Along with climate change come mosquito-borne diseases. Is Hong Kong ready for a public health emergency?

Climate change is not just an environmental but also a looming public health crisis: expect more cases of heat-related illnesses and mosquito-borne diseases. Asian countries are finding hi-tech solutions and Hong Kong should prepare, too

Jennifer Lo

Published: 2:00pm, 16 Apr 2019

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Months after Hong Kong was ranked by Bloomberg as the economy with the world’s most efficient health care, its public health system is caught in a crisis. More than 100 medical staff protested about the manpower crunch and ward overcrowding amid a winter flu surge in January, with many holding placards that sent the desperate message: “Breaking point”. This has been followed by a spike in measles infections since mid-March, and a shortage of vaccines.

More alarmingly, the next public health crisis might already be brewing. The growing effects of climate change on Hong Kong, if not addressed head-on and soon, with more innovation, will take a significant health toll and put further strain on the city’s overloaded public health sector.

Climate change is more than an environmental problem. The Lancet, a leading medical journal, has described climate change as a “public health emergency”. Last year was Hong Kong’s third hottest on record, with 36 days at 33 degrees Celsius or above.

The rising number of hot days is likely to trigger more cases of heat-related illnesses such as heatstroke and aggravate chronic conditions, including cardiovascular and respiratory diseases, driving a surge in demand for hospital services. A Chinese University of Hong Kong study found that during the hot season, hospital admissions increased by 4.5 per cent for every increase of 1 degree above 29 degrees Celsius.

The buzz of mosquitoes during warm Hong Kong nights is not just annoying. It should also sound warning bells that disease-carrying mosquito species like Aedes aegypti are growing faster and surviving longer. Climate change shortens the incubation period of pathogens causing dengue fever, which infects as many as 400 million people around the world every year. While dengue is not endemic in Hong Kong, a record 163 cases were reported here last year.

Hong Kong is not alone in the uphill battle to guard against these public health concerns. There is a lot Hong Kong can learn from its neighbours in Asia when it comes to the use of innovation and technology to meet the dual challenge of climate change and public health.

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Hong Kong’s private sector could engage more in climate adaptation efforts. When dengue broke out in the city last year, pest control teams sprayed chemicals to kill mosquitoes. Insecticides are toxic to the environment and their effects are temporary. Also, vaccination has been affected by a backlash against Dengvaxia, a dengue vaccine found to put some people at greater risk.

The Tahija Foundation of Indonesia is among the sponsors for research on injecting mosquito eggs with Wolbachia bacteria. The microbes, which are found naturally in insects like bees and flies, are safe for humans but reduce the ability of mosquitoes to transmit diseases like dengue and Zika. This is an example of harnessing the agility and resources of businesses to come up with climate solutions.

If Hong Kong does not have the right technology at hand, it can consider partnering with top tech companies. Singapore’s National Environmental Agency has tapped the tech expertise of Verily, the life sciences business and sister company of Google, for an initiative to mass-breed and release Wolbachia-carrying mosquitoes to fight dengue. During a trial of this method in Fresno County, California, Verily successfully reduced dengue-carrying mosquitoes by 95 per cent.

Hong Kong can also turn to artificial intelligence to improve forecasts of climate-related diseases. Equipped with this knowledge, the Hong Kong government can implement more targeted public health interventions, such as boosting health care staffing, taking mosquito control measures and sending mobile alerts to residents.

For Manila, researchers have run AI algorithms on weather and land use data to generate a map of areas at risk of dengue fever. In Penang, a similar project predicts outbreaks three months in advance with more than 80 per cent accuracy.

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As climate change brings more extreme weather, the use of technology to produce accurate forecasts of climate disasters, such as heatwaves and floods, will also facilitate prevention strategies that save lives, minimise injuries and counter the emergence of diseases. The Hong Kong government has used AI to assess the risk of landslides. In the aftermath of Typhoon Mangkhut, the city is getting new storm defences, including a wave warning system and floating breakwaters.

These are all good initiatives to build resilience to climate change, but more collaboration across departments and disciplines is the way forward. Public health must be on the radar of those working on Hong Kong’s climate solutions, because it also makes economic sense – it is far better to spend 10 cents on prevention than a dollar on treatment.

Jennifer Lo is programme associate of the Asia Business Council and co-author of the council’s latest research, “Public Health, Climate Change, and Technology: Innovating Toward a Healthier Asia”

This article appeared in the South China Morning Post print edition as: Prevention before cure

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