TR EMERITUS

The Government could have done better by holding a meeting with supermarket operators before they announced the raising of the Disease Outbreak Response System Condition (Dorscon) to orange (No risk of shortage of essential food, household items, Feb 8). This would have allowed all parties concerned to prepare in advance and to limit the purchase of essentials, which was eventually done. Not only were there long queues at supermarkets, but many impatient shoppers also abandoned their trolleys and baskets full of perishable food near checkout stations and walked away because of the long wait, further aggravating the chaotic situation. The staff didn't know if the shoppers would return so they left the filled trolleys and baskets there, leaving the perishables to possible rot and wastage. It is important that the Government work with supermarket operators to prevent panic buying in future. Such panic buying and hoarding will deprive shoppers in genuine need of supplies a chance to buy what they need. In the end, it would be the poorer households and the vulnerable in the community who would be more exposed to any resulting shortages. If supply cannot keep up with the panic buying, there could be a jacking up of prices, which will hit the poor hardest.   CF Cheng      Read More →

Source: 中国疾病预防控制中心-CDC (Click to enlarge) Hundreds of medical workers in China have been infected by the Covid-19 and at least 6 have died, according to health authorities and medical sources. Most of the infected medical workers had contracted the virus through "cross infection", which Zhang Ke, a doctor at Beijing’s Youan hospital, who specialises in communicable diseases, said were a serious concern, particularly as many hospital wards were not designed to handle communicable diseases. Even in designated hospitals, receiving and treating patients was quite chaotic in Wuhan. Fever patients rushed to hospital and they hospitals became an incubator for the virus because their design is less scientific than that of the communicable disease hospitals. And the number of infected is expected to rise to about 20%, Dr Zhang opined. During the Sars outbreak in 2003, 18 per cent of mainland medical staff and 22 per cent of Hong Kong medical staff were infected. I estimate we will see 10-20 per cent of medical staff infected. In Wuhan alone, the epicentre of the Covid-19 outbreak, at least 500 medical workers have been infected with the deadly virus since mid-January, with at least another 600 suspected cases, according to multiple medical sources and a slide (shown above) that has been circulating online. A source from a major hospital in Wuhan with knowledge of the situation confirmed that the slide was authentic. The figures shown on the slide were also in line with the figures given by 2 other doctors from major hospitals in Wuhan. The figures are expected to be higher as the slide only reflects hospitals with 15 or more infected. Those infected includes at least 100 staff from both Wuhan Xiehe Hospital and Renmin Hospital of Wuhan University, with a further 50 cases each from Wuhan Number 1 Hospital and Zhongnan Hospital. Yu Changping, a respiratory specialist with the Renmin Hospital of Wuhan University, developed a fever on January 14 and was later confirmed to have contracted the virus. Dr Yu said he was not sure when he became infected since he treated many patients every day and the chance of getting infected was high. The virus is too contagious. We did not have enough understanding about the virus. He was admitted to hospital on January 17 with another colleague from the same department and is still undergoing treatment. Dr Mei Zhongming, Deputy director of the late Dr Li Wenliang's department, whose case triggered national storm of outrage about initial attempts to cover up the outbreak, is also reportedly infected. Ian Lipkin, John Snow professor of epidemiology at the Mailman School of Public Health at Columbia University, said the risks faced by health care workers were high even with protective gear. The reason for this is that physicians and health care workers have a very intimate relationship with their patients, and even with personal protective equipment, sometimes we use it late, sometimes we get exposed inadvertently, and the efforts we make to support them with fluids and such place us at extremely high risk. In addition, those individuals who are working in hospital settings may be immunosuppressed because frankly they’re exhausted … the viral load that they receive may be larger. The professor had visited China at the invitation of the government. The Chinese authorities have since mobilised around 20,000 additional medical workers to treat patients in Wuhan and its neighbouring cities, and more protective gear has been sent to major hospitals in the Hubei province. But frontline doctors warned that medical workers in other cities, especially those with less attention and supplies, faced a higher infection risk. Infections among health care workers are now less serious than in January... The biggest concern is protective gear, but as long as there is gear, it is unlikely we will get infected. The situation may be worse in other cities in Hubei province, one of the Wuhan doctors said, many medical workers in the neighbouring city of Ezhou had been infected. To the South of Hubei province, on the island province of Hainan, the local health commission said a doctor and nurse had become infected after being exposed to a patient for 6 minutes even though they were wearing surgical masks. At Beijing's Fuxing hospital, 6 medical staff, 5 patients and 4 caretakers were infected by a single patient. The hospital’s president Li Dongxia had reportedly been sacked as a result. Apart from hampering the capacity of hospitals to contain the outbreak and treat patients, medical specialists said the rate of infections among frontline medical workers was an important indicator of how easily the Covid-19, which has killed more than 1,017 people, could be transmitted and the risks of contracting the virus in hospital. A doctor from a major hospital in Wuhan, who requested anonymity, said the development had hit morale, adding that many medical workers were "devastated" when they saw the CAT scans of colleagues who had been infected. That is why we have been crying out for more donations of medical supplies, especially hazmat suits... We have seen too many colleagues falling ill because of insufficient protection. Doctors and medical experts have said that a shortage of protective gear, prolong working hours as well as lack of awareness about how contagious the virus was, had been major factors in the large number of infections among medical workers. However, the shortage situation is expected to improve with the resumption in production of major factories in China as the extended Lunar New Year holiday for workers outside Hubei province comes to an end. Meanwhile, the provincial government of Hubei have tentatively extended the lock-down status for all cities in the province to Sunday (16 Feb). What is a cross infection? A cross infection is the transfer of harmful microorganisms, usually bacteria and viruses. The spread of infections can occur between people, pieces of equipment, or within the body.      Read More →

Diamond Princess at port of Yokohama, Japan Two citizens evacuated from Wuhan, the epicentre of a Covid-19 outbreak have been diagnosed with the infection after initially testing negative, Japan's health ministry said on Tuesday (11 Feb). The 2 were evacuated from Wuhan on January 29 and January 30 respectively via government chartered flights, with both tested negative for the Covid-19 upon landing in Japan. Of the 2 evacuees, the man who returned on January 29 had tested negative twice while he was isolated in a hotel room. However, a subsequent third test 12 days later found the man, who is in his 50s, infected with the deadly virus. The other man, in his 40s, was confirmed infected on this second test on Monday (10 Feb). Medical experts have concluded that the Covid-19 could remain dormant for up to 24 days and hard to detect. The 2 cases appear to support their conclusions, with both turning symptomatic within 2 weeks. With the new infections, Japan's total tally of people infected with the Covid-19 has risen to 28 (excluding the figures from cruise ship Diamond Princess which is classified by WHO as "International conveyance"). Singapore is currently on the top of the lists for the most number of Covid-19 infections in a country outside of China, at 47. Japan currently shares third placing with Korea, after second-placed Thailand with 33. * Hong Kong, Macau and Taiwan are strictly not countries and therefore not considered on the list when calculating placing for countries outside of China. Diamond Princess The cruise ship carrying 3,711 people is currently quarantined off the port of Yokohama, with 174 confirmed infections while more cases are expected to surface as some passengers have reportedly developed fever. Of the 174 infected, 4 are currently in critical condition. Diamond Princess arrived off the coast of Japan on the evening of February 3, and was officially placed into quarantine 2 days later after an 80-year-old passenger that had earlier sailed on the ship disembarked in Hong Kong and developed symptoms 6 days later. Health authorities in Japan are considering testing all the remaining passengers on board the cruise ship after the quarantine ends on February 19. Only those who tested negative will be allowed to leave. Meanwhile, Japan is planning to send a fifth evacuation flight to Wuhan later this week.      Read More →