LCQ17: Treatment of post Coronavirus Disease 2019 condition
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Question:
It has been reported that more than 900 000 recovered patients of Coronavirus Disease 2019 (COVID-19) have developed at least one of the symptoms of post COVID-19 condition (commonly known as "long COVID"). There are views that COVID-19 has become a local endemic disease and the number of patients developing symptoms of long COVID will be increasing. In this connection, will the Government inform this Council:
(1) given that the Health Bureau and the Health and Medical Research Fund have awarded grants to seven long COVID related research studies, of the names, contents and results of such studies, as well as the names of the research institutes; the expected completion time of the research studies which have not been completed;
(2) whether it has compiled statistics on the respective numbers of members of the public who went to public and private healthcare institutions for seeking medical consultation in each of the past six months due to the development of long COVID symptoms; if so, of the relevant symptoms and their duration;
(3) given that the Hospital Authority (HA) launched the "Special Chinese Medicine Out-patient Programme for COVID-19 infected persons" (the Special Programme) in 2020 to provide eligible Hong Kong residents who have been confirmed to have contracted COVID-19 locally but still have COVID-19 sequelae with no more than 10 free Chinese medicine general consultations in the 18 Chinese Medicine Clinics cum Training and Research Centres, whether the Government knows the number of persons seeking medical consultation and the average number of diagnoses and treatments received by each patient under the Special Programme since its launch till the 30th of last month (i.e. the date on which the arrangement of issuing isolation orders was cancelled);
(4) given that persons receiving services under the Special Programme need to produce the isolation orders issued by the Department of Health, but the arrangement of issuing isolation orders was cancelled on the 30th of last month, whether the Government knows if HA will revise the requirements for using such services, so that eligible members of the public can receive such services;
(5) given that the Special Programme will end six months after the last date on which isolation orders were issued, whether the Government knows if HA will extend the Special Programme and collaborate with private Chinese medicine practitioners to provide more consultation quotas, thereby meeting the service demand; and
(6) whether it has plans to carry out extensive publicity and education for members of the public, focusing on information such as the symptoms and treatment of and the nursing of health for long COVID?
Reply:
President,
According to information from the World Health Organization (WHO), some COVID-19 patients may experience mid- and long-term effects from the virus, collectively known as "Post COVID-19 condition", or "Long COVID". The Government strives to provide suitable care and support services for patients recovered from COVID-19, and also supports a number of studies on "Long COVID" in order to support the formulation of better policies for assisting recovered patients to receive appropriate care.
In consultation with the Hospital Authority (HA), my reply to the various parts of the question raised by Professor the Hon Chan Wing-kwong is as follows:
(1) Since April 2020, the Health Bureau (HHB) and the Health and Medical Research Fund (HMRF) have approved a total of $556 million to support 70 COVID-19 related research studies from bench to bedside and at the community level through application of new technologies. These studies address important research areas including transmissibility and infectivity of the virus, effective detection and surveillance, prevention strategies of the disease and development of treatments and therapies.
To better understand the impact of "Long COVID" in Hong Kong, seven studies covering a wide variety of topics in relation to "Long COVID" conducted by the University of Hong Kong, the Chinese University of Hong Kong and the Hong Kong Polytechnic University have been supported. These studies cover topics ranging from understanding the prevalence of clinical manifestations of "Long COVID" and investigating the prognostic values of various biomarkers, to the effects on physiological functions such as the lungs and the cardiopulmonary system, as well as neuropsychiatric sequelae. In addition, different interventions targeting prevention, treatment and rehabilitation have also been tested, including the oral microbiome formula, centre-based and novel digital-based cardiopulmonary rehabilitation programmes, cognitive behavioural therapy and mindfulness-based psychological programmes.
These studies last two to five years and all of them are expected to be completed in the second half of 2026. Some initial findings have been disseminated in press conference or published in scientific journals in 2022. For example, one study reported the beneficial effects of a cardiopulmonary rehabilitation programme in COVID-19 survivors; another study discovered that post-COVID gut microbiome dysbiosis could persist for more than one year and was closely associated with the symptoms of "Long COVID"; and a study reported the occurrence of neuropsychiatric morbidities one year after COVID-19 infection.
(2) The HA has carried out the collation and analysis of medical related data of "Long COVID" in accordance with the definition of "Long COVID" by the WHO. Taking reference from the HA’s provisional figures, about 2 800 general outpatients were diagnosed with "Long COVID" from August 15, 2022 to February 6, 2023. The main symptoms include persistent cough, shortness of breath and generalised weakness. As the relevant work on data collection and analysis is still in progress, no further figures are available at this stage.
The Government has not compiled statistics on medical consultations made to private healthcare institutions in connection with "Long COVID" symptoms. Currently, most private healthcare institutions have not uploaded patients’ medical records to the Electronic Health Record Sharing System, making it practically difficult to collect the relevant data.
(3) to (5) The HA launched in 2020 the "Special Chinese Medicine (CM) Out-patient Programme for COVID-19 Infected Persons" to provide eligible Hong Kong residents who have been infected with COVID-19 in Hong Kong and have completed isolation but still have COVID-19 sequelae with free CM general consultations based on Chinese medicine practitioners’ clinical assessment at the Chinese Medicine Clinics cum Training and Research Centres (CMCTRs) in the 18 districts. In response to the sharp rise in the demand for CM rehabilitation services amid the fifth wave of the epidemic, the HA has, in collaboration with the CMCTRs, taken various measures swiftly to enhance the service capacity to meet the increased demand. As at end-January 2023, nearly 440 000 consultations for more than 100 000 recovered patients were provided by the CMCTRs.
In addition to providing government-subsidised CM out-patient services for eligible Hong Kong residents, the 18 CMCTRs also provide other non-government-subsidised CM services to cope with the healthcare needs of persons seeking consultations. Upon the Government’s official cancellation of the arrangement of issuing isolation orders on January 30, 2023, members of the public with healthcare needs can still seek medical consultations at the 18 CMCTRs. The HA will closely monitor the service demand and co-ordinate with the CMCTRs to mobilise resources to enhance their services when necessary.
The HA has all along been in support of the Government to step up the involvement of CM in the whole process of COVID-19 epidemic prevention, treatment and rehabilitation. Apart from providing CM services through the HA to COVID-19 patients, the Government has enhanced the use of CM on all fronts at different levels via various modes (including the tele-advice hotline, outreach or telemedicine services, dispensing and delivery of CM drugs, etc.) and has provided CM support to confirmed patients, persons under isolation/quarantine and recovered patients in need of follow-up rehabilitation amid the fifth wave of the epidemic, thereby giving full play to the strengths and functions of CM. The "Together We Unite - Chinese Medicine COVID-19 Rehabilitation Scheme", funded by the Chinese Medicine Development Fund (CMDF) under the HHB and implemented by the Federation of the Hong Kong Chinese Medicine Practitioners and Chinese Medicines Traders Association, has been launched earlier to meet the needs of recovered patient for rehabilitation. Considering that the resources of Hong Kong’s CM sector are mainly concentrated in the private market, the Government will continue to work closely with stakeholders in the sector to provide the public with appropriate CM support.
(6) The Centre for Health Protection (CHP) of the Department of Health raises public awareness about "Long COVID" through various channels and encourages COVID-19 vaccination as a preventive measure. Apart from dissemination of relevant information through the "COVID-19 Thematic Website" (www.coronavirus.gov.hk), the CHP also explains to the general public about the health impact of "Long COVID" and the preventive measures through various channels such as social media, Announcements in the Public Interest, short video clips, and interviews and seminars with medical experts, etc..
On the other hand, the HA clinical teams will continue to identify for any complications or persistent symptoms of "Long COVID" based on patients’ signs and symptoms, provide necessary treatment, rehabilitation support and health recommendations accordingly, and refer them to other rehabilitation services from different specialties, allied health and psychological support services, according to clinical needs.
As regards CM, the CMDF has also been funding applications for training, promotion and research projects related to the COVID-19 epidemic initiated by the sector. Some of the funded projects have provided health information and advice on the management and rehabilitation of COVID-19 to the public through publications and short video clips.
Ends/Wednesday, February 15, 2023
Issued at HKT 15:09
Issued at HKT 15:09
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