Test scramble over first hospital cluster

Jane Cheung

All patients and medics at United Christian Hospital's intensive care unit and palliative care ward and those who made visits there have been issued with mandatory test notices after a super spreader sparked Hong Kong's first Covid-19 medics cluster of 12 patients and seven staff.

A mobile specimen collection station will be set up at a sports ground next to the public hospital in Kowloon Tong from today to Thursday, with all its 6,000 staff encouraged to take the test. More than 60 workers in the palliative ward have been sent to quarantine.

Hong Kong yesterday recorded 70 new cases, including one imported. Among the 69 local cases, 23 were from unknown sources.

Hospital Authority chief manager for quality and standards Lau Ka-hin said the 12 infected patients have stayed in palliative care ward 2D, including an 84-year-old woman believed to have triggered the cluster.

The 12 - ages 20 to 92 - were from three neighboring cubicles and the corridor connecting the cubicles. The seven infected staff - a phlebotomist, four nurses and two operational assistants - have all cared for the 84-year-old woman, including feeding and cleaning her. A 71-year-old woman is in critical condition and 18 others are stable from the cluster.

Since the 84-year-old woman had stayed in the ICU from December 15 to 18, the mandatory test order covers all patients and staff at the ICU and the palliative care ward, as well as visitors from December 15 to yesterday.

Despite a ban on hospital visits, discretionary visits have been allowed to those who are terminally ill or have special needs and pediatric patients.

Government adviser Yuen Kwok-yung believes air transmission could be at play for the cluster and suggested stepping up with screening hospital patients, particularly those with persistent pneumonia and flu symptoms.

Yuen, of the University of Hong Kong, believes the 84-year-old woman had contracted the virus before she was admitted on December 15, despite a negative test on admission. She was found to be infected on a second test after her pneumonia persisted for more than a week.

He said the virus could have spread within the palliative care ward by air transmission, which would explain why two patients staying on the aisles outside the 84-year-old's cubicle were also infected.

He proposed mandatory tests for all those who visited the ward, but added it would not be necessary to test all the hospital's patients.

Lau said medics have been vigilant in monitoring patients' conditions.

"When we find their symptoms very suspicious, we'll test them again, even for a third or fourth time," he said, adding air filters have been installed in the palliative ward.

Among yesterday's cases, the Centre for Health Protection's head of communicable disease branch, Chuang Shuk-kwan, said the imported one was an 18-year-old student who arrived from Britain on December 7.

He completed the 14-day hotel quarantine on December 20 and had a get-together with family members last Tuesday. However, his third test on the 19th day of his arrival came back positive, with a low viral load.

"We will see if his family members from the gathering are also infected," Chuang said. "We will also conduct genetic sequencing on his virus to see if it's imported or local."

She said there was also a rise in infections relating to family gatherings during the Christmas break.

Yuen warned the drop in the number of daily cases could slow down - or the figure may even rise - as crowds flood outdoors this holiday season.

He said around 3 percent of samples collected from high-risk groups did not contain human DNA, speculating that they "submitted tap water" instead of deep-throat saliva.

"Many of them have high-risk occupations, like taxi drivers and restaurant and care-home workers. They worry they could lose their jobs if they were infected. That could be the reason they cheated," he said.

Chuang warned the submission of fake samples violates the law.

Hong Kong's infection tally stands at 8,611 including 137 deaths. There are more than 50 preliminary positive patients pending confirmation.

jane.cheung@singtaonewscorp.com