Novel Coronavirus Pneumonia (NCP) update

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.
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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.
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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