Coronavirus: Hong Kong records four new preliminary positive cases, after earlier confirming three locally transmitted Covid-19 infections

Elizabeth Cheung

There are fears of a fresh community outbreak in Hong Kong as four more preliminary positive Covid-19 cases were recorded on Monday night, according to government sources, after health authorities had earlier confirmed three new locally transmitted cases.

All seven cases are related to a case reported on Sunday, a 34-year-old woman who works at a Kerry Logistics warehouse in Kwai Chung.

They involve two of the woman’s colleagues and four of her neighbours from Lek Yuen Estate in Sha Tin, as well as the paramedic who transported her to hospital. Authorities are still trying to determine how they contracted the virus.

Hong Kong had previously gone more than two weeks without a locally transmitted case.

A woman who worked at Kerry Logistics’s temperature-controlled food warehouse was confirmed to have Covid-19 on Sunday. Two colleagues tested positive for the virus. Photo: Winson Wong

“The paramedic should be the first [of his profession] to possibly get infected due to work,” said Dr Chuang Shuk-kwan, head of the communicable disease branch at the Centre for Health Protection.

“His viral load was quite low. If he was at the early stage of infection, the viral load should be high. We found it was a bit strange.”

The man was asymptomatic and further investigation, including testing for antibodies, would be needed to understand how and when he was infected, Chuang said.

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“We are not sure whether he is recently infected or he had been infected by another source a while ago,” she said. “If he already has antibodies, it is unlikely he was infected by [the woman].”

A close contact of the infected man was sent to hospital for tests after showing symptoms.

The four new preliminary positive cases were women who lived in Luk Chuen House at Lek Yuen Estate, the same building in which the 34-year-old woman and her husband lived, sources said.

They were found to be infected after tracking by the Department of Health. A source said there could be environmental contamination in the building, with residents contracting the virus through the use of lifts. Four of the cases live either on the same floor or one or two floors above or below.

Monday’s confirmed cases take the total number of Covid-19 infections in the city to 1,087, with four related deaths. The previous local transmission involved a family from Tsuen Wan, with that first case reported on May 13.

Health authorities revealed on Sunday that two warehouse workers had tested “weak positive” for the coronavirus.

Like their colleague, they labelled pre-packaged fruit and vegetables imported from Britain, raising the possibility the warehouse workers had contracted the virus through handling the items. But authorities had no evidence to support that conclusion.

Chuang said 20 samples taken from computer keyboards, desks and lockers among other areas in the warehouse, as well as 11 from the food packaging, tested negative for the virus.

It was unlikely the two women, who began showing symptoms in late April, were infected by their colleague, who fell ill in late May.

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The doctor and staff at the Sha Tin clinic who had treated the 34-year-old woman and her husband had also been placed in quarantine.

Dr Lau Ka-hin, the Hospital Authority’s chief manager of quality and standards, said 11 of the 12 hospital staff who were involved in treating the woman had been given the all-clear, while the remaining one was waiting to be tested.

Food and Health Undersecretary Dr Chui Tak-yi said more testing in the community was needed, after several infected people were not tested after seeing private doctors for their symptoms.

He called on the private sector and its roughly 7,000 doctors to offer tests to patients showing mild symptoms, to form an “extensive network”.

Dr Ho Pak-leung, a top microbiologist at the University of Hong Kong, said health authorities should step up testing as there could be new sources of the virus.

“If the authorities are unable to track down the source of this case, it will be very difficult to have targeted measures to stop cases with unknown sources,” he told public radio.

Ho cited two potential sources for the local transmissions – returning travellers who might have violated home quarantine rules and recovered patients who might have relapsed.

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“The government should not have a false sense of security and think these cases will not cause a community outbreak,” Ho said. Authorities should increase monitoring of both groups to ensure they observed quarantine rules and consider setting up street testing booths.

Some social-distancing measures, including a ban on public gatherings of more than eight people, are set to expire on Thursday, but Ho suggested continuing the limit on crowd sizes for indoor venues, particularly restaurants. But the restriction was not necessary for outside as long as people wore masks.

Ho also addressed concerns over the threat of coronavirus in the food packing industry.

“I think people should not scare themselves,” Ho said. While the virus could survive on surfaces for several days, as long as people washed their hands after touching the food and cooked it thoroughly, there was no cause for alarm.

Dr Ho Pak-leung said Hongkongers should not frighten themselves over the fact that recent cases included workers at a food warehouse. Photo: Xiaomei Chen

On Sunday night, British retailer Marks and Spencer said Kerry Logistics, which operated the warehouse, had disinfected the facility in coordination with the Department of Health. It had not been advised of any direct health risks to customers but would disinfect all of its stores in Hong Kong.

The Fire Services Department said that the paramedic did not know the woman was related to Covid-19 when handling her. He had handled two more patients after sending the woman to hospital.

Two other paramedics who also handled the woman's case were tested negative to the virus and have been placed in quarantine.

Another six paramedics were considered as close contacts of the infected man, and one of them was sent to hospital for treatment and virus test after showing symptoms. The remaining five would be sent for quarantine.

Lee Wai-hau, chairman of the HKFSD Ambulancemen’s Union, said paramedics had sufficient protective gear and what they wore depended in part on what information about the patient they received from the emergency call.

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“Colleagues at our control centre will ask a few questions, such as whether they had left Hong Kong in the past 14 days or had close contact with Covid-19 patients,” Lee said. Some callers might not disclose all information, he said.

When performing riskier procedures such as oxygen therapy, paramedics would need to wear a N95 mask and gown.

A balance needed to be struck if using the highest level of protective gear in handling every case, given N95 masks remained in tight supply globally.

“If it is to raise the safety level, we think it is absolutely possible,” he said. “But how should we use the resources prudently?”

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