Confinement ruled out of virus plan, source says

PUBLISHED : Tuesday, 12 May, 2009, 12:00am
UPDATED : Tuesday, 12 May, 2009, 12:00am

Hong Kong would no longer rely on confinement measures - such as quarantining the hotel where a swine flu patient stayed - to combat the deadly disease if it spread rapidly in the city, government sources said.

The government steering committee on pandemic preparedness met yesterday to work out strategies to combat the disease, especially if there were cases of local infection. Its risk assessment found that kindergartens, instead of flights, were likely sources of an outbreak.

Hong Kong government last week declared victory in stopping swine flu from spreading to the community after quarantining more than 300 guests and staff at the Metropark Hotel, where a Mexican tourist, the index patient, had stayed.

But health officials believed that such drastic measures might not be sustainable in the future, especially if there were multiple cases.

The government believes that Hong Kong should go from 'confinement' to 'mitigation' once the former method becomes futile.

A government source told the South China Morning Post that 'mitigation' referred to measures such as shutting down schools and suspending public activities to stem the spread of swine flu and avoid a rapid increase in cases that would overwhelm the health system.

'Instead of having a big number of cases in one month, we want to flatten out these cases in three months so [as] to minimise the crash to the public health care system,' the source said. 'The aim is to buy time for the community to build up herd immunity. The summer holiday will be a cushion for us, if Hong Kong can successfully delay the [swine flu] peak to the winter, vaccines could be available by that time and the mortality will be lower.'

The source said the United States, with more than 2,500 swine flu cases, had given up confinement measures and Hong Kong would gradually follow this path.

Hospitals and borders were regarded as the battle lines to stop the virus from spreading to the community. Once the virus got through these battle lines, schools would be the place where local outbreaks would be generated.

The source said kindergartens would be the first to be shut down. 'Kindergartens rate as the highest risk as young children can easily pass the virus around. Homes for the elderly rate a lower risk as many residents are not that mobile ... We can see that transmission of the swine flu virus on planes is not effective.'

Another government source said new measures to be announced this week would detail what to do if cases were found in workplaces, schools or residences.

The government hoped that by informing the public of the 'rules of the game', it could reduce fear and confusion during an emergency. The committee would also work out guidelines on the use of Tamiflu.

Secretary for Food and Health York Chow Yat-ngok said yesterday the review would also clearly define 'close contacts' with a patient.

Dr Chow visited Princess Margaret Hospital, the city's main hospital for infectious diseases, and assured medical staff that the government would provide sufficient resources.

Medical sector legislator Leung Ka-lau said the government could scale down its quarantine operation if there was a second swine flu case, as mortality and infection rates for the virus were not high.

He was also concerned about Tamiflu use. 'In the Metropark Hotel case ... all 300 guests and staff were given Tamiflu for just one index case. There should be a clear policy on the drug's use or it will be used up.'