Furious expat's plight raises issue on re-positive cases

A returning expat is furious over health authorities' decision to extend his isolation order after testing positive for what he believes to be residual virus from his infection in Singapore last month.

British-American Jonathan's dilemma raised the issue on how authorities draw the line between new infections and re-positive cases.

The Centre for Health Protection's officials have said people are unlikely to contract Covid more than once in three months, yet Jonathan is still being ordered to isolate longer than the usual seven-day period in a hotel even after he provided evidence of his recovery in Singapore early last month.

"Because my day-five PCR test was indeterminate on first examination, and the next day, after a detailed [I assume] laboratory analysis, they found Covid. As they should, as I recovered from Covid five weeks ago in Singapore. Could it have been contaminated? Who knows," Jonathan told The Standard.

After arriving on April 12 from Singapore, Jonathan tested positive on April 16 and was required to extend his isolation period until tomorrow in a facility for mild patients at Regala Skycity Hotel.

Although he does not have to pay extra for the extended stay, Jonathan demanded he be freed immediately, having already completed the initial seven-day period following his arrival.

He said authorities never showed him a report of his positive test result or arranged for him to undergo another PCR test, describing his experience as an example of "failed policies and lack of transparency."

He added: "How much Covid did they find? You can't catch it twice in five weeks so must be mere traces, right? Who knows!? What is the threshold? What level of the pathogen was identified which has resulted in my seven-day incarceration being extended by a further week?"

He said he has tested negative in 13 rapid tests since his arrival, adding that the authorities' decision to further extend his isolation period is "arrogant, ignorant, unscientific and unreasonable."

Jonathan, who has lived in Hong Kong for over eight years, said he is "very, very frustrated" and the incident is "the final nail in the coffin" after many of his friends have left the city.

He added that other friends who were planning to come to Hong Kong have now canceled their plans after hearing about his experience.

"Every person returning to Hong Kong, especially recovered patients, should be aware that the seven-day quarantine is not just seven days."

Jonathan said he wants to leave Regala Skycity, but hotel staff said they will call police if he does so.

In a reply to The Standard, the Food and Health Bureau sidestepped questions on arrangements for recovered patients, saying arrivals who test positive are treated the same as local patients.

Government expert Yuen Kwok-yung said the Department of Health should conduct more PCR tests, as well as an antibody tests, to figure out whether a case with a low viral count is a new or re-positive infection.

But respiratory expert Leung Chi-chiu said it would still be difficult to tell the difference even after several PCR tests.

"In the early stage of new infections, the viral count could be very low, which is the same as re-positive cases," Leung said.

"Health authorities need to observe the case for a while and also find out the genetic sequencing of the virus.

"[It could be a re-positive case] if the genetic sequencing is different from the viruses currently spreading in the country where the arrival came from."

However, the genetic analysis would take some time and cannot be conducted sometimes if the case has a low viral count, he said.

Although health authorities have said it is unlikely for people to get infected twice within three months, Leung said it is only generally true in Hong Kong's case because the city has been dealing with only one or two variants. But it is not the same in other countries.

"We are aware of whether there are new variants in Hong Kong but we do not have the information from the rest of the world. So we cannot exclude the possibility that overseas arrivals who have recovered from Covid might have contracted some new variants recently," Leung said.

wallis.wang@singtaonewscorp.com