An Open Letter from an Ordinary Hong Kong Doctor to Secretary for Food & Health
Translated by Guardians of Hong Kong / Be Water - Hong KongThe following is an open letter published on Stand News on August 27, 2020. The article raises several questions over the universal COVID-19 testing scheme organized by the Hong Kong SAR Government, with test results run by Chinese companies.
"In a bid to thrust forward a universal COVID-19 testing scheme, the HKSAR government exhausted almost all possible means to repudiate oppositional opinions.
Sophia Chan Siu-chee, Secretary for Food and Health in Hong Kong, attacked medical professionals who found the testing scheme unnecessary and those who advised citizens to refrain from taking the test. Chan dismissed these opinions as "conspiracies" that obliterated the aim of the scheme in blocking the transmission chain.
In my capacity as a doctor, I would like to raise some urgent scientific inquiries about the scheme.
1. For citizens who have taken the test, should they undergo self-quarantine while awaiting the result?
Since the scheme aims to identify the transmission chain, it means any citizen could be an invisible carrier.
While the test result takes days to be ready, if these potential carriers move freely as before, wouldn't they be like a time bomb by incessantly spreading coronavirus in the community?
Therefore, rolling out a universal testing scheme is useless without necessary back-up measures (e.g. home-quarantine for certain groups or at certain location). That is to say, as long as an invisible carrier continues their daily routine after the test and before the test result, this would not stop them from infecting the people they contact.
What's worse, those who have tested negative at the first instance could lower their vigilance. As they consider themselves “perfectly healthy”, there is a high chance they might not be aware of potential onset and would easily delay medical attention.
In sum, this group of citizens is highly likely to spread the coronavirus during the initial incubation period of the viral attack.
2. According to studies by the University of Hong Kong, recurrent infection is possible with COVID-19. Antibodies developed after the initial infection were found unable to prevent a reinfection.
I wonder, in what ways, has this case inspired the Secretary for Food and Health? As the coronavirus might mutate, when should one go for a second test despite the first negative result?
It not only takes a substantial amount of the public expenses to conduct universal testing; considering the mutation speed of the coronavirus and the chance of recurrent infection, how many rounds of tests can our government sensibly fund?
It takes several weeks to complete a round of universal test that covers a reasonable portion of the population. What if there is a viral mutation within these few weeks? After all, how effective is this universal testing scheme?
3. Whereas the coronavirus pandemic is not under control across the globe, the Hong Kong government allows quarantee exemptions in their relaxed border control. Isn’t this contrary to the intention of the universal testing scheme?
It only takes a few asymptomatic patients to enter Hong Kong, then the outcome of the universal testing would be dispelled. Will the HKSAR government enforce a lockdown for 14 days or more to facilitate the current testing scheme?
4. There are always certain errors in viral tests. In event of "false negative", patients, who were mistaken as healthy, would easily delay medical assistance despite the onset of symptoms. Worse still, they pose health risks to the people they meet.
In event of "false positive", are there sufficient isolation wards to accomodate these patients for 'treatment'? If a false positive patient shares a ward with a confirmed coronavirus patient, it will certainly increase the infection chance of the false positive patient.
Treating false positive patients in isolation wards is, therefore, the only way to prevent such exposure, until further diagnosis is carried out to validate whether it is a false positive case or the viral level is just too low to be detected.
This validation diagnosis, however, could not be completed in one or two days.
Even I am not a specialist in coronavirus like Prof. Yuen Kwok-yung, I am concerned with these public health questions. If Prof. Sophia Chan could not address these questions, how can she convince the population in Hong Kong to undertake the COVID19 test, which is rolled out as a voluntary program? "
Source: Stand News #Aug27
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