Following is a question by the Hon Yang Wing-kit and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (February 8):

Question:

     The Government has since January 30 this year cancelled the arrangement of issuing isolation orders to persons infected with the Coronavirus Disease 2019 (COVID-19) according to the Prevention and Control of Disease Regulation (Cap. 599A). Also, members of the public are not required to report cases that tested positive by rapid antigen tests or nucleic acid tests. However, some members of the public are worried that the cancellation of the relevant arrangement may increase the burden on Hong Kong's healthcare system. In this connection, will the Government inform this Council:

(1) whether it has assessed when Hong Kong will enter the stage of having the whole population infected with the disease; if so, of the details; if not, the reasons for that;

(2) whether it has assessed if public hospitals have sufficient manpower and resources to treat confirmed COVID-19 patients, especially those with severe symptoms; if it has, of the details; if not, the reasons for that; of the measures in place to ensure that patients receive appropriate treatment when the occupancy rate of negative pressure beds has reached saturation;

(3) whether it will expand the scope of persons eligible for the fifth dose of COVID-19 vaccine and the bivalent vaccine, and purchase vaccines which have been developed using different technologies (including the nasal spray COVID-19 vaccine developed by the University of Hong Kong in collaboration with the Mainland, the recombinant COVID-19 vaccine (adenovirus type 5 vector) for inhalation, etc.), so as to strengthen the local immunity barrier; if so, of the details; if not, the reasons for that;

(4) given that the Government has stopped distributing anti-epidemic kits to confirmed patients, whether the Government will still provide anti-epidemic supplies to confirmed patients in need; if so, of the details; if not, the reasons for that; and

(5) whether it will allocate additional resources to further assist schools and residential care homes for the elderly (RCHEs) in enhancing their anti-epidemic capabilities, so as to reduce the severity rates and mortality rates of school children and elderly persons residing in RCHEs; if so, of the details; if not, the reasons for that?

Reply:

President,

     Following three years of COVID-19 epidemic in Hong Kong, with the ever evolvement of the virus and Omicron becoming the predominating variant, coupled with the enhancement of prevention and treatment capacities of the local healthcare system and the handling capacity of society as a whole, the risk posed by COVID-19 to local public health has apparently altered. With the cancellation of issuing isolation orders from January 30, 2023, the management of the COVID-19 epidemic by the Government has entered a new stage and a new mode, with a view to gradually establishing a system of the "new normal" and having COVID-19 managed as a type of upper respiratory tract infections.

     In consultation with the Education Bureau (EDB), the Labour and Welfare Bureau and the Hospital Authority (HA), the reply to the various parts of the question raised by the Hon Yang Wing-kit is as follows:

(1) COVID-19 may cause symptomatic or asymptomatic infections. As at January 30, 2023, the Centre for Health Protection (CHP) of the Department of Health recorded a total of around 2.88 million number of cases tested positive for COVID-19, showing that a significant proportion of the population in Hong Kong with history of infections.

     Meanwhile, the third dose vaccination rate plus the effective vaccination rate equivalent to having received three doses resulting from infection has already exceeded 95 per cent in Hong Kong. Hong Kong has built up a strong immunity barrier.

(2) Since onset of the epidemic, the HA has been reviewing and updating the anti-epidemic measures of public hospitals in a timely manner in accordance with the Government's overall prevention and control strategy and the latest scientific evidence, while adopting multi-pronged approach to enhance HA's capacity in combating the epidemic. This includes formulating effective contingency plans, launching different phases of Bed Mobilisation Plans in view of the epidemic, extensive use of COVID-19 antiviral drugs, telemedicine and collaboration with private hospitals. As the virus continues to evolve with lower pathogenicity, most infected people are currently mild or asymptomatic cases that do not require hospitalisation.

     In view of the latest epidemic development and the cancellation of the isolation order arrangement, experts of the HA have further adjusted the arrangements for COVID-19 infected persons after reviewing their infection risk in balance with patient service demands. If the patient's clinical condition is stable, he or she can be discharged from the hospital. Alternatively, if the test results fulfil the criteria, the patient can be transferred to general ward for other treatments.

     Meanwhile, the HA has strengthened its services to sustain support for COVID-19 patients in the community. At present, all General Outpatient Clinics provide treatments for COVID-19 patients, including prescribing COVID-19 oral drugs for suitable patients. The HA has also increased the consultation quota for episodic illnesses including COVID-19 patients and reserved quota for patients with higher risks to make appointments. In addition, if COVID-19 patients have medical related enquiry, they may call the HA support hotline 1836115. The hotline staff will provide appropriate assistance to patients, including referring high-risk patients in need to General Outpatient Clinics for treatment. The HA will also enhance the support of outreach medical teams for infected persons in residential care homes.

     The HA will continuously monitor the bed occupancy rate of public hospitals and mobilise beds as necessary to provide patients with appropriate treatment.

(3) The COVID-19 Vaccination Programme (Vaccination Programme) led by the Government provides members of the public with two safe and efficacious COVID-19 vaccines, namely the Sinovac and Comirnaty vaccines. The two vaccines are respectively developed from the inactivated virus and mRNA technology platforms. According to the recommendations of the Scientific Committee on Vaccine Preventable Diseases and the Scientific Committee on Emerging and Zoonotic Diseases (JSC) and the Chief Executive's expert advisory panel (EAP), persons aged 18 or above who had received four doses may choose to receive the fifth dose (or the fourth dose for recovered persons) for better protection after considering the individual risk and benefit (e.g. at a higher risk of COVID-19 exposure or with personal needs). In accordance with the guidelines of the drug manufacturer, the Comirnaty bivalent vaccine can be used as a booster dose for those who have completed the primary course of vaccination. Regarding the COVID-19 vaccination arrangements, the Government will closely monitor and make reference to the latest scientific evidence, recommendations of the World Health Organization and relevant overseas health authorities, and will consult the JSC-EAP from time to time.

     The quantity of vaccines procured by the Government is expected to be sufficient for providing the first to third dose vaccine to all citizens of Hong Kong under the Vaccination Programme led by the Government. Persons aged 18 or above may also choose to receive the fourth and fifth dose for better protection after considering the individual risk and benefit (e.g. at a higher risk of COVID-19 exposure or with personal needs). The Government has no plan for the time being to supply COVID-19 vaccines other than the Sinovac and Comirnaty vaccines for use under the Vaccination Programme. The Government will continue to monitor the overall situation of research and development of COVID-19 vaccines and the global epidemic situation, as well as keep close liaison with various drug manufacturers. Having regard to scientific evidence, clinical data and experts' advice, the Government does not rule out the possibility of purchasing other types of vaccines as needed in the future. Furthermore, the Government has amended the relevant legislation to facilitate drug manufacturers to register their COVID-19 vaccines in Hong Kong and supply to the private healthcare market, with a view to providing members of the public with more different choices when getting vaccinated.

(4) Since February 2022, the Government has been providing various forms of assistance for citizens undergoing home quarantine (applicable to close contacts) and home isolation (applicable to infected persons), including the distribution of anti-epidemic kits. As the risk posed by COVID-19 to local public health has changed, the Government ceased to define close contacts and issue quarantine orders starting from December 29, 2022. The distribution of anti-epidemic kits to close contacts was also suspended. Subsequently, from January 30, 2023 onwards, the Government would no longer issue isolation orders to infected persons and has ceased the distribution of anti-epidemic kits to them.

     Having considered that citizens are no longer subject to home quarantine or home isolation and thus are free to go out to purchase anti-epidemic supplies, the Government has no plan to distribute anti-epidemic kits again.

(5) The EDB has all along been requiring schools to strictly put in place the anti-epidemic measures stipulated in the "Health Protection Measures for Schools" issued by the EDB and the "Health Advice to Schools for the Prevention of COVID-19" issued by the CHP. In order to help schools implement various anti-epidemic measures, at the time when there was tight supply of anti-epidemic items due to severe epidemic situation, the EDB disbursed a one-off Special Anti-epidemic Grant to schools offering a full and formal curriculum in Hong Kong to purchase items for epidemic prevention, or procure the relevant services and items related to cleaning the school premises. Schools may make use of the grant on or before August 31, 2023. In addition, the Government has distributed rapid antigen test (RAT) kits to students with financial needs through schools to tie in with the requirement of conducting daily RAT before going to school.

     With the orderly resumption of normal campus life, public sector schools may continue to make good use of various subventions provided by the EDB and flexibly deploy various resources for epidemic prevention according to school-based circumstances. In order to create a safe and healthy campus environment for students to study with a peace of mind, the EDB, apart from updating the health guidelines in a timely manner, has been collaborating with the CHP to provide a number of vaccination facilitative measures for schools, as well as co-ordinating with schools and school sponsoring bodies to organise a number of "School Vaccination Day" activities across various districts in Hong Kong to actively promote early vaccination for teachers and school staff as well as students and their family members, which will reduce the risk of severe cases and fatalities. From May 2022 to January 2023, the Regional Education Offices had organised/co-organised more than 70 sessions of the vaccination day with around 940 schools and 16 000 persons enrolled for vaccination. The EDB will continue to make concerted efforts to co-organise "School Vaccination Day" that provide one-stop vaccination services.

     On the other hand, the Government is committed to protecting targeted groups, especially residents of residential care homes for the elderly and for persons with disabilities (RCHs), as well as frontline staff of RCHs. Notwithstanding that the Government no longer issues isolation orders to persons infected with COVID-19, it strongly recommends that staff of RCHs who are infected should not return to duty in order to reduce the risk of transmission of the virus to RCH residents. The Social Welfare Department (SWD) also appeals to RCH operators to allow these staff to rest at home and return to work until they have obtained negative RAT results for two consecutive days. During the epidemic, the SWD has been providing RCHs with a special allowance for manpower support to subsidise the cost of hiring temporary staff, relief staff or for internal staff redeployment to work overtime in cases of absence of staff due to infection. The allowance is still available and can be applied by RCHs to cover the expenses of hiring relief staff or for staff redeployment.

     At present, RCH staff are required to undergo a nucleic acid test 48 hours before entering RCHs, and to undergo daily RAT prior to work. The SWD would regularly distribute RAT kits to staff and residents of RCHs for use. To facilitate RCH staff to undergo nucleic acid test, the SWD will also arrange for testing operators to collect nucleic acid test samples at RCHs, arrange for them to receive free priority testing and obtain early results at community testing centres, community testing stations or mobile specimen collection stations. In addition, the SWD will continue to distribute personal protective equipment to RCHs.

     To improve ventilation at RCHs, the SWD arranged in mid-2022 professionals to inspect ventilation equipment and put forward recommendations, and collaborated with the Hong Kong Jockey Club Charities Trust to subsidise RCHs in need to procure items such as air purifiers and mobile negative pressure cabins.

     The Government has been working closely with RCHs and medical teams to ensure timely vaccination of RCH residents, so as to build up the protection barrier and to lower the risks of severe cases and deaths for RCH residents upon infection. While the vaccination rate of the third dose of RCH residents has reached nearly 90 per cent, given the protection conferred by vaccines will diminish over time and that there are still infection cases among RCH residents and staff from time to time, the Government has to continue to drive up vaccinate rate of RCH residents. In this connection, the Government rolled out two rounds of outreach vaccination service special programme for RCHs on July 25 and November 25, 2022 respectively. The second round has extended till February 17, 2023. Under the special programme, an allowance is offered to medical teams to cover the manpower and transportation costs arising from additional visits to RCHs. Medical teams also provide seasonal influenza vaccination concurrently for residents to attain dual protection. The special programme helps to increase the vaccination rates of RCHs, thereby effectively strengthening protection to the residents and building a protective barrier for RCHs.

Ends/Wednesday, February 8, 2023
Issued at HKT 15:50

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