Two of Hong Kong's laboratories have been recognised by the World Health Organisation as regional diagnosis centres for the influenza virus, making this city a global bulwark against the impending flu pandemic.
Given our state-of-the-art hospitals, and the professionalism and dedication of frontline doctors, we just need leadership with foresight to make the city a centre of excellence in medical care. But this will not happen if policymakers still refuse to apply evidence-based knowledge in public health policy.
Every year, when the weather turns cooler, there are hundreds of extra deaths from flu-related illnesses. These can be averted if our medical elite breaks down the mental barriers between public and private sectors, and plans public-health activities for both sectors.
A study undertaken by C. H. Wong, Anthony Hedley and other associates estimated that between 650 and 1,230 Hong Kong people died annually from influenza-related illnesses from 1996 to 1999. Vaccinations are known to reduce these deaths by half. If we can achieve an ideal vaccination rate of 90 per cent, we should ultimately be able to prevent 290 to 550 deaths each year.
The US Centres for Disease Control (CDC) co-ordinates annual flu vaccinations, exercising surveillance and public education. The CDC's first task of the year is to influence manufacturers to deliver a desirable total aggregate for the coming season. Its second task is to prioritise and modify sectoral demands for vaccine, so as to match national availability. To prioritise needs for vaccine, the population is divided into three tiers: the most vulnerable includes people over 65, children from six to 23 months and those with chronic diseases.
The effectiveness of the CDC's co-ordination effort was demonstrated last year, when the US population only received 61 million doses of flu vaccine, far short of the usual 75 million doses. Yet, because of the centre's direction, the vulnerable attained the usual vaccine-coverage rates of previous years.
There could be two factors in Hong Kong's current shortage of flu vaccines. One is the inflated demand because of the increased awareness of avian flu. The other factor is almost certainly the increase in 'pre-booking' by the CDC and other developed countries' health departments.
