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.
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:
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.
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.
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:
In severe cases, there could be:
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.
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:
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@example.com.
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:
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).
Due to the recent Coronavirus outbreak in Mainland China, please be advised that ALL patients with fever and cough and recent travel to China in the PAST 2 weeks should go to their local hospital. The only place with Coronavirus testing is the public hospital. If you present to the clinic, we will be legally obliged to report you as a suspected case and transfer you directly to a public hospital by ambulance.
We apologise for this seemingly extreme policy but it is required to limit further spread of this potentially deadly virus in our community. More updates and advice on the virus will be available here later today.
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