Should Hong Kong follow mainland China and Macau to start imposing travel restrictions and quarantine rules on arrivals from countries that have been worse hit than the city by the coronavirus epidemic? The debate has intensified with leading health advisers to the government advocating tougher measures on Monday for people coming from countries such as Italy and India, although the administration remained vague as to whether it would make such a move. Executive Council member Dr Lam Ching-choi, a cabinet-level adviser, raised the issue a day after Macau announced it would impose a 14-day quarantine from Tuesday on travellers who had been to Germany, France, Spain or Japan. Germany and France have each recorded more than 1,100 infections, Spain 999, and Japan at least 1,000, including cases from the Diamond Princess cruise liner, while Hong Kong has confirmed 115 so far. On Monday the city reported one more case of Covid-19 – a 44-year-old man who works as a driver for a previously confirmed patient. A pet dog belonging to another patient diagnosed on Sunday was also sent to a quarantine facility for testing, after another dog last week was found to have a low-level infection. Hong Kong currently bans only non-locals arriving from South Korea, which has reported more than 7,000 Covid-19 cases, and those from the Hubei province epicentre in mainland China. A 14-day mandatory quarantine is imposed on anyone arriving from other parts of the mainland, Iran, and three regions in northern Italy. Hongkongers returning from Daegu and Gyeongsangbuk-do in South Korea are also required to undergo mandatory quarantine. Secretary for Constitutional and Mainland Affairs Patrick Nip Tak-kuen and Director of Immigration Erick Tsang Kwok-wai will be tested on Tuesday, after they shared the same chartered flight back to Hong Kong from Wuhan with a woman who was later confirmed to be infected. Lam suggested extending the quarantine measures to travellers from all areas of Italy, which has also recorded more than 7,000 cases. “A variety of immigration controls can be considered, depending on a series of factors such as the number of infections per capita in a particular country. A blanket ban would not help,” he told the Post. Other factors included the speed of infection in a country, its ability to control the epidemic and the flow of travellers to Hong Kong, he said. Lam added that the city might also need to impose restrictions on some countries with fewer confirmed cases, as they lacked the ability to diagnose the virus, or were not doing enough testing. He noted that several members of a Hong Kong tour group to India last month were infected. Indian authorities have confirmed at least 43 cases nationwide. “Not many cases have been confirmed in India, but we are suspicious because of its large population and because so many [Hongkongers] in the tour group were infected,” Lam said. Health authorities said five members of the tour group of 21, together with a family member who did not travel to India, were confirmed to have contracted the deadly virus. Professor Yuen Kwok-yung , a leading infectious disease expert at the University of Hong Kong (HKU), joined the growing calls for health authorities to consider imposing stringent restrictions on people arriving from hard-hit countries. “[Travellers] can first be quarantined at home for 14 days and be tested at their home countries,” Yuen said, suggesting that they should be allowed to fly out only after being confirmed to be healthy. Dr Ho Pak-leung, a top microbiologist from HKU, accused the government of reacting too slowly in imposing quarantine measures on those coming from countries such as France, Germany and Spain. Hong Kong records third death as five more cases confirmed, bringing total to 114 He noted the situation in those countries was similar to that of South Korea and parts of Italy, which prompted the city to start quarantining their incoming citizens from late February . Ho warned of a surge in cases in Hong Kong if more control measures were not put in place. While quarantine camps were the best option, he said, homes or hotels could also be used because of limited space, and there should be heavy penalties for those who violated the rules. Asked if the government would act on the experts’ advice, the Food and Health Bureau remained non-committal, only saying a “thorough risk assessment” would be conducted before formulating port health measures. “The assessment will take into account factors such as the number, distribution and rate of increase of infected persons, measures put in place for surveillance and control of the outbreak, and the frequency of visit by Hong Kong residents,” a bureau spokeswoman said. The Centre for Health Protection also had a warning about social distancing, saying clusters of infections were observed in the local community involving meal gatherings. “Members of the public are urged to go out less and reduce social activities,” a spokesman said. Professor Leo Poon Lit-man from HKU’s school of public health said the epidemic was under control on the mainland, but it might remain a threat in the near future. “If the situation is not controlled in other countries, the outbreak will continue and it will be just as regular as a seasonal influenza,” he said. Though vaccines and drugs were in various stages of development, Poon questioned whether they would be available worldwide and accessible to less-developed countries. Poon said the virus would not disappear and people should figure out how to “live with it” by maintaining good personal hygiene. The Society of Hospital Pharmacists said the first batch of remdesivir, an antiviral drug to undergo clinical trials in Hong Kong’s public hospitals, would arrive as early as next Monday. Yuen also agreed with Poon that Covid-19 could become a seasonal disease. “The hypothesis is based on the condition that countries are unable to completely cut the transmission routes, which seems increasingly more likely to happen,” Yuen said. He suggested the epidemic would only die down after about 70 per cent of the world’s population had developed antibodies against the virus through being infected. Additional reporting by Olga Wong