As the number of H7N9 avian influenza case continues to increase in mainland China, it is vital that Hong Kong is well prepared for the potential emergence of H7N9 in Hong Kong. The Hospital Authority (HA) will work with the government in accordance with the established response mechanism for influenza pandemics – a structure with three response levels: Alert, Serious and Emergency – and is closely monitoring the H7N9 risk.
HA Chief Executive Dr PY Leung (centre) and the management team explain HA’s preparedness for avian flu to members of the media.
Given that H7N9 is a new influenza strain, it is imperative that we have good understanding about this infection and make accurate assessments of the risk. From the current available information, the drugs Tamiflu and Relenza are effective against the virus and there is currently no evidence that it is transmitting between humans.
If the response levels further escalate, appropriate management decisions will be made at the Central Command Meeting regarding staff deployments, compensatory leave for staff working in high-risk areas and temporary accommodation for staff as needed. Factors to be considered include human-to-human transmission, and caseloads presenting to various hospitals. Pregnant colleagues will not be assigned to work in high-risk areas.
HA has made comprehensive provision to deal with a broad range of risk scenarios. Healthcare professionals are covered by insurance in accordance with the Employees’ Compensation Ordinance, as well as HA Insurance Policies and Medical Malpractice Insurance. Irrespective of whether Hong Kong is at the Alert Response Level, Serious Response Level or Emergency Response Level, colleagues will be covered by HA’s support and insurance.
To provide frontline colleagues with effective protection, HA has stocked up a three-month supply of personal protection equipment, including 38 million surgical masks, 1.4 million N95 respirators, as well as an ample supply of goggles, gowns and gloves.
With a stock of 18 million doses of Tamiflu and more than 1,400 isolation beds in 15 major hospitals, HA is well equipped to fight any local outbreak of H7N9. The isolation wards are equipped with negative pressure ventilation systems for infection control purposes. Should any hospital identify a suspected case of H7N9, patient will be isolated, rapid testing will be conducted and test results will be returned within hours to enable early drug treatment to patient and adoption of appropriate infection control strategy for the patient concerned in a timely manner.
 HA’s hospitals have prepared sufficient stock of personal protection equipment. Picture shows the storeroom in Queen Elizabeth Hospital. |
 Dr Daniel Chu, Chief of Service and Cluster Service Coordinator (Family Medicine and Primary Healthcare), HKEC, introduces the high-efficiency particulate air (HEPA) filter equipped in Shau Kei Wan Jockey Club General Out-patient Clinic. To safeguard the health of people indoors and outdoors, exhaust air from the clinic will be filtered by a HEPA filter system, which can change the indoor air at least four times per hour. |
 Dr Daniel Chu, Chief of Service and Cluster Service Coordinator (Family Medicine and Primary Healthcare), HKEC, introduces the high-efficiency particulate air (HEPA) filter equipped in Shau Kei Wan Jockey Club General Out-patient Clinic. To safeguard the health of people indoors and outdoors, exhaust air from the clinic will be filtered by a HEPA filter system, which can change the indoor air at least four times per hour. |
 Training will be provided to the frontline medical staff every 18 to 24 months to remind them of the correct way to rub their hands with alcohol, and put on and take off personal protection equipment. |
Dr Cheung Wai-lun, Direction (Cluster Services)
Dr Cheung Wai-lun, Director (Cluster Services), says if Hong Kong needs to activate a major contingency response, HA has four strategies for managing workload demand and staff deployment.
1. Adjust services to reduce non-emergency andelective services, day services, as well as general and specialist out-patient services. However,HA will continue to provide emergency services,cancer service and treatment to those with seriousmedical conditions. Such measures will enable us to deploy staff to the highly impacted services.
2.Reduce workload of acute hospitals by enhancing services at rehabilitation hospitals so that they can support the stablised acute patients. The Community Geriatric Assessment Team will provide onsite treatment at old-age homes to reduce emergency admissions.
3. Turn selected general out-patient clinics intodesignated clinics to serve patients with fever to alleviate the pressure on accident and emergency services.
4.HA will also make available additional manpowerthrough the Special Honorarium Scheme for doctors and recruit additional part-time staff. Leave taking and the provision of non-clinical training will be reduced.
Colleagues should remain vigilant and pay more attention to personal hygiene, especially after direct contact with patients. If frontline staff encounter any patient with influenza symptoms who has recently travelled to areas now affected by the flu outbreak or had direct contact with birds or poultry, they should immediately report this via the Notifiable Disease Outbreak Reporting System (NDORS).
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HKSAR Chief Executive CY Leung, accompanied by HA Chairman Anthony Wu, visits Major Incident Control Centre and the Infectious Disease Centre to learn about the emergency drill, named “Sapphire”, conducted by the HA Head Office, which simulated the arrival of the first suspected case of an H7N9 patient at an HA hospital. Mr Leung says the government is watching the disease’s development closely and will fully support the measures to fight it. |
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Staff who are ill should immediately inform their supervisor or designated officer and seek medical attention. If any unwell member of staff has avian flu symptoms, their supervisor or designated officer should ensure such symptoms are promptly entered into the SESAS.
Frontline colleagues are reminded to always use the FTOCC triage system when assessing patients:
Fever: above 38°C
Travel History: travelled to an area where H7N9 infection has been suspected or confirmed in the past six months
Occupation: laboratory worker or works with contact of wild birds / poultry
Contact: potential human-to-human case or wild bird / poultry
Clustering: clustering of persons with fever and pneumonia
Make sure that you wear a surgical mask in all patient care areas and observe good hand hygiene and infection control measures.
For the past few months, unfounded rumours about the H7N9 avian influenza virus have been spreading rapidly in Hong Kong via mobile messaging services and social media, creating a lot of bother and concern for Hospital Authority staff. To help combat this scaremongering activity, HA Chief Executive Dr PY Leung has sent an e-mail to all colleagues, asking them not to listen to these rumours and stories from unreliable sources.
HA Head Office’s Corporate Communication Department provided additional information via HA’s internet and mobile communications platforms. Chief Manager (Corporate Communication) Frankie Yip says: “To combat the spread of untrue information, we have formed a WhatsApp group to facilitate communication with medical reporters from major media, particularly the provision of fact-based updates and the quashing of unfounded rumours or speculation.”
When the H7N9 outbreak was first discovered in eastern China, an HA expert working group flew to Shanghai to exchange relevant clinical treatment experience and collect first-hand information. An HA delegation, led by Chairman Anthony Wu, subsequently visited the Department of Health in Guangzhou to discuss infectious disease prevention with health officials and enhance the risk management capacity of both sides.
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 Shanghai |
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