Tourism Board (discoverhongkong.com), and Hong Kong’s Centre for Health Protection (chp.gov.hk).