I am delighted that you and your sons like my song “Beat the Virus”, which I wrote to boost the morale of Hong Kongers in the pandemic. As your mentor, I applaud your wise parenting, spending time with your children amidst your busy schedule as a front line doctor; and I appreciate your sense of humour to laugh along with your colleagues watching the video together.
Indeed, stressful doctors and nurses in the pandemic have to keep mentally healthy and happy, in the face of daily challenges. We need to relax often when we face excessive expectations, demands and frustrations. While no health workers were infected in the first and second waves, many doctors and nurses were infected in the fourth wave. A doctor was even admitted to the ICU. In the third and fourth waves, more than 150 citizens died, as compared to 8 deaths in the first and second waves.
It is really high time for the Government to classify Covid-19 as an “occupational disease” for those who got infected through their work.
It is worrying that despite restrictive social distancing measures since November, the number of daily confirmed cases failed to return to single digits, with many cases of unknown origin.
Hong Kongers must continue to be vigilant in masking, social distancing, staying home, avoiding social gatherings, and washing hands with soap water or disinfecting them with alcohol sanitizers for 20 seconds after touching objects or before touching face, eyes, nose and mouth.
However, I observe that many people don’t wear masks properly, failing to cover the nostrils; many touch their masks frequently and do not sanitize their hands after touching the polluted masks; some pull the masks down to the neck when they drink, eat or smoke, thus contaminating the inside of the masks by the droplets on the exposed neck and when they pull the masks up again, the contaminated inside of the mask would touch the nose and mouth.
I know your husband John is a smoker. As smokers are more vulnerable to Covid-19 infection, he is endangered especially if he, like many others who smoke in the streets, pull their masks down; and the pedestrians around him would also be at risk.
These loopholes could account for the cases with unknown origin.
To end this pandemic nightmare, mass vaccination is now hailed as light at the end of the tunnel; and in many countries, vaccination has already begun. The Hong Kong Medical Association has liaison with medical associations around the world. The President of the Israel Medical Association told me that Israel has already vaccinated 2 million, that is 22% of its 9.3 million population.
Our Government has ordered 7.5 million doses each of the three chosen types of Covid 19 vaccines : Sinovac, Pfizer-BioNTech and AstraZeneca-Oxford; and it is announced that vaccination will begin around the Lunar New Year, in Community centers, Government and private clinics, and elderly homes.
For mass vaccination to succeed, the Government must try its best to educate the public about the need for vaccination; and to fend off misconceptions and false messages, especially the fallacies wrapped in pseudoscience, denouncing the vaccines.
The choice of vaccines , should of course be based on published peer reviewed scientific research data , rather than emotional or political considerations.
For herd immunity to develop, we should vaccinate at least 80% of the population, or over 2/3 of the population within this year, i.e. 5 million of our 7.5 million people, with 2 injections for each person, amounting to 28,000 injections per day.
So this is a daunting task which requires resolute leadership, with seamless inter-departmental cooperation and collaboration of different bureaus. The Government needs well-planned user-friendly logistics. Transparency builds confidence. People need “informed choices”, with pre-vaccination consent, and 15-30 minutes’ rest time after vaccination. Resuscitation equipment should also be available at each vaccination centre, although severe allergic reaction is extremely rare. Israel has only one reported case of anaphylaxis in the 2 million vaccinees, and the person had recovered without complications.
As a doctor, you know vaccines take weeks to develop immunity. As the elderly were more susceptible to Covid-19 infection, all elderly citizens and all staff working in the elderly homes should be vaccinated as early as possible.
Scientific researches have found Vitamin D supplement useful in the prevention and management of Covid-19 infection; and in the reduction of mortality of Covid-19 patients, though there is still ongoing debate, pending randomized controlled trials. As citizens are advised to stay home due to Covid-19 pandemic, many Asians with coloured skin cannot produce sufficient Vitamin D in the winter. Vitamin D is not only vital for our bones but also important for our immune system. 4000 iu of Vitamin D per day has been advised for adults to maintain a serum level of 50 nmol/litre of 25 OH Vit D. Overweight people are suggested to take 1.5 times more the usual dosage.
As the elderly are prone to Vitamin D deficiency, I urge the Government to provide Vitamin D for all elderly over 65 years of age for the potential protective benefit. Daily Vitamin D fortifications could be given to residents in the elderly homes. In fact, mandatory Vitamin D fortification of milk products has already been implemented in Canada and Sweden.
As incentives for the mass vaccination programme, the Government could consider giving out Vitamin D supplement for all Covid-19 vaccinees when they leave the venues, together with educational materials on the vital role of Vitamin D in our immune system, and a vaccination certificate or code, good for job applications, travelling, reopening of restaurants, gyms, theatres and businesses alike.
Vaccination is not 100% protection. We need to continue proper masking, social distancing, hand hygiene, and daily Vitamin D fortification.
Jane, keep up your morale with good mood while working hard with dignity and passion in the frontline, especially during this difficult time when doctors are often misunderstood and unfortunately, even demonized in Hong Kong.
Thank you for encouraging me to stand for the Medical Council election last autumn. With your support I was elected again. The Medical Council, made up of both doctors and non-medical members representing the benefits of patients, plays the important role of upholding the standard of Hong Kong’s doctors, safeguarding the health of all citizens and serving the interests of all people in Hong Kong.
In closing, I pray that God will bless your family and all Hong Kongers with good physical, mental and spiritual health in the New Year!
Yours sincerely, Uncle Alvin
With the World Health Organization declaring COVID-19 a “pandemic”, the impact of the new coronavirus on the entire world has entered a new phase. Medical experts in Hong Kong have also warned that, with outbreaks taking place around the world, the epidemic in Hong Kong is most likely to be endless due to new cases being imported into our city. Based on our SARS experience in 2003, we estimated that the epidemic could come to an end in the hot weather of summer. This estimate will have to be re-evaluated. If the epidemic is unfortunately no longer a short-term and localized threat, but a medium-to-long-term and global one, its impact on public health, economy, politics, education and other aspects might become formidable.
Impact on Economy
At a meeting between democratic Legislative Councillors and the Chief Secretary for Administration CHEUNG Kin-chung on 12 March, I clearly conveyed this message: The first round of Government's anti-epidemic fund has fallen behind the situation. Many businesses have not been covered and the impact of the epidemic on the economy and people’s livelihood is very likely to continue and become more serious. It is necessary that the Government launch a second round of anti-epidemic fund and assist businesses not covered in the first round such as tuition institutes, education centers, part-time tutors and coaches who provide extra-curricular training for schools. There is also a need to enhance support for the unemployed and the semi-unemployed, and to strengthen the loans available to the SMEs to tide them over their difficulties. Compared with other economies, Hong Kong has a substantial reserve. Now is exactly the time to deploy a small portion of it. Hong Kong must also carefully monitor the impact of the epidemic on the global economic structure and the changes the epidemic will bring about in the short, medium and long terms. As an open and dynamic economy, we have to swiftly respond and adapt to the changes in the environment.
The impact of the epidemic on the education sector goes far beyond public expenditure. Classes have been suspended for more than two months, and there is no certainty when classes can be resumed. While the slogan “No class but learning goes on” via distance learning alleviates the cost of class suspension, its effectiveness has been extremely uneven. It can be regarded, at best, as an inevitable remedial measure. Distance teaching has exposed the disparity between the rich and the poor and the gravity of the “digital divide” in our community. Students of some of our families in the middle and lower social strata are not able to participate in distance learning because they simply do not have computers at home, or they cannot afford access to the Internet, or the speed of the Internet available to them is too slow. The digital highway, the very structure for online teaching, simply cannot reach some of our grass-roots children, resulting in the dire consequence of “No class, No learning”. We do not know whether similar lengthy class suspensions will occur in the future but what we do know is that bridging the “digital divide” is definitely an issue which compels priority.
Essential considerations for class resumption
When to resume classes is a topical issue in the community. From the viewpoint of education, we naturally hope to see, soonest possible, classes being resumed and school life returning to normal. We must, however, be cautious about public health, particularly that of teachers and students. As it now stands, there are two major considerations before we could have class resumption: (a) The epidemic must have come under control. For example, there are no confirmed cases with unknown history in 28 consecutive days; and (b) Schools must have sufficient anti-epidemic materials, the most outstanding problem of which is the availability of face masks, bearing in mind that comprehensive class resumption entails the consumption of one million face masks every single day, which is no small number and that face masks have to be of different sizes to cater for the different needs of adolescents and small kids. Does the Government have confidence in solving this problem?
Other issues with which people are concerned include arrangements for HKDSE examinations; the returning of Hong Kong students from Hubei, Europe and the US; and the economic pressure faced by private post-secondary institutions, schools and kindergartens. The challenges faced by the education sector posed by the epidemic are many and varied. What has been mentioned above constitutes only the tip of the iceberg. I hope that the Government and all sectors can work together to overcome each and every one of the problems.