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LCQ19: Issues relating to novel coronavirus epidemic
     Following is a question by Dr the Hon Chiang Lai-wan and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (February 26):
     In recent months, the novel coronavirus epidemic has continued to spread and it has been confirmed that the virus is capable of human-to-human transmission. Up to the present, tens of thousands of confirmed cases have been recorded on the Mainland, and the number of confirmed cases in Hong Kong has also been on the rise. On the issues relating to the epidemic, will the Government inform this Council:
(1) of the latest measures to cope with the occurrence of community transmission in Hong Kong;
(2) whether it knows the effective methods currently known for treating the infection of the virus; whether it has exchanged with the Mainland authorities the experience in treating the patients concerned; if so, of the details; if not, the reasons for that;
(3) as recently a number of healthcare staff of the Hospital Authority (HA) have taken sick leave, gone on strike or resigned, of the new counter measures put in place by the authorities to ensure that there is sufficient manpower in hospitals to deal with the epidemic;
(4) whether it knows the types and other details of those non-urgent services which HA has reduced in order to deal with the epidemic;
(5) whether it will consider invoking section 3 of the Reserved Commodities Ordinance (Cap 296) to (i) specify face masks as a reserved commodity, as well as (ii) coordinate the procurement of face masks and control the storage, distribution and prices of such items, so as to avoid panic hoarding of face masks by members of the public which exacerbates the shortage of such items; whether it will provide face masks and antiseptic items for free to the grass-roots people in need; if so, of the details; if not, the reasons for that;
(6) whether it will, by following the practice of the Macao Government, set up a dedicated webpage and require retailers to report, on a daily basis, on their real-time stock of face masks on the webpage, so as to facilitate the purchase by members of the public;
(7) as the Government has appealed to those members of the public returning to Hong Kong from the Mainland to self-isolate for 14 days as far as possible upon their return to Hong Kong, whether it will issue guidelines on whether employers may regard those employees who are absent from work due to self-isolation as having taken leave, or deduct the salaries of such employees; and
(8) given that the Occupational Safety and Health Ordinance (Cap 509) stipulates that employers must, so far as reasonably practicable, ensure the safety and health at work of the employees, whether it will require (i) employers to provide sufficient infection-protection supplies (e.g. face masks and antiseptic liquid) to employees at work, and (ii) cleansing service contractors to provide protective clothing for frontline workers; if not, of the reasons for that?
     Since the outbreak of COVID-19, the Government has been closely monitoring the development of the epidemic situation. Guided by the three key principles of responding promptly, staying alert to the situation and working in an open and transparent manner, and having regard to experts' advice and opinions, we have responded comprehensively with decisive and appropriate measures. According to the Government's prevention and control strategies, we introduced a host of specific and practicable measures in the areas of health surveillance, compulsory quarantine, isolation treatment, health declaration, exit screening, reducing people flow between Hong Kong and the Mainland, enhancing "social distancing" and supporting frontline healthcare staff, etc.
     In consultation with the Hospital Authority (HA), Commerce and Economic Development Bureau, Financial Services and the Treasury Bureau, Labour Department and Policy Innovation and Co-ordination Office, my reply to the various parts of the question raised by Dr the Hon Chiang Lai-wan is as follows:
(1) To prevent a large-scale community outbreak in Hong Kong, the Government has adopted a strategy of "containment" of the virus to achieve early identification, early isolation and early treatment of the infected.
     First of all, since February 8, 2020, the Government has issued quarantine orders to all persons entering Hong Kong from the Mainland, including Hong Kong residents and visitors from other places. These persons are required to stay at home or other accommodation for a 14-day compulsory quarantine.
     Furthermore, the Government will continue to strengthen "social distancing" measures, as well as personal hygiene and environmental hygiene measures so as to minimise the risk of the further spread of the novel coronavirus infection locally.
     At the same time, for early detection of cases of novel coronavirus infection, the HA has implemented the "Enhanced Laboratory Surveillance Programme" since mid-January 2020 to conduct tests for novel coronavirus infection on pneumonia patients meeting the relevant criteria, and has further expanded by phase to cover all in-patient pneumonia cases. With a view to further enhancing the surveillance, prevention and control strategy in Hong Kong, since February 19, 2020, the HA has expanded the "Enhanced Laboratory Surveillance Programme" to cover outpatients.  Deep throat saliva specimen testing will be arranged for patients seeking medical attention at Accident and Emergency Departments and General Out-patient Clinics with fever and respiratory symptoms or mild pneumonia to help with the early detection of mild cases in the community and provide a better understanding of the epidemiological situation.
(2) At present, public hospitals mainly provide supportive treatment for patients diagnosed with the coronavirus infection, including oxygen therapy, intravenous fluid infusion, and empirical antibiotics for secondary bacterial infection. Extracorporeal Membrane Oxygenation life support machine will be used where necessary. The HA has a group of experts to conduct assessments according to the clinical conditions of diagnosed patients for providing suitable patients with combination antiviral therapy, such as protease inhibitor, interferon and ribavirin. The efficacy and the possible side effects of the medications are closely monitored. These drug treatments are formulated in accordance with the experts' understanding of the coronavirus infection.  The experts will make reference to the latest research data and make adjustments as appropriate.
(3) With regards to the earlier industrial action, the Government and HA have been urging healthcare workers participating in the industrial action to return to work as soon as possible to avoid affecting public hospital services and patient treatment. The HA has also activated the Major Incident Control Centre to closely monitor the operation of public hospitals and to deploy manpower and adjust non-emergency services with regard to service needs, with a view to focusing resources on management of the epidemic and maintaining emergency medical services.
(4) In view of the latest development of the epidemic situation, the HA announced on February 15, 2020 to adjust non-emergency and non-essential medical services significantly in the four weeks starting from February 17, so as to focus manpower and resources on providing care for the most critical patients and responding to the epidemic.  Specific measures include:
(i) except for emergency and essential treatment, non-emergency services such as elective surgeries will be postponed;
(ii) specialist outpatient clinics will contact patients with stable conditions to reschedule their appointments and arrange drug refills for them according to their conditions; and
(iii) except for emergency and essential examinations, non-emergency examinations such as routine endoscopy will be rescheduled.
     The HA expects that the service adjustments can substantially reduce the flow of people in hospitals and allow public hospitals to focus on providing emergency services and managing the epidemic. The HA will closely monitor the manpower and service situation of public hospitals and make timely adjustments.
(5) and (6) For the supply of surgical masks, the Government has been adopting a multi-pronged approach to procure surgical masks globally through different channels and means. These include the Government Logistics Department procuring directly from suppliers and through referrals from the Hong Kong Economic and Trade Offices and from individual sources in order to secure the supply of masks and other protective items as soon as possible to meet the Government's operational needs.  At the same time, the Government prioritises the distribution of surgical masks of the Government stock in accordance with the risk level. Priority is given to healthcare staff and personnel providing care services (including front-line healthcare staff, nursing staff in institutions, healthcare personnel in private clinics); and personnel who provide essential services and who are required to have contact with the public at work (such as those providing public transport, emergency services, immigration services). In addition to imports, the Government strives to explore prospects of local production. The Correctional Services Department (CSD) has also increased its production volume. The Government is maintaining close contact with members of local chambers of commerce and the retail industry and collaborating with the relevant Mainland Authorities to facilitate clearance so as to speed up the delivery of masks to the market.
     Given experts' assessment that the virus may last for a period of time and that there are confirmed cases in various countries and regions, the demand for surgical masks has risen sharply, causing difficulties in procurement. As the supply of surgical masks is tight in the short run, the Government considers that it is more pragmatic to strive to increase supply of surgical masks and manage the demand. The Government currently does not have any plans to mandatorily control the supply and prices of surgical masks through legislation, because this could be counterproductive, rather than addressing the problem at source, i.e. inadequate supply.
     In response to private organisations and groups' donation/plans of donation of masks and disinfection products to the Government and non-governmental organisations recently, the Labour and Welfare Bureau and Social Welfare Department will contact the relevant organisations in accordance to the wishes of the donors. The Government also encourages private and charitable organisations to donate surgical masks to the underprivileged, and stands ready to play a facilitation role with financial resources and coordination.
(7) Since February 8, 2020 0.00am, in accordance with the Compulsory Quarantine of Certain Persons Arriving at Hong Kong Regulation (Cap 599C), the Department of Health (DH) has required all persons entering Hong Kong from the Mainland, or from other places but have visited the Mainland over the past 14 days, including Hong Kong residents, Mainland residents and other visitors, to be subject to mandatory quarantine for 14 days upon their arrival. Any person concerned who leave accommodation without permission may commit a criminal offence. The Employment Ordinance (Cap 57) has no statutory requirement regarding leave or wage arrangements for employees who undergo self-isolation. Nonetheless, the Government encourages employers to be considerate and show understanding to such employees’ situation and make flexible arrangements.
(8) Under the Occupational Safety and Health Ordinance (Cap 509), employers must, so far as reasonably practicable, safeguard the occupational safety and health (OSH) of their employees at work.  Therefore, each employer has the duty to conduct risk assessment of the work of his/her employees, and based on the result of the assessment, provide them with the necessary equipment to safeguard their OSH.
     Cleansing service contracts are normally contracts that rely heavily on the deployment of non-skilled workers. For these service contracts, the four major procuring departments, namely the Food and Environmental Hygiene Department (FEHD), Leisure and Cultural Services Department, Government Property Agency and Housing Department (HD) (on behalf of the Housing Authority), normally require contractors to comply with the relevant laws of Hong Kong (including the requirements of the Occupational Safety and Health Ordinance) and specify in the service contracts that adequate and suitable personal protective equipment (PPE) should be provided to the workers. The four major procuring departments have also enhanced communication with their contractors, asking the latter to provide sufficient PPE such as masks to their workers. Departments will also provide relevant working guidelines to their contractors, with reference to the "Health Advice on Prevention of Severe Respiratory Disease associated with a Novel Infectious Agent in Workplace" issued by the Centre for Health Protection of the DH.
     In general, equipment and masks required for the work of the cleansing workers should be provided by the contractors. Considering the difficulties of the contractors in sourcing these supplies for the protection of the cleansing workers delivering public services, the Government has decided to reserve the 700 000 additional masks produced by the CSD each month for free distribution to the cleansing workers employed by government service contractors. The FEHD and HD have started distributing masks to cleansing workers on February 17, 2020, with priority given to those who are responsible for cleaning public toilets, public markets, refuse collection points, streets and public housing estates.
Ends/Wednesday, February 26, 2020
Issued at HKT 16:40
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