“I’m very worried about the epidemic conditions of the fifth wave,” Ko said. “The risk is very imminent … we need to prepare several strings to our bow.”

Globally, there has been a resurgence in infections fuelled by the Delta variant of the coronavirus. Even countries which did well in initially safeguarding themselves, such as Australia and New Zealand, have seen cases rise.

In Hong Kong, Ko is worried that more children and elderly might be infected in a new wave, and the challenges this will pose to the health care system.

“Young children are not protected from Covid-19 as they cannot be vaccinated. If there are lots of such cases, they could infect their parents,” Ko said.

“Beds for children are fewer than for adults. Taking care of children is also more difficult than looking after adults. They could be very active and show no symptoms, and won’t just sit here doing nothing.”

Public hospitals have about 1,200 isolation beds of the highest infection-control standards, and around 140 of them are slated for children.

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Some countries, such as the United States and Australia, are already seeing a rise in child patients amid the spread of the Delta variant.

A rise in infections among the elderly in Hong Kong would also be worrying, Ko said.

“If elderly people are infected, they have a higher chance of developing severe symptoms … This is a very big concern,” he said.

Ko said hospitals were preparing to cope with a possible surge in child patients, and also what to do if entire families were infected.

Doctors, nurses and other health care workers from paediatric wards have been rotated through infectious disease units to allow staff from both sides to exchange experiences in dealing with patients.

Ko said Hong Kong had bought more ventilators to be prepared for any increase in older Covid-19 patients who needed help breathing.

Since the start of the pandemic last year, more than 260 extra ventilators have been bought and there are now about 1,500 across the city’s public hospitals.

Ko also outlined how the past 19 months of the pandemic had helped public hospitals become better prepared for new waves of infection. They were now able to carry out faster, more automated tests to identify patients carrying variants of the coronavirus.

There was also wider acceptance of telemedicine. Although remote consultations were first rolled out in Hong Kong nearly 20 years ago, more residents have taken to the service since the pandemic emerged.

“Patients might not want to come back to hospital, especially during a time when the epidemic situation is serious,” he said.

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Telemedicine worked well in areas such as speech therapy, follow-up consultations for those who were stable and psychiatric services, he said, while acknowledging that personal interaction was important for the well-being of both patients and health care workers.

The Hospital Authority runs 43 public hospitals and institutions, 49 specialist outpatient clinics and 73 general clinics.

Despite all the steps taken to prepare for a new wave of infections, the constant drain of much-needed manpower remained a challenge for the public health care system.

Authority chairman Henry Fan Hung-ling recently voiced concerns about the loss of manpower, which he believed was partly because of emigration trends in the wake of the national security law introduced in June last year.

The attrition rates for doctors from July 1 2020 to June this year was 4.6 per cent, and 6.5 per cent for nurses. The rate dipped from 4.9 per cent for doctors over the same period between 2019 and 2020, but went up from 5.6 per cent for nurses.

Ko said the situation in some specialities such as anaesthesiology and radiology was more worrying, but it remained difficult to assess the overall effect of the manpower loss on services.

“Will the situation stabilise later? We need to closely monitor how it develops,” he said.

But he said he believed those who remained understood they played a vital role in serving Hongkongers. If they experienced satisfaction and fulfilment working in areas they hoped to pursue, they were likely to stay.

“The most important thing is that our colleagues can feel they are creating value for themselves while serving here,” he said.

Separately, speaking at a forum on Saturday, Dr Lam Ching-choi, a member of the Executive Council, city leader Carrie Lam Cheng Yuet-ngor’s de facto cabinet, accused the government of poor planning when it came to staffing levels in the medical sector.

While officials planned to relax the rules to allow more foreign-trained doctors to work in the city, Lam said it was not a solution if they did not consider how to retain locals in the face of a wave of emigration.

He said the government’s long-term plans in attracting local young doctors to stay had not been ideal.

“To be frank, I am disappointed. The government has done a poor job in long-term planning. When there is a lack of resources, ‘fat chicken meals’ are introduced, or the number of medical student places are cut,” he said, referring to the offer of compensation packages for doctors under voluntary retirement schemes.

The government has tabled a bill in the Legislative Council to introduce more foreign-trained doctors without them having to pass a local licensing exam, provided they are permanent residents and graduated from a recognised medical school and are registered to practise medicine elsewhere.