Covid-19 claimed the lives of two patients in one day for the first time, as Hong Kong confirmed 19 new coronavirus cases and the government’s sweeping social-distancing measures including mandatory mask wearing on public transport took effect.

The city’s 10th fatality was an 89-year-old man with chronic illnesses who had been admitted to United Christian Hospital with pneumonia on Saturday but his condition worsened and he died on Wednesday night, a hospital spokesman said.

The Ngau Chi Wan resident was married to a 73-year-old woman who was also infected.

In the afternoon, a 90-year-old woman who had been admitted to Pamela Youde Nethersole Eastern Hospital last Thursday died. She also had chronic illnesses including heart disease and diabetes, according to the authorities.

She was a resident of Kong Tai Care for the Aged Centre Limited in Tsz Wan Shan, where there have been clusters of infections.

She was also the second fatality from the care facility after a 95-year-old woman suffering from Covid-19 died on Monday.

Public hospitals, meanwhile, would step up Covid-19 screening for patients, including asking doctors to arrange virus tests for inpatients based on clinical judgments, after three people in the same general ward at Queen Elizabeth Hospital in Yau Ma Tei were infected with the virus.

The hospital said on Wednesday night that a patient care assistant who worked in the same ward also tested preliminarily positive for the virus. She did not go to work from Friday to Tuesday, and had tested negative to the virus on Sunday. She returned to work on Wednesday afternoon, and was found to be positive after a voluntary test. The worker lived in Tsz Wan Shan.

“The patient care assistant was on leave when the hospital had cases of transmissions. It is believed she is not related to the cluster of infections in hospital. There is also no evidence showing she infected other patients during work,” the hospital said.

With the city’s tally now at 1,588 cases and another 37 preliminarily positive ones to be confirmed pending further tests, public health officials warned against a rising number of infections and said testing would be prioritised for residents in housing blocks that had two or more households with unrelated cases.

“As there are too many cases now, we will prioritise our distribution of specimen bottles to places with higher risks,” said Dr Chuang Shuk-kwan, head of the Centre for Health Protection’s communicable disease branch.

Chuang said testing in each affected block would usually involve around 1,000 residents, but some 22,000 sample bottles distributed for this purpose since the beginning of the third wave of infections had yielded only 31 patients, representing a positivity rate of just 0.14 per cent.

Public laboratories of the Department of Health and Hospital Authority had worked to their maximum capacity of 10,000 tests a day, and most of the 31 patients had symptoms but did not seek medical attention, she said, urging people with respiratory problems to visit private clinics to be tested and for others to await their bottles patiently.

“In these two weeks, we hope citizens, especially the elderly, can try their best to stay at home, and go out less to the markets or restaurants,” Chuang added.

She suggested people take note of any symptoms in elderly parents, and help buy their groceries to reduce the need for them to go out.

Since July 6, 85 of the 236 local infections have been of unknown sources.

Of the 19 confirmed infections on Wednesday, five were imported and included an aircrew member from India as well as seamen and domestic workers from the Philippines. Seven of the local cases had unknown origins of transmission.

Two government workers, at the Food and Environmental Hygiene and Immigration departments, were among the new cases.
The former is a 57-year-old woman who works in mail delivery in the Queensway government offices in Admiralty and is married to a previously confirmed case.

The immigration officer, a 43-year-old woman who is the daughter of a previous case, is the third infected in the department. A customs officer, 36, whose office is at the Trade and Industry Tower in Kai Tak was among the tentatively positive cases.

Hospital Authority chief manager Dr Lau Ka-hin said Covid-19 screening for patients would be stepped up after the three cases in the Queen Elizabeth ward.

Patients who were of higher risk of being linked to current clusters, such as residents from Tsz Wan Shan where the care home and some restaurants reported outbreaks, would be tested for Covid-19 before admission, even if they did not show any symptoms.

He also said testing was not reserved for those newly admitted to hospital.

“We allow doctors to execute their clinical judgments whenever they think the patient is in the high-risk groups, according to their history, including occupation, residential address as well as symptoms,” Lau said.

Earlier, two health experts called for the elderly and the chronically ill to undergo virus testing before being admitted into hospital, in light of the Queen Elizabeth cases.

Both Dr David Hui Shu-cheong and Professor Yuen Kwok-yung also told a radio programme that symptoms among older people might be less obvious than in younger patients, because many of them already suffered from other diseases.

The Queen Elizabeth cases were believed to have originated from a 92-year-old woman who showed signs of heart disease but no fever when admitted.

“For patients who are high risk, such as elderly people and those with chronic diseases, even if they are admitted to hospital for various reasons [other than the virus], it is better to get them tested for Covid-19 for safety purposes,” Hui, an expert in respiratory medicine at Chinese University, said.

Hui said as nearly 40 per cent of local infections were of unknown origin, the virus had already “found its way into the community”.

“Patients who are admitted to hospital may already carry the virus,” he said. “Some elderly people may also not have immediate symptoms.”

But Hui added that as patients in the same ward at Queen Elizabeth Hospital had now been tested, the risk of a further spread there was not high. Still, he said it was worrying that similar situations could happen at other public hospitals.

Yuen, a top infectious disease expert at the University of Hong Kong, agreed that high-risk patients should be tested for the virus before being admitted.

“Many elderly may also have chronic illnesses such as cardiovascular diseases,” he said. “When they get infected by the virus, their heart or lung conditions may get worse. Doctors may believe it was more related to their chronic illnesses than linking it with Covid-19.

“But whether virus tests can be implemented on every single patient being admitted to hospitals, [at this stage] we do not have the necessary resources to do so.”