Re: HONG KONG, PRC SAR: RESPONSE AND TRACKING (by Govt Agencies)
Re: HONG KONG, PRC SAR: RESPONSE AND TRACKING (by Govt Agencies)
Hong Kong: SFH on human swine flu (5/8/09)
Following is the transcript of remarks made by the Secretary for Food and Health, Dr York Chow, the Controller of the Centre for Health Protection, Dr Thomas Tsang, the District Commander (Wan Chai) of the Hong Kong Police Force, Mr Blake Hancock, and the Principal Transport Officer of Transport Department, Mr Albert Su, at a press conference today (May 8):
Secretary for Food and Health:
Today there is no new confirmed case. Hong Kong is preparing ourselves for the termination of our quarantine period for the 300 people who are being quarantined until today. They can leave the Metropark Hotel and also the camps at 8.30 tonight. I will invite the Transport Department and the Police to explain the arrangements later on. I believe most Hong Kong people feel that we have won the first battle and are able to control the spread of the infection from the first index patient. But it does not mean that we can be complacent. As an international city with very frequent international travels, it is not surprising that might be encountering subsequent cases in future. So, I hope that everyone in Hong Kong will be able to keep up high vigilance and sensitivity, ensure that you look after your own environment, the hygienic conditions and your personal hygiene, and support and cooperate with the Government in this battle against the potential pandemic. I would like to thank various sectors of the society and our citizens for your support and understanding. You allow us to enforce an appropriate policy in order to ensure that we can contain this unknown virus. As I mentioned two days ago, we shall review the operation and later gathered information from various countries and the World Health Organisation so that we can update our policy for subsequent handling of any index patient. In view of that, we might have to adjust some of our strategies in future. And I promise we shall announce those measures later next week. First, I invite the Controller of the Centre for Health Protection to read out some of the data today, and then subsequently I would invite the District Commander (Wan Chai) Mr Hancock and Mr So from the Transport Department.
District Commander (Wan Chai) of Hong Kong Police Force:
Over the past seven days, Hong Kong Police Force has been working very closely with other government departments to facilitate the operations at the hotel in Wan Chai. Clearly, that causes disruption to the area, Wan Chai, being the very busy part of Hong Kong Island. However, all the departments, including the Police, are working very hard to minimise the disruption around the hotel. Those ground rules apply equally this evening and in close conjunctions with our colleagues and other departments as Transport Department. We will do everything we can to minimise the disruption this evening when roads around the hotel are to be closed. Those closure will only be put in place fully as and when required by the events on the ground.And as soon as the situation outside the hotel starts to clear, we will, with the Transport Department colleagues, attempt to reopen vehicle lane as early as we possibly can and get traffic and pedestrian areas back to normal. Thank you.
Reporter:
When to lower the response level?
Secretary for Food and Health:
What I mean for success is so far, after seven days of confining the index patient, we have not found a case as related to him. I think this is what we term as success for this index patient. It does not mean that it is successful for every subsequent case. But we learn a lot from this case. We also learn a lot from other countries on this particular virus in the last week. So, this gives us more time to understand this virus and this infection. I am sure with this time, we are able to have a new strategy for subsequent handling of this infection in the days to come. As far as the alert level goes, I have mentioned time and again that our emergency level is linked to two elements. One is a reported case in Hong Kong and second is the WHO's warning on the imminent pandemic. As
WHO will be reviewing their level of alert in the next couple of days, so it is not appropriate for us to lower our emergency level at this moment. We will see what is happening and also the world figure seems to be still climbing. So, it is important we should know what the rest of the world is facing and not just what we are facing. It is important to know that this level of alert is important and is also an alert to signify that everyone, including everyone in our community, need to be on alert about this situation and we should not relax yet.
Reporter:
(contact tracing)
Controller of the Centre for Health Protection:
According to our latest record, the number of missing guests in the hotel now stands at two because we found some extra people and also our record checks with the Immigration Department and so on. So, it is not a perfect record. Right now, there are 286 people staying at the hotel, we still haven't found two. It is like 99 per cent, we are still not 100 per cent yet. So, we have done our best and sometimes assess how reality goes but we maintain a very vigilant attitude towards contact tracing. We are doing our very best to trace all the contacts.
Reporter:
Are they local or overseas guests?
Controller of the Centre for Health Protection:
Overseas guests.
Reporter:
(inaudible)
District Commander (Wan Chai) of Hong Kong Police Force:
Actually you have to appreciate that this is a major undertaking for the whole Government. And the operation at the hotel was not through much of the choice. That is what it happens. That is the timing. It is a very busy street corner. It is a very busy hotel. It is a very busy part of Wan Chai. So, when we consider the necessary arrangements for the release operation at 8.30pm tonight, you have to look at all of the associated action that goes along with that. And while we try to facilitate the multiple government departments involved in the operation, clearly, we also have a duty and responsibility to the local residents and traffic passing through. Therefore, a lot of consultations and discussions were made with colleagues from other departments looking at their needs, and especially with professional colleagues in the Transport Department, looking at how this would help and affect on local bus routes and traffic and pedestrian flow. Taking all those factors into account, the closure orders were issued and covered the period we consider was coming up to the peak on the Friday evening in Wan Chai, which is just clearly a busy time of the week. However, as I have said before, we will try to introduce the closure on the rolling bases as and when required. Certainly, as soon as the situation outside the hotel starts to clear, we will begin to reopen lanes as quickly as we possibly can. Thank you!
Reporter:
Is it the Mexican national patient will not be released today? What would you expect once the quarantine ends, all the guests are going to be coming out at once, are they free to go where they want? Are they getting on a bus?
Controller of the Centre for Health Protection:
The most important criteria, of course, is that the index patient should not be infectious. He should not be carrying the virus. And he should have zero chance of infecting other people. So, we will make sure that it is satisfied before we release him. Based on the laboratory tests that have been conducted on this patient for the past few days, we are pretty sure he was free of the virus. Plus the fact that he has been put on the Tamiflu, which would effectively reduce the virus load. And the ultimate decision when to release the patient is up to the attending clinician.
District Commander (Wan Chai) of Hong Kong Police Force:
Once the isolation order expires at 8.30 tonight, all the guests and all the staffs who are under isolation are free to leave the premises. Is there free choice? Is there anywhere they wish to go? And I understand that my colleagues and other government departments have made arrangement to facilitate their onward movement, either to the airport, to local hotels, or other places they wish to go. The police's role in that is to ensure that we can maintain smooth traffic flow in the area, that the operation to move the guests elsewhere, facilitate the press, monitoring of that and the attention to that is maintained that the operation proceeds smoothly, the hotel can get on with it. So, we can get the street and the people back to normal for the residents of Hong Kong.
Reporter:
So if they come down to the press area, are we free to approach them as they come out of the hotel?
District Commander (Wan Chai) of Hong Kong Police Force:
At the moment, because this is a major international event and it is attracting so much attention both locally and overseas. There is excessive press interest. And the interest of facilitating the press at the scene, it has to be some element of control, otherwise, if everybody is running around on the street and the pavement and that clearly is going to cause even more disruption in that corner of Wan Chai. So, what has been done is that together with colleagues in information service, and other involved departments, we have agreed a number of measures, to provide the best possible viewing area and interview area for the press to monitor the process of the people being released. As soon as the situation quiets down and the guests start to go or leave the area. Then, clearly we will review how we are setting up the operation outside the hotel and getting traffic and pedestrian flow back to normal.
Reporter:
Are there buses for them, taxi, what kind of transportation?
District Commander (Wan Chai) of Hong Kong Police Force:
That is not really a matter for police to comment on, but of course I am aware of that there are arrangements tonight for a number of buses to be parked outside the hotel and guests who wish to go to other destinations will be facilitated and of course police will assist with that.
Secretary for Food and Health:
Maybe I can supplement that a little. The principle is to ensure that those people who are leaving for the airport to go first because they might have a flight to catch. So I hope the media would allow at least that group to leave without any difficulty and so on. The second thing is, I have also received the comments from some of the people staying in the hotel, and they may not like to be approached too directly by the media, and I hope that you can also respect their privacy and only request them if they are willing to talk to you, and come up to the microphone area so that they are free to express their experience and so on. But, I hope, at that place, we do not actually think that it is feasible for you to approach them individually because they will be travelling with luggage, and all sort of other articles. If we allow too many people there, there might be difficulty in organising everybody to go to the place at the right time. As far as transports go, we have arranged different destinations for different groups. As you know that we have offered two hotels for them to go to, and most people actually prefer to go to the two hotels while a number of people go to the airport directly, some to the land borders, and some would also like to make their own arrangements as well. And we will respect that.
Reporter:
(inaudible)
District Commander (Wan Chai) of Hong Kong Police Force:
As I have said, there will be regular emphasis put on introducing the closure smoothly in a phase way to meet the need. And likewise, at the other end of the operation, as soon as things at the hotel starts to calm down, we will be clearly aiming at getting traffic to be moving again. That would mean opening one lane to start with, and then gradually, open a second or third lane. Whether we can clear the road immediately really depends on what happens after 8.30 tonight. And at the moment, that is a big question mark. So, we will be closely monitoring. I am the commander on the ground. I have senior traffic officers on the ground with me. And it is not someone who would sit back and wait. We will actually be very actively looking at getting traffic moving again.
Reporter:
(inaudible)
District Commander (Wan Chai) of Hong Kong Police Force:
When it is closer to 8.30 this evening, our manpower would peak because as I have said before, the big unknown is exactly what would happen at 8.30pm, when the staffs and guests come out, whether they want to spend sometime on the side celebrating, or want to go straight on the bus, or talk to the press. Clearly, it is not something I am in the position to answer. So, the majority of the resource is drawn from within Wan Chai district, under my direct command, but we will be assisted by officers from police technical unit, and of course traffic Hong Kong Island, to make sure traffic in the area remains smooth.
Reporter:
(inaudible)
District Commander (Wan Chai) of Hong Kong Police Force:
The buses will be parked in Fenwick Street, immediately outside the hotel because that is the best location to facilitate the guests and staff coming out, getting on board. It also causes the least disruption to the other parts of Wan Chai.One of our aims in working closely with other departments is to minimise the disruption in and around the hotel. Clearly this operation has been on a week and the biggest part now is to clear the hotel, and for everybody to resume their lives. So the buses will be confined within an area in Fenwick Street between Hennessey Road and Lockhart Road. And now the route they take, would depend on their destinations, and as the Secretary has already said, some would go to the airport, some would go to other hotels in Kowloon or Hong Kong, some will go up to the boundary in Huanggang and then clearly, there will be people facilitating them to go elsewhere. That process will clearly, after take place at 8.30, once everybody is on the bus, and that will also be facilitated by the police.
Question:
(inaudible)
District Commander (Wan Chai) of Hong Kong Police Force:
At the moment, the idea is to bring them not on the Hennessy Road. Clearly, this is going to create even more problems if we do that. So, bring them down towards Gloucester Road way, but then the routes vary depending on where they are going and also would depend on the traffic situation on the time.
Reporter:
This is a question of some of the international guests in the hotel asked me to ask you. They wonder why do you decide to quarantine the whole hotel with all these floors and all these separate rooms, but do not decide to quarantine the whole airplane, but just the part of the people in the airplane with shared air-conditioning. What is the difference and what is your conclusion?
Secretary for Food and Health:
I think we made that explanation a few days ago, perhaps Dr Tsang can repeat that, particularly for the Dutch viewers. Controller of the Centre for Health Protection: Yes, I think it is important to address that question. There is a difference here. In airplanes, there is more information from the literature regarding the spread of respiratory infections like tuberculosis, like measles and so on. So it is rather standard practice in terms of contact tracing and here in this case, quarantine, that we identify the passengers a few rows in front and to a few rows behind and then observe them for a defined period, which is seven days. There is another point. It is the airflow conditions in the plane. It is supposed to be very high airflow volume situation. Professor KY Yuen of Hong Kong University mentioned on averages like 20 air changes per minute. And that is a very high degree of air circulation, which place a limit the spread of these diseases. And there is a filter called a HEPA filter in the airplane, which effectively clears all the viruses. In the hotel, the situation is different for a number of reasons. First of all, there is very little literature regarding spread of these infections in the hotel. Secondly, looking back in SARS during 2003, we have one very famous case living in one hotel, and because of environmental contamination, he had the infection and spread to at least a dozen other guests in the hotel. And those guests further spread the disease and causing many clusters locally and internationally. So this time around, we adopt a rather cautious attitude. We do not know how this virus behaves in a hotel setting. So that is why we determine to put the whole hotel and the guests under quarantine and observe them for seven days.
Reporter:
who live 10 or 15 floors higher than the Mexican that have never met him, or a French person that just walked into a room for a couple of minutes, has more chance of being infected with this influenza virus than someone who was sitting four rows in front of him?
Controller of the Centre for Health Protection:
Well, I think that depends on whether there is you know some unknown factors in disease transmission in hotel setting. If you remember the report in the 2003 SARS outbreak, apparently we found some virus remnants on the carpet, you know, on the floor. And that is believed to be one of the major routes where the virus spread. So that has to do with the environment. Another example was of course the famous Amoy Gardens outbreak, in which the sewer was implicated as an environmental vehicle for spreading the disease. So this time we got to be sure that similar factors are not at play in the hotel. So that is why we adopted more prudent attitude. We hope that by gathering more data this time, trying to eliminate some of these factors, and this will guide our future directions whether we are going to do the same next time around.
Reporter:
Mr Secretary, after 8.30 tonight, would you issue arrest warrants for the two missing guests? And what sort of legal action are you going to take?
Secretary for Food and Health:
We will consider legal advice whether that is necessary and also perhaps the public health angle whether it is also necessary. Of course they were given a quarantine order. So in a way they still have a legal responsibility there.
Reporter:
(inaudible)
Controller of the Centre for Health Protection:
I think we do have that information but we need to see whether there is any contravention to privacy issue and so on. We may have to seek legal advice on that.
Reporter:
(inaudible)
Secretary for Food and Health:
I have not actually gone through the list myself, so I can't comment on that.
Reporter:
If missing guests are found in the control points, do they need to be quarantined?
Controller of Centre for Health Protection:
I think that depends on whether they have any illness at the time they are located or identified. If they are completely symptom free, then there is no point to do any quarantine because incubation period has already passed.If they are symptomatic, then they definitely need to undergo a health check to make sure they do not have the infection.
(Please also refer to the Chinese session of the transcript)
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