Hong Kong’s winter flu season started early with 6 outbreaks in the first week of January 2019, however that number skyrocketed to over 250 by January 16th. The heaviest hit age groups have been young children and the elderly, leading to school closures and overcrowded public hospitals. The elderly have been especially vulnerable, making up the majority of severe cases and tragically deaths.
School Closures due to flu outbreaks
The largest number of outbreaks have been seen in kindergartens and child care centres, with at least 200 outbreaks (defined as 3 cases within 4 days) making up 70% of influenza-like illness outbreaks occurring in schools and institutions. While the first few incidences were seen in week 1 (December 30 – January 5), it has rapidly accelerated in weeks 2 (January 6 – 12) and 3 (January 13 – 19).
|Type of institution||Week 1 outbreaks(Dec 30 - Jan 5)||Week 2 outbreaks(Jan 6 - 12)||Total number of outbreaks as of January 16|
|Kindergarten/child care centre||0||87||175|
|Residential care home for the elderly||2||5||10|
|Residential care home for the disabled||1||2||5|
|Total number of outbreaks||6||121||251|
|Total number of persons affected||28||936||1762|
*Source: Hong Kong Centre for Health Protection’s Flu Express report published January 17, 2019.
After an interdepartmental Government meeting on the 17th, Hong Kong’s Centre for Health Protection (CHP) published a list of kindergartens and child care centres that would temporarily close for 7 days to help prevent further spread of the illness. Local news has reported that this list of schools comprises approximately 20% of all such facilities across the territory.
High rates of influenza-related hospital admissions overcrowding
The large number of outbreaks occurring in kindergartens, child care centres and some primary schools has led to high rates of influenza-related hospital admissions for children under 6 years old and those aged between 6 and 11 years. The CHP reports that the rate of admission for 0-5 year olds rose from 6.04 admissions per 10,000 population to 9.23 between weeks 1 and 2, while the admission rate for 6-11 year olds 1.1 to 1.84 over the same period.
The high rate of admission for children under 6 years old is the highest it’s been during a major influenza season within the past 3 years, which has ranged between 6.18 to 9.07 per 10,000 population.
|Age Group||Week 1 admission rate per 10k people (Dec 30 - Jan 5)||Week 2 admission rate per 10k people(Jan 6 - 12)|
|0-5 years old||6.49||9.23|
|6-11 years old||1.29||1.84|
|12-17 years old||0.25||0.59|
|18-49 years old||0.27||0.36|
|50-64 years old||0.51||0.74|
|65 years old and above||1.58||1.89|
Though young children have had the highest rates of hospital admission, the majority of severe cases of flu-associated hospitalisation which required treatment in an intensive care unit have been in adults above the age of 50.
By January 16th there had been 121 severe cases across all age groups, with 34% of the cases being adults between the ages of 50 to 64, and 47% of cases being adults being over the age of 65. Sadly, the current flu season has resulted in some deaths, with a total of 46 fatalities so far. Out of the 41 cases of severe influenza in the 50-64 age group, 6 people have died, and out of the 57 cases of severe influenza among elderly people 65 and over 40 people passed away. The CHP reports that about 89% of the fatal cases involving influenza also had had chronic conditions.
The surge in hospitalisations has led to overcrowding in public hospitals, with overall occupancy rates reaching more than 100%, requiring temporary beds to be put in hospital hallways. Some hospitals have reached well over 120% occupancy during the weekends.
The increased number of patients has caused waiting times at public hospitals to rise significantly, with a local news company reporting that non-urgent patients had to wait up to 8 hours at some public hospitals earlier in the month. Even on Monday January 21st, some hospitals were reporting an estimated waiting time of over 4 hours.
The rapid rise in patient numbers has caused nurses at public hospitals, who have long complained of understaffing, to reach a breaking point, with over a 100 members of Hong Kong’s largest nursing association protesting the manpower shortage outside of government headquarters on Sunday 20th. One nurse at the protest said each nurse had to care for over 20 patients, at the same time and was concerned it could affect service quality and increase the chance of mistakes, with others bringing up the amount of clerical and administrative work that nurses had to complete.
In response, the Hospital Authority has said they have hired 800 temporary and part-time nurses to assist with the flu surge, as well as planning to recruit some 2,230 nurses in 2018-2019, for a net increase of 830 nurses.
Focus on prevention through vaccinations
The Centre for Health Protection has urged kindergartens and child care centres to take advantage of the Enahnced Vaccination Subsidy Scheme (VSS) Outreach programme, which allows them to invite participating doctors to visit their locations and provide free seasonal influenza vaccinations.
Launched in October 2018, the scheme has been expanded to provide subsidised vaccinations from private doctors to adult aged 50-64, on top of other at-risk groups including pregnant women, adults 65 and older, children aged 6 months to 12 years old, persons with intellectual disabilities and people receiving government Disability Allowance.
Parents and staff at schools and organisations have also been encourage to get vaccinated as they frequently come in contact with the young, elderly and people with chronic conditions who are vulnerable to influenza.
Check that your private health insurance covers vaccinations
To make sure you and those around you are protected, check whether your children or those around you can take advantage of Hong Kong’s Vaccination Subsidy Scheme, or alternatively check whether your private health insurance plan includes coverage of vaccinations. Private health insurance will also cover you at private hospital facilities, helping you to avoid lengthy waiting times as well as freeing up resources at public hospitals. For more information about our international health plan designed to cover you in Hong Kong, visit our MyHEALTH Hong Kong health insurance product page, alternatively you compare our international health insurance plans which can cover you around the world or contact us today.