The Hong Kong Sar. Zone is also the best place to study Opmi Kerong.
Written by | Yan Xiaoliu
Source | "Medical Community" public account
The fifth wave of the outbreak in Hong Kong, China, has recently occurred.
On January 27, 164 new cases were confirmed in the Hong Kong Sar.
Xu Shuchang, expert advisor of the Steering Committee on The Fight Against Covid-19 and Chair Professor of Respiratory Science at the University of Chinese in Hong Kong, believes that the epidemic is severe. The HKSAR currently has at least 90 chains of transmission, most of which have gone undetected.
For this round of the epidemic, Hong Kong's Wen Wei Po previously reported that the hardest hit areas were concentrated in Kwai Chung Estate, New Territories. "Of the 16 buildings in the whole estate, 12 have become epidemic buildings."
According to a statement by Carrie Lam, chief executive of the Hong Kong Special Administrative Region, the strain of the virus in the chain of transmission in Kwai Chung Estate has been confirmed to be Omicron subtype BA.2. "The outbreak happened very quickly, and in just two or three days, the number of infections increased and there was a geometric outbreak."
Ba.2 has been reported in 40 countries and territories worldwide. The UK Health Security Agency (UKHSA) lists it as a "variant under surveillance", saying there is research support that it is more contagious than the original Strain BA.1 of Omi kerong.
At the same time, the variant delta strain Delta and the original strain BA.1 of TheOmexjon are also popular in the Hong Kong SAR.
At the end of December last year, BA.1 entered the community and spread rapidly. This has led the HKSAR government to reduce its epidemic prevention measures from 7 January 2022, including banning dine-in and closing bars.
In addition, the Causeway Bay pet shop infection group that allowed the SAR government to declare "culling 2,000 hamsters" stemmed from Delta transmission. A female employee of the pet shop is suspected to be the world's first confirmed case of covid-19 infected by hamsters.
"The scientific community has gathered astonishing information about mutant strains. But the key question remains, how strong are the spread of BA.1 and BA.2? Is BA.2 more spreadable than BA.1, Delta, etc.? U.S. medical news website STAT said.
STAT writes that perhaps the best place to answer this question is in the Hong Kong Special Administrative Region. "In many parts of the world, a large proportion of people are either vaccinated or previously infected, or both. It is difficult to figure out locally which factors have a greater impact on the spread of the virus, the mutation of the virus and the immunity of the human body. But Hong Kong is an exception. ”
Photo caption: Epidemic prevention personnel are carrying out environmental disinfection in pet stores involved in the epidemic. /EPA
Vaccination rates in high-risk groups are significantly inadequate
The HKSAR adheres to the "zero clearance" strategy: 21 days of quarantine for importers from outside the Chinese mainland; active screening for the new crown virus; and rapid tracking and isolation of close contacts when confirmed cases occur.
To a large extent, these measures have effectively prevented the spread of the new crown virus, resulting in a very low infection rate in the whole society. As of 00:00 on 28 January, the HKSAR had reported a cumulative total of 13,905 confirmed cases, accounting for about 0.19% of its total population.
But vaccinations in the HONG KONG SAR are less than ideal.
Data from the SAR Government show that as of 12:00 on January 29, the vaccination rate of the elderly is still very low. 48.71% of those aged 70-79 completed two doses of vaccination. Among people aged 80 years and older, the two-dose vaccination rate was 20.65%, and only 8458 people over 80 years of age had received intensive injections, accounting for 2.1%.
Among the elderly, the elderly who are admitted to nursing homes are "high risk of high risk".
Nursing homes in various countries have repeatedly exploded cluster infections in past epidemics, and the damage has been serious. The New York Times reported in May 2020 that at that time, 1/3 of COVID-19 deaths in the United States came from elderly care facilities. Industry body Care England estimates that as of April 2020, the number of deaths from nursing homes in the UK may be nearly 1,000.
At present, the vaccination rate in nursing homes in the Hong Kong Special Administrative Region continues to decline. Leung Cheuk-wai, dean of the University of Hong Kong School of Medicine, told STAT: "From our current research, it is only 16%. ”
Part of the reason is the "vaccination hesitation" that appeared in the early days of vaccine promotion.
In February 2021, the Hong Kong SAR officially launched the COVID-19 vaccine. Since then, the media has reported a number of adverse events after vaccination, including the appearance of Bell's palsy (facial paralysis). This has aroused widespread concern among the public.
"In countries and regions with high rates of COVID-19 transmission, the benefits of vaccination outweigh the risks, and people tend to be vaccinated. But in Hong Kong, the risk of infection has been low. Some clinicians will advise their elderly patients not to be vaccinated. Liang Zhuowei believes that this sets the wrong tone. Over time, this "inoculation hesitation" solidifies.
Photo caption: Epidemic prevention personnel guide the public to complete the test under the Yingkui building of the epidemic-related residential building. /newswav
Multiple variant strains spread simultaneously
"Nursing homes may be the 'perfect laboratory' to find the unsolved mystery of the virus." Liang Zhuowei said that 84% of the elderly who stayed in the house had not been vaccinated and had no history of natural infection. If the virus breaks through the physical barrier of epidemic prevention, they will be extremely susceptible to infection. And because the immunity is zero, there is no interference problem such as "immune evasion".
In this way, the scientific community may be able to answer a few questions.
For example, the scientific community has previously proposed that the spread of BA.2 may be 30%-35% higher than BA.1. So, is this because the way the virus infects people has changed? Or is it because BA.2 gets more "escape techniques" and can bypass human immunity?
Another special feature of the HKSAR is that it is one of the few regions in the world where Delta, BA.1 and BA.2 are popular at the same time.
These strains have a high transmissibility and are very susceptible to infection and transmission in people without immune protection. "We can see a series of data in the real world, answering questions about whether one strain is more contagious and lethal than another." Natalie Dean, a biostatistician at Emory University's Rollins School of Public Health, said.
Natalie Dean added that the HKSAR's strength also lies in its excellent data collection and analysis capabilities.
But Leung stressed that he did not want this to happen. "I'd rather not have this first."
Photo caption: Epidemic prevention personnel sealed off epidemic-related residential buildings in Kwai Chung Estate and sent at-risk infected people to quarantine points. /Getty Images
The time has not come
At present, many countries and regions around the world have chosen to "coexist with the virus".
Singapore, which has repeatedly tried to establish a "travel bubble" with the HKSAR, announced in October 2021 that its epidemic prevention strategy has changed from zero to "coexistence with the virus".
Singapore Prime Minister Lee Hsien Loong said that the country's COVID-19 vaccination rate is increasing, and covid-19 is no longer a dangerous disease for most people. As of 25 January, 88% of Singapore's total population had completed two doses of vaccination.
In the Hong Kong Special Administrative Region, there are also people who advocate "coexistence with the virus".
Siddharth Sridhar, a clinical assistant professor in the Department of Microbiology at the University of Hong Kong School of Medicine, said in a social media facebook post that the elderly are severely under-vaccinated, which means that a significant vulnerable group in the population is completely unprotected against the new crown virus.
Once the controls are loosened, the rapid rise in deaths caused by the rapid spread of Omikeron will lead to the crowding out of medical resources. Deaths from other diseases may also rise. "If there is a major outbreak, there is no doubt that the health care system will collapse." Xue Da said.
"The risk of hospitalization, severe illness and death in the unvaccinated population remains high, much higher than that of influenza." Chen Xi, an associate professor of global health policy and economics at Yale University, told the BBC.
He argues that the condition for coexistence with the virus is for the entire population to reach high levels of immunity, whether through vaccination or natural infection. "The basic threshold for herd immunity levels is influenced by the ability of the virus to spread. When Omikejong becomes the dominant epidemic strain, herd immunity may require antibodies in at least 90% of the population. ”
Liang Zhuowei believes that vaccination should be insisted on.
bibliography:
[1] Why Hong Kong may become a living laboratory in search for Covid-19 answers. STAT
An overview of COVID-19 vaccination data in Hong Kong. The Government of the Hong Kong Special Administrative Region
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