Hong Kong could be on the verge of the deadly coronavirus spreading widely in the community, health authorities warned on Tuesday, with three new locally transmitted cases confirmed just hours after a 39-year-old patient became the city’s first fatality.
The prognosis came as public hospitals were under strain, with the Hospital Authority reporting that 5,000 workers walked off their jobs on the second day of a strike intended to force the city’s leader to completely shut down the border with mainland China. The strikers hope that such a move would curb the threat of more infections.
Appealing to them to return to work as the lives of newborn babies and cancer patients were being put at risk by their industrial action, public hospital bosses said they would turn to the private sector for help. Meanwhile, the union behind the move demanded a meeting with Chief Executive Carrie Lam Cheng Yuet-ngor on Wednesday morning, saying they would escalate their actions if she refused.
Lam courted her own controversy on Tuesday when she asked officials not to wear surgical masks, except in strict circumstances, prompting criticism that her edict was not based on science and could provoke further panic.
As the city marked its first full day of drastically restricted cross-border travel on Tuesday, the number of patients in mainland China continued to rise, with the tally of confirmed cases surpassing 20,000, and deaths at 490.
In Hong Kong, the Centre for Health Protection said the three newly diagnosed patients – taking the number of confirmed cases in the city to 18 – had not travelled to mainland China in the 14 days before falling ill.
Dr Chuang Shuk-kwan, head of the centre’s communicable disease branch, said in a press conference on Tuesday that so far four confirmed cases presented “no obvious source of infection”, and warned of the possibility of outbreaks in the community.
“It is highly probable the four were infected locally, so there could be invisible chains of infection happening within communities,” Chuang said. “We are not ruling out a large spread [of the virus] in the future.”
The detection of three new cases on Tuesday further indicated a significant risk of the virus being transmitted in the area, she added.
Late at night, a 25-year-old man became the youngest local patient to be confirmed as infected, having first visited Baptist Hospital in Kowloon Tong before going to Prince of Wales Hospital in Sha Tin. Shadows were found on his lung scan and he also tested positive for influenza A.
A 64-year-old woman was admitted to Queen Elizabeth Hospital in Yau Ma Tei on February 1, before being transferred to Princess Margaret Hospital in a critical condition. She had first displayed symptoms on January 23.
Dr Lau Ka-hin, the Hospital Authority’s chief manager of quality and standards, said the woman had a lung infection and required breathing support.
Seven health care staff at Queen Elizabeth were put in quarantine after coming into contact with the patient. Five had undergone tests for the virus, with two turning out negative while results of the other three were pending. The remaining two would also be tested.
A retired man, 60, had visited four private doctors before he went to United Christian Hospital and then Tseung Kwan O Hospital on January 31 where he later tested positive for the virus.
Local transmission of the coronavirus, which originated in the mainland Chinese city of Wuhan, has also occurred in countries such as Thailand, Vietnam and Singapore.
Chuang reinforced the need for personal hygiene and called on residents to wash their hands frequently, as some reports had shown the virus could linger in the environment – such as on door handles – for a few days.
Earlier on Tuesday morning, a man with underlying health issues being treated for the virus at Princess Margaret Hospital died after suffering sudden heart failure, according to medical sources.
The Whampoa Garden resident was previously identified as Hong Kong’s 13th confirmed case and his death was the second reported fatality outside mainland China to be linked with the outbreak.
Lau said the case would be referred to the Coroner’s Court to determine the cause of death.
“He deteriorated quite rapidly and doctors felt his cause of death could not be explained, even though he had the coronavirus-related pneumonia,” Lau said.
The man had a record of diabetes and had been stable since his admission to hospital before suddenly deteriorating at around 6am on Tuesday, when he had difficulty breathing and his heart stopped, Lau said.
He was certified dead at around 10am after resuscitation efforts failed.
But on a day when the government’s drastic border closures first took effect, as four more entry points to the city were shut down at midnight on Monday, the city’s leader sparked an outcry when she suggested officials and civil servants should not wear surgical masks as health care workers were the priority, according to internal guidelines issued to all departments.
Lam, who appeared without a mask before the media, said that only those who felt unwell, worked in frontline services or attended crowded places should wear a mask.
“If they do not match these criteria, they are not allowed to wear masks,” Lam said.
“They have to take them off even if they are already wearing [them].”
Social media users quickly criticised her for flip-flopping as she was photographed wearing a mask previously and was also spotted wearing a mask earlier in the morning when receiving petitions outside her office, just before she met reporters.
The Chief Executive’s Office later added the guidelines issued did not apply to civil servants who brought their own masks and was merely intended to preserve government supplies.
“The government has not told people not to wear masks,” it said.
Dr Joseph Tsang Kay-yan, a specialist in infectious diseases, said there was little scientific reason behind Lam’s approach, with the virus already in the city.
“We already have cases in the community and it is possible there are already some hidden carriers of the virus,” he said. “You don’t have a way to identify whether people you came in contact with carried the virus or not.”
Both pro-establishment and opposition politicians attacked Lam, with the Democratic Alliance for the Betterment and Progress of Hong Kong lawmaker Holden Chow Ho-ding warning she risked sparking “fear and panic that there are no masks left on the market” and may prompt further buying.
Democratic Party’s lawmaker Helena Wong Pik-wan accused Lam of neglecting the safety of civil servants.
As concerns over the spread of the virus mounted and queues for masks were spotted in various parts of the city, another institution of Hong Kong life announced drastic moves for public safety: the Jockey Club announced the immediate closure of all 101 off-course betting branches until further notice.
All telephone betting services will be suspended on Thursday. The club said customers could still make use of their app or 1886 telebet automated services for betting, adding that it was considering how to minimise entry for the coming horse races and would make a further announcement soon.
The Department of Health also announced on their website that 24 Hong Kong families returning from Hubei province would need to wear electronic tracking wristbands at home as self quarantine measure.
According to the list, the families live in various districts in the city, and in private and public housing. There were four cases in Sai Kung and three cases each in Sha Tin, Yuen Long and Tuen Mun districts. The list also included the finishing dates ranging from Tuesday to next Thursday.
The government reassured the public on Monday that the cases were low risk.
Hong Kong’s neighbour of Macau on Tuesday also continued its efforts to combat the virus. Leader Ho Iat-seng declared on Tuesday that casinos in the gambling hub would be closed for 15 days after a hotel worker was infected locally.
The city also confirmed two more cases, bringing its total to 10.
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