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HKDU⠀
2021-10-27

Type 2 Diabetes Mellitus Treatment & Management

Management of Coronary Heart Disease There is contradictory epidemiologic evidence as to whether diabetes is in fact a CHD risk equivalent. For the present, however, that is the position adopted by most groups, such as the National Cholesterol Education Program (NCEP) and the ADA. [342] Although the risk for CHD is 2-4 times greater in patients with diabetes than it is in individuals without diabetes, control of conventional risk factors is probably more important in event reduction than is glycemic control. Control of hypertension, aspirin therapy, and lowering of LDL cholesterol levels are vitally important in reducing CHD risk. Aspirin The ADA recommends that patients with diabetes who are at high risk for cardiovascular events receive primary preventive therapy with low-dose, enteric-coated aspirin. For patients with aspirin hypersensitivity or intolerance, clopidogrel is recommended. [344] However, a randomized, controlled trial from Japan found that using low-dose aspirin as primary prevention did not reduce the risk of cardiovascular events in patients with type 2 diabetes. [345] These investigators subsequently reported that low-dose aspirin therapy reduces cardiovascular risk only in patients with a glomerular filtration rate (GFR) of 60-89 mL/min; low-dose aspirin had no beneficial impact if the GFR was above 90 mL/min or below 60 mL/min. [346] A study by Okada et al reported that low-dose aspirin therapy (81-100 mg) in patients with diabetes who are taking insulin or oral hypoglycemic agents does not reduce atherosclerotic events. [347] This is yet another argument against using low-dose aspirin for primary prevention of cardiovascular disease in patients with moderate or severe diabetes. Statins The Scandinavian Simvastatin Survival Study (4S) showed a 42% reduction in CHD events in diabetic patients with simvastatin therapy (mean dose 27 mg daily, with LDL reduction approximately 35%). Participants in 4S had known CHD and very high LDL cholesterol levels. [348] A smaller reduction was seen in the Heart Protection Study (HPS) in patients with CHD or other vascular disease and diabetes. [349] Patients in the HPS treatment arm received simvastatin 40 mg daily. Lesser degrees of risk reduction have been shown in other secondary prevention studies in patients treated with pravastatin with mild to moderate LDL cholesterol elevation at baseline. Atorvastatin, 10 mg daily, did not reduce CHD risk among diabetic patients with hypertension and no previous CHD who were enrolled in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). [350] In contrast, the Collaborative Atorvastatin Diabetes Study (CARDS) showed a significant reduction in CHD risk in patients with type 2 diabetes mellitus and 1 other risk factor when treated with atorvastatin 10 mg daily. [351] Some studies have suggested that statin therapy may be associated with an increased risk of developing diabetes. In a pooled analysis of data from five statin trials, intensive-dose statin therapy was associated with increased risk of new-onset diabetes compared with moderate dose statins. [352] A study by Ahmadizar et al of subjects over age 45 years who had no diabetes at baseline reported that compared with individuals who have never used statins, the risk of incident type 2 diabetes development in persons who have ever taken statins is 38% greater, with the likelihood being particularly high in persons with impaired glucose homeostasis and in individuals who are overweight/obese. However, analyses stratified at baseline for gender and body mass index (BMI) indicated that statin use was not significantly associated with type 2 diabetes in women or in persons with a normal body mass index (BMI). [353, 354] The American Diabetes Association (ADA) provided recommendations on the use of statins in patients with diabetes to align with those of the American College of Cardiology and the American Heart Association. [355] The ADA recommends statin use for nearly everyone with diabetes. The ADA guidelines divide diabetes patients by 3 age groups: Younger than 40 years: No statins for those with no cardiovascular disease (CVD) risk factors other than diabetes; moderate intensity or high-intensity statin doses for those with additional CVD risk factors (baseline LDL cholesterol 100 or greater, high blood pressure, smoking, and overweight/obesity); and high-intensity statin doses for those with overt CVD (including previous cardiovascular events or acute coronary syndrome). Age 40-75 years: Moderate-intensity statins for those with no additional risk factors, and high-intensity statins for those with either CVD risk factors or overt CVD. Older than 75 years: Moderate-intensity statins for those with CVD risk factors; and high-intensity statins for those with overt CVD. Lipid monitoring for adherence is recommended as needed, and annual monitoring is advised for patients younger than 40 years who have not yet started on statins. There is a new BMI cut point of 23 kg/m2 (instead of 25 kg/m2) for screening Asian Americans for prediabetes and diabetes, based on evidence that Asian populations are at increased risk at lower BMIs relative to the general population. The premeal glucose target of 70-130 mg/dL was changed to 80-130 mg/dL to better reflect new data that compared average glucose levels with HbA1c targets. The goal for diastolic blood pressure was raised to 90 mm Hg from 80 mm Hg to better reflect data from randomized clinical trials. (This follows ADA's 2013 shift from a systolic target of 130 mm Hg to 140 mm Hg.) With regard to physical activity, the document now advises limiting the time spent sitting to no longer than 90 min. The ADA does not support e-cigarettes as alternatives to smoking or to facilitate smoking cessation. Immunization against pneumococcal disease is recommended. A new HbA1c target of less than 7.5% for children is now recommended. HDL cholesterol therapy The benefits of raising HDL cholesterol levels in patients with type 2 diabetes remains uncertain. Some of the statin trials suggest that statin therapy eliminates some of the excess risk from low HDL cholesterol levels in patients with LDL cholesterol elevation at baseline. The Veterans Administration HDL Intervention Trial (VA-HIT) showed an approximately 22% reduction in CHD events in patients with diabetes and known CHD when HDL cholesterol levels were increased by approximately 6% by gemfibrozil. [356] This was a population with low LDL cholesterol levels, however, so whether these same benefits would accrue in patients with elevated LDL cholesterol who are treated with a statin before their low HDL cholesterol is addressed is unclear. Triglyceride therapy An elevated triglyceride level is a common abnormality in type 2 diabetes mellitus. However, whether therapy to reduce triglycerides helps to reduce CHD events has not been determined from clinical end-point trials. Revascularization The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) study, which was conducted in 2368 patients with type 2 diabetes mellitus and heart disease, showed no significant difference in the rates of death and major cardiovascular events between patients undergoing prompt revascularization and those undergoing medical therapy with insulin or insulin-sensitizing drugs. [357] These data emphasize the need to customize therapy to the patient’s circumstances and therapeutic goals.

HKDU⠀
2021-10-19

CUHK Develops a Novel Faecal Test that can Detect Polyps and Early Colon Cancers with Sensitivity Over 90%

The faecal immunochemical test (FIT) is commonly used to screen for colorectal cancer but it has low sensitivity (around 50%) for early cancer detection and fails to detect polyps. The Faculty of Medicine at The Chinese University of Hong Kong (CU Medicine) has developed the world’s first faecal “bacterial gene markers” test (M3) based on metagenomic analysis of over 1,100 cancer subjects. The sensitivity of this non-invasive test is 94% for colorectal cancer detection which is comparable to that of a colonoscopy. The test can also accurately detect polyp recurrence with over 90% sensitivity. It is the first test to offer a non-invasive approach to screen for polyp recurrence. The novel test can spare patients from an unnecessary colonoscopy thus reducing the risk of invasive testing and the pressure on medical services. The research findings on early colon cancer detection have been published in the high impact international medical journal Gut.   Early Detection and Treatment of Colorectal Cancer Improves Survival     According to statistics of the Hong Kong Cancer Registry on colorectal cancer diagnosed between 2010 and 2017, the 5-year survival rate of patients with stage I colorectal cancer was 96%, but it dropped dramatically to less than 10% when patients were diagnosed at stage IV. Early diagnosis and treatment of cancers are associated with a favourable prognosis. As most colorectal cancers originated from polyps, early detection and removal of polyps can prevent the development of cancer.     Major Shortcomings of Current Screening Tools for Colorectal Cancer and Polyps     Current colorectal cancer screening tools have two major shortcomings. Firstly, FIT cannot accurately detect early colorectal cancer with less than 50% sensitivity and a high false-negative rate. Secondly, no non-invasive tool exists for the detection of recurrent polyps. These patients need to undergo surveillance colonoscopy on a regular basis to detect polyp recurrence. The inconvenience and discomfort of repeated colonoscopies deter many people from having the examination. It also adds a huge demand to the existing burden for colonoscopy services.             Bacterial Gene Markers Test Has the Potential to Enhance Effectiveness of Colorectal Cancer Screening     Using data from metagenomics sequencing, the research team from CU Medicine identified a group of four unique bacterial DNA markers, known as M3, which is effective in detecting colorectal cancer. Through analysis of stool samples from over 1,100 participants, including individuals with colorectal cancer and polyps, M3 CRC showed a 94% sensitivity in detecting colorectal cancer. The sensitivity of M3 is comparable to that of a colonoscopy for cancer detection (94%) and supersedes that of FIT for early cancer (50%) and polyp (<10%) detection.     The research team also tested the accuracy of M3 in the detection of recurrent polyps. They followed over 200 subjects who had undergone polyp resection within 5 years. They found that subjects who developed polyp recurrence had higher levels of M3 in their stool samples than those without recurrence. Using their novel proprietary detection algorithms, the M3 CRC test showed a remarkable sensitivity of over 90% for detecting recurrence of polyps. Professor Jun YU, Professor of the Department of Medicine and Therapeutics at CU Medicine, highlighted, “The M3 CRC test is the result of our research team’s hard work for over a decade. We have successfully identified novel faecal bacterial markers that can accurately detect colorectal cancer and polyps which can now serve as a non-invasive tool for many patients and their families.” Professor Jessie Qiao Yi LIANG, Research Associate Professor of the Department of Medicine and Therapeutics at CU Medicine added, “Our recent study further showed that the clinical application of M3 is not limited only to cancer detection but it can also be applied to predict polyp recurrence. With this new innovation, we are hopeful that the number of unnecessary colonoscopies could be reduced.”     Professor Siew Chien NG, Associate Director of the Centre for Gut Microbiota Research at CU Medicine, stated, “This discovery is based on our unique metagenomic dataset of thousands of subjects. The data are reproducible and can potentially be applied globally. Unlike blood tests or colonoscopic procedures that need clinic or hospital visits, this test only requires a small sample of stool and can be performed at home. The bacterial gene markers test can detect cancer early, when it can be cured. We are thrilled to report that it can also detect polyps, making colorectal cancer prevention a reality”.     Professor Francis KL CHAN, Dean of Medicine and Director of the Centre for Gut Microbiota Research at CU Medicine regarded this new innovation as a prime example of successful translational research whereby scientific findings can be transformed into a clinical screening tool. He remarked, “Globally, approximately 2,800 million people are eligible for colorectal cancer screening. The potential of bacterial gene markers is huge. Not only can it assist us in prioritising medical resources, it will also bring benefit to both individual patients and society as a whole.”

HKDU⠀
2021-10-19

Telehealth Privacy and Security Tips

In response to social distancing recommendations resulting from the COVID-19 pandemic, healthcare providers are rapidly deploying remote or virtual healthcare services to sustain care for their patients. In many cases, telehealth approaches are new to the patient and the provider. Not withstanding, maintaining patient privacy remains important. Below are some critical recommendations to maintain patient privacy and security in these challenging times. The following link contains recommendations from the Department of Health and Human Services:  hhs.gov Buzz, a HIPAA-complaint platform enables providers to conduct secure video conferences or calls with patients quickly, easily & seamlessly. FOR HEALTHCARE PROVIDERS Before Telehealth Sessions Always use HIPAA-compliant applications to help reduce security and privacy risks. Share updated privacy and security practices with your patients, using different communications channels such as posting them on your website, or by phone or email when offering appointment reminders. Share some of the tips provided below with your patients to safeguard their health information during telehealth sessions. During Telehealth Sessions  Always use a private space and limit the number of people who participate in a session. For providers, this means only permitting personnel directly involved in the patient’s care and individuals the patient permits to participate in the session. Secure private room from which you are conducting telehealth sessions (e.g., close the door and post a sign outside the door, indicating unauthorized individuals should not enter while your session is underway). We recommend to use headsets and limit audio being heard by others and position screens out of the line of sight of others. Enable all available encryption and privacy modes when using telehealth applications and notify patients that these third-party applications could potentially introduce privacy risks if the procedures are not followed. Limit the information requested to what is necessary to treat the patient. Don’t forget to sign out of or close applications and turn off all microphones, cameras, and monitors once the telehealth session is complete. Additional Practices Run updates for equipment and applications as soon as they are available, to take advantage of the latest security capabilities. Secure any notes, written materials, electronic devices, and storage media when not conducting patient sessions. Avoid saving patient data on personal or shared devices and implement device authentication measures. Use applications that maintain records of patient interactions  during each session. This will be important to address any future concerns regarding accessing records and managing privacy or security breaches. Immediately report a privacy or security breach, using your existing procedures for doing so if any patient information is lost, accessed, or disclosed inappropriately while scheduling, facilitating, or conducting a telehealth session. FOR PATIENTS Before Telehealth Sessions Be aware of updated privacy and security practices from your healthcare provider. Contact your healthcare provider with any questions or concerns you have about the privacy and security of the information shared during your telehealth session. During Telehealth Sessions Pick a private location. Hold your telehealth session in a location away from others, such as a room with a door so that you can control who hears your conversation. Secure your device. Follow your healthcare provider’s instructions for securing the device that you use for your telehealth session. Log out of your telehealth session when you are done. Remove unnecessary items. Before beginning a conversation with your healthcare provider, make sure you remove items that are not needed to discuss your health concerns. Technology devices such as home security cameras, voice assistants, or other devices you are not using to contact your healthcare provider should be removed to make sure they do not capture potentially sensitive information. Control your background. Be aware of what will be displayed in the background during a video call and remove any personal information you do not want to share.

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HKDU⠀
2021-04-26

香港西醫工會呼籲 領展高層立即採取行動 助屋邨醫生診所租戶解困 | Urge Link Management for Prompt Measures To Help Link Estate Clinic Doctors

新聞稿  香港西醫工會呼籲 領展高層立即採取行動 助屋邨醫生診所租戶解困   二零二一年四月二十六日 致新聞界朋友們:   「香港西醫工會」前身是「新邨西醫協會」,用以協調房屋處轄下公共屋邨醫生診所的安排。為了進一步投入社區服務及照應全港醫生, 於2002 年演變為「香港西醫工會」。屋邨醫生是每一個邨的開荒牛,照顧邨內居民的身心靈健康。我們不是生意人,只是一羣有德有心的醫生,收取相宜的診費來救急扶貧疾,有些醫生甚至贈醫施藥。   因百年一遇的疫症,香港現正面臨極嚴峻的挑戰 —— 經濟懸崖式下滑和失業率高企在7個百分點,為最近17年前所未有。   當屋邨醫生會員知會西工會有關領展最近加租的行徑,我們甚為震怒,舉例如下:   1)東涌富東邨醫生 (其生意懸崖式下滑,最高峰月入跌多過8成,而平均月入跌至5成。原因是富東邨商場鄰近東涌港鐡站,在2019 下半年社會和機埸暴動期間,常被要求關閉,再加上2020 世紀疫症的影響,大家有目共睹。最近港龍解散,而國泰和其他空運行業亦減人手和工資,對醫生來說尤如雪上加霜,因富東邨居民大多從事有關機場和空運行業,但領展竟要求加28.57% 之月租!)   2)上水屋邨醫生(其租約在5月期滿,不肯減租,只推説可能凍租,並不鼓勵醫生租客和上司商討。該醫生指出,因沒有大陸來客 ,上水市集變得冷清,有很多空置店舖,整體租金都下滑了。惟他現在付的租金高達每方呎$60,而附近上水廣場和上水滙的辦公室租金為每方呎$25 至$28。)   以上例子只是冰山一角,屋邨醫生會員現面對前所未有的巨大挑戰, 比2003 年 SARS 更甚 。租金一向是醫生診所最大的支出項目,而屋邨醫生對一向高企的服務費 (如管理費和冷氣費)無從過問,只能屈從。屋邨居民均來自中下層,在世紀疫症的影響下,很多都沒有工作或只能半工作了。   在此, 香港西醫工會鄭重要求領展高層能承擔企業社會責任 ,助屋邨醫生和居民共渡難關。   如有關資料查詢,敬請聯絡香港西醫工會電話2388 2728。   香港西醫工會會長 梁漢輝醫生 香港西醫工會領展屋邨診所委員會主席 林偉樑醫生 Press Release Urge Link Management for Prompt Measures To Help Link Estate Clinic Doctors   26th April 2021 Dear Correspondents,   Hong Kong Doctors Union (HKDU) is formerly known as Estate Doctors Association which dealt with allocation of medical clinics of public housing estates owned by Housing Department of Hong Kong. We changed our name to HKDU in 2002 as we wished to look after the affairs of the people and doctors of Hong Kong. Estate clinic doctors are the pioneers of their estates and look after the well beings (bio-psycho-social) of their estate residents. We are not businessmen, just hardworking doctors who endeavour to maintain a good standard of medical practice and charge residents at an affordable price. We are most shocked to learn from our Link Estate Clinic Members about their recent rental situation, given the current cliff like drop economy and record high unemployment rate (7.2 %) of Hong Kong. For instance: a) case of One Fu Tung Estate doctor (business dropped sharply since riot mob in the second half of 2019 as the Estate is close to HKIA & Tung Chung MTR station and severe COVID pandemic in 2020. With closure of DragonAir and the staff cuts (numbers and wages) of Cathay Pacific Airways and other related aviation/airport industries, most residents of Fu Tung Estate have now become redundant. The business drop is literally speaking, like falling frost on the land of ice and snow. Still Link asks for a 28.57% rental rise! b) Case of One Sheung Shui doctor (lease would be expired in 5/2021. Junior staffs refuse reduction and say that it maybe freeze and that there is no need to go to senior level). This doctor also points out that there are now many empty shops in the town of Sheung Shui because there are no mainlanders. All rentals are on the fall not only for clinics but all other trades. He is already paying a high rental at $60 psf whilst office rental in the nearby Landmark North/Sheung Shui Spot ranges from $25 to $28 psf only.   The above two cases are just tip of iceberg. Our members are facing a tough challenge they have never had before, even worse than 2003 SARS period. Rental is the largest expense item of a medical clinic. Estate doctors have no say over the ever rising service fees (management fees and air conditioning charges). Estate residents come from low income class. A lot of them have now become semi-employed or unemployed due to the Covid pandemic.   Now we urge Link Management to take up corporate social responsibility to help Estate doctors and residents weather the storm.   For enquiries, please contact HKDU at 2388 2728.   Dr LEUNG Hon Fai (President, HKDU) Dr LAM Wai Leung Anthony (Chairman, Link Estate clinic Committee, HKDU)

HKDU⠀
2020-07-31

2019新冠狀病毒病疫情第三波爆發的新聞稿 家居治療和餐飲安排 | Press statement in the midst of COVID-19 Third Wave in Hong Kong Home treatment and dining arrangement

新聞稿 2019新冠狀病毒病疫情第三波爆發的新聞稿 家居治療和餐飲安排   二零二零年七月三十一日 致新聞界朋友們: 香港西醫工會是唯一一個向職工局註冊處註冊並為公營及私營醫生提供服務的工會,以維護醫生在僱主僱員關係中的權益,香港西醫工會秉承為醫生提供不同的延續醫學進修活動,以維持和確保醫生提供最高水平的醫療服務及提升香港市民的健康。 隨著全球2019新冠狀病毒疫情爆發大流行,香港也不例外。我們感激我們的醫學專家所做的一切 ,但對於政府官員的措施及干預的努力就不敢苟同。 政府最近實施在限制餐廳、食店堂食等的措施,便是另一種以隨意方式處理事務的例子,就像放寬跨境人流限制和豁免某類別人士進入香港境內而無需隔離的那樣。 我們很遺憾地從新聞報導中得知,辛勤工作的建築工地工人,清潔工人等不得不以一種混亂的方式在狹窄的地方吃飯,這引來全世界的批評及嘲笑。另一方面,這種飲食行為實在會增加市民在炎熱天氣下中暑等健康問題,並且還會增加新冠狀病毒交叉感染的機會,而無法追踪接觸者,從而使香港的狀況每況愈下。若港府考慮開放其公共場所供工人用餐,那麼一旦爆發疫情,這將會再成為全世界的笑柄。 我們建議採用一種更好的管制方法,限制所有餐廳食肆為一人一桌,每枱餐桌需隔1.5米,禁止用膳時說話,將進餐時間限制在30分鐘以內。借助目前在餐廳食肆中實行的預防和消毒措施,這肯定會達到減少交叉感染的機會。 我們的私人執業醫生一直在與政府合作,要求有症狀的病人接受新型冠狀病毒深喉唾液核酸測試。然而,最近等候檢測結果時間越來越長,一般超過10天。此外,新型冠狀病毒確診病人等候入院的時間甚至更長,需等候接近一周。我們認為這種延誤是完全無法接受的,這正正是把確診病人推向死亡。到目前為止從治療新型冠狀病毒病人的資料中,我們察覺到早期接受治療的病人完全康復的機會較高。因此在診斷新型冠狀病毒病人的第一周內,我們必須好好把握治療病人的機會。鑑於目前延誤入院的現狀以及在家居條件允許的情況下,香港西醫工會支持“對新型冠狀病毒檢測呈陽性的病人進行家居隔離,及家居治療”的建議,作為入院前的臨時醫療措施,以減低病人的痛苦並減少新型冠狀病毒在家居傳播。我們得到公共醫生,社區護士,社區藥劑師,病人組織以及其他相關醫務人員的全力支持,以挽救新型冠狀病毒病人。  有關查詢,請致電9013 6478 聯絡香港西醫工會會長楊超發醫生。   Press Release Press statement in the midst of COVID-19  Third Wave in Hong Kong Home treatment and dining arrangement 31 July 2020 Dear Reporters,   Hong Kong Doctors Union (HKDU) is a unique trade union with doctor members in both public and private services. Registered with the Trade Union Registry to look after the interests and rights of doctors in their employer employee relationship, HKDU is committed to provide Continuing Medical Education for doctors to maintain and ensure the highest standard of the healthcare doctors to cater for the health of the Hong Kong community. With the explosion of COVID-19 pandemic around the world, Hong Kong is no exception to share the horrific consequences. We appreciate the efforts offered by our medical experts so far but not quite those by our Government officials. The lately imposed measure of restriction of dining inside restaurants by the Government is another example of handling matter in a haphazard manner just like that of loosening border restrictions and exempting certain groups of people entering Hong Kong from quarantine. From news reporting, we are sorry to learn that the hard-working construction site workers, cleaners, etc have to find their ways to consume their meals in such a chaotic manner that invites criticism from all directions. On the other hand, such eating behaviour would increase health hazards like heat stroke in this hot summer weather and also the chance of cross-infection of COVID-19 with untraceable contacts resulting in a more dangerous situation in Hong Kong. If the Government considers opening their public places for workers to take meals, it would turn out to be a laughing stock if there is an outbreak. We would suggest a better method of restricting restaurant service to: ONE PERSON ONE TABLE WITH TABLES 1.5 METRE APART, prohibition of talking during meals, limited meal time to less than 30 mins. With the presently practiced preventive and disinfection measures at restaurants, these will surely serve the purpose of further minimizing cross-infection. We, doctors in private practice, have been cooperating with the Government by asking patients with symptoms to undergo the COVID-19 PRC tests. However, the time for test results to return is getting longer and longer to more than 10 days recently. Furthermore, the waiting time for confirmed COVID patients is also getting longer to nearly one week. We find such delay IS TOTALLY UNACCEPTABLE AND IS PUSHING COVID SUFFERERS TO DEMISE. From the evidence on treating COVID patients so far, we have found that early treatment would lead to a better chance for the patients to recover completely. We have to grasp the golden opportunity of treating COVID patients within the first week of diagnosis. As such, in view of the present situation of delay in hospitalization and if household condition allows, HONG KONG DOCTORS UNION supports the idea of HOME ISOLATION, HOME TREATMENT for COVID TEST positive patients as an interim medical measure before hospital admission to decrease the patient’s sufferings and to minimize the spread of COVID within the household. We shall work with public doctors, community nurses, community pharmacists, patients’ organizations, and other allied health personnel in this endeavour to save COVID patients.   For enquiries, please contact Dr. Yeung Chiu Fat, President, HKDU at 90136478.  

HKDU⠀
2020-05-04

香港西醫工會呼籲地產商立即採取措施,幫助私人診所的租戶 | Call Upon Estate Tycoons for Immediate Measures To Help Private Clinic Tenants

香港西醫工會呼籲 地產商立即採取措施,幫助私人診所的租戶   二零二零年五月四日 致新聞界朋友們:     香港西醫工會是唯一一個向職工局註冊處註冊並為公營及私營醫生提供服務的工會,以維護醫生在僱主僱員關係中的權益,香港西醫工會秉承為醫生提供不同的延續醫學進修活動,以維持和確保醫生提供最高水平的醫療服務及提升香港市民的健康。   當前的新型冠狀病毒肺炎(COVID-19)疫症大流行,已對香港許多中小企業的業務產生了不利影響,屋邨的私人診所也不例外。隨著大流行的發展導致實行封閉邊界和社區隔離,我們在公共和私營屋邨的私人診所的業務下降了7成至9成,一些同事面臨每月的淨虧損為港元十萬至港元二十萬和即將關閉的威脅。我們知道房委會和房屋協會自2019年10月以來暫時降低了他們的房地產診所的租金。但是,領匯似乎根本沒有降低其所有屋邨診所的租金。取而代之的是,他們堅持在本月租期屆滿後,將天水圍的一家屋邨診所的租金提高1成。   私家醫生在屋邨診所內給病人測試病毒,與政府一齊對抗COVID-19 疫情。因此,我們為診所的操作配備了完整的個人防護設備,每月花費約10,000港元的額外診所費用。   與17年前的SARS時期一樣,本會已於2020年3月13日要求領展降低租金。我們已經告訴領展關於在與COVID-19的戰鬥中處於最前線的屋邨醫生的業務損失。我們對於領展的管理層的態度感到失望。我們從報章中得悉,領展已經建立了所謂的“領展商戶同舟計劃”。但是,領展從未告知我們所有作為租戶的醫生會員這個計劃的存在,更不用說申請程序和批准標準了。   我們的會員面臨著前所未有的巨大挑戰,甚至比2003年SARS時期還要糟糕。租金是私人診所最大的支出項目。地產大亨應承擔企業社會責任,以分擔當前危機的不利影響。我們希望他們,尤其是領展,能夠立即採取真正的措施,以幫助我們的會員繼續為屋邨居民提供服務。   在此,香港西醫工會重申要求地產商,包括領展 : (1) 停止進一步增加租金一年。 (2) 為所有屋邨診所租戶暫時減租50%,為期6個月。   有關查詢,請致電9013 6478 聯絡香港西醫工會會長楊超發醫生。   Press Release Call Upon Estate Tycoons for Immediate Measures  To Help Private Clinic Tenants   4 May 2020 Dear Reporters, Hong Kong Doctors Union (HKDU) is an unique trade union with doctor members in both public and private services. Registered with the Trade Union Registry to look after the interests and rights of doctors in their employer employee relationship, HKDU is committed to provide Continuing Medical Education for doctors to maintain and ensure the highest standard of the healthcare doctors to cater for the health of the Hong Kong community. The current COVID-19 Pandemic has been adversely affecting many businesses in Hong Kong. Private clinics in public and private housing estates are no exception. With the evolution of the pandemic leading to the implementation of Closing Borders and Social Distancing, the business of our private clinics in public and private housing estates has dropped by 70 to 90 % and some colleagues are facing a net loss of HK$ 100,000 to 200,000 per month and the imminent threat of closing down. We note that the Housing Authority and Housing Society have temporarily lowered the rent of their estate clinics since Oct 2019.  However, none of our LINK estate clinic tenant members has reported that his/her rent has been temporarily lowered by any amount at all. Instead, LINK insists to raise the rental by 10% for an estate clinic in Tin Shui Wai upon its tenancy expiry this month.     We, private doctors, have to fight with the Government against the COVID-19 by containing the virus through vigilant detection. As such, we have equipped full PPE for our clinic operations which cost additional clinic expenses around HK$ 10,000 per month.  Our Union has asked LINK on rental reduction on 13th March 2020 as in the period of SARS 17 years ago. We have told LINK about the loss of business of public estate doctors who are in the frontline in this battle with COVID-19. We are disappointed with the LINK on the attitude of her management. We note from the media that the Link has established a so-called ‘Support Scheme for Small and Medium-sized Tenants’. However, none of all our member doctors, who are tenant doctors, has ever been informed by Link about the existence of such a scheme, let alone the application procedure and approval criteria. Our members are facing a big challenge they have never had before, even worse than the SARS time during 2003. Rent is the biggest expense item of a private clinic. Estate Tycoons should take their corporate social responsibility to share the adverse impact of the current crisis. We hope they, particularly LINK, would take immediate and genuine measures to help our members to continue providing services to estate residents. HKDU hereby calls upon Estate Tycoons, including Link to   (1) Stop further increase rental for one year. (2) Reduce rent by 50% temporarily for six months for all its estate clinics. For enquiries, please contact Dr. Yeung Chiu Fat, President, HKDU at 90136478.  

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2020-02-09

Flu Express (Week 43)

流感速遞 流感速遞是由衞生防護中心傳染病處監測科每星期出版有關監測本地及世界各地的流行性感冒流行情況的總結報告。 本地流感流行情況 (截至2019年10月30日) 報告周期:2019年10月20至26日(第43周) &nbsp;  本地季節性流感的整體活躍程度處於低水平。最新監測數據顯示,呼吸道樣本中檢測到季節性流感病毒的百分比和公立醫院流感相關入院率均維持在基線水平以下。  流感樣疾病爆發個案維持在低水平。在過去四周,流感樣疾病爆發個案主要在小學(10)發生,其次為幼稚園/幼兒中心(6)、安老院舍(1)和殘疾人士院舍(1)。  2019/20 年度季節性流感疫苗接種計劃中的「疫苗資助計劃」及「政府防疫注射計劃」已分別於10月9日及23日展開。在2019/20 年度,「疫苗資助計劃」會繼續為六個月至未滿十二歲兒童、50歲或以上人士、孕婦、智障人士及領取傷殘津貼人士提供資助接種流感疫苗。在「政府防疫注射計劃」下,免費接種流感疫苗的合資格組別亦與2018/19年度相同。而「院舍防疫注射計劃」下的季節性流感疫苗接種服務已擴展至所有留宿幼兒中心。季節性流感疫苗學校外展已經恆常化,給所有小學參加,及以先導模式擴展到幼稚園、幼兒中心及幼稚園暨幼兒中心。有關詳情請瀏覽網頁 (http://www.chp.gov.hk/tc/view_content/17980.html)。 定點普通科診所及私家醫生的流感樣病例監測,2015-19 在第43周,定點普通科診所呈報的流感樣病例平均比率是5.2宗(每千個診症計),高於前一周的3.3宗(圖一左)。定點私家醫生呈報的流感樣病例平均比率是27.2宗(每千個診症計),低於前一周的29.4宗(圖一右)。 &nbsp; 圖一 圖二 &nbsp; 圖一 定點普通科診所及私家醫生(圖二)的流感樣病例求診率,2015-19 &nbsp; 實驗室監測,2015-19 在第43周所收集的呼吸道樣本中,季節性流感病毒陽性百分比為1.73%,低於10.3%的基線水平,及高於前一周錄得的1.47%(圖二)。上周檢測到的82株季節性流感病毒包括53株(65%)甲型(H1)流感、19株(23%)甲型(H3)流感、9株(11%)乙型流感及1株(1%)丙型流感。 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 流感樣疾病爆發監測,2015-19 在第43周,本中心錄得9宗在學校/院舍發生的流感樣疾病爆發的報告(共影響55人),對比前一周錄得4宗爆發報告(共影響26人)(圖三)。第44周的首4天(10月27至30日)有4宗在學校/院舍發生的流感樣疾病爆發的報告(共影響17人)。 &nbsp; &nbsp; &nbsp; 公立醫院出院診斷為流感的入院率,2015-19 在第43周,整體公立醫院主要診斷為流感的入院率為0.03(每一萬人口計),低於0.23的基線水平,及低於前一周錄得的0.04。0-5歲、6-11歲、12-17歲、18-49歲、50-64歲及65歲或以上人士在公立醫院主要診斷為流感的入院率分別為0.27、0.11、0.03、0.01、0.02和0.03宗(該年齡組別每一萬人口計),對比前一周的0.27、0.03、0.03、0.01、0.04和0.05宗(圖四)。 &nbsp; &nbsp; &nbsp; 甲型(H1N1)pdm09流感病毒對奧司他韋呈抗藥性個案的監測  第43周及第44周的首4天(10月27至30日)均沒有新增甲型(H1N1)pdm09流感病毒對奧司他韋(特敏福)呈抗藥性個案。自2009年至今,本港共有48宗甲型(H1N1)pdm09流感病毒對奧司他韋出現抗藥性的個案。 世界各地的流感流行情況 北半球溫帶地區大部分國家的流感活躍程度維持在非季節水平。在南亞地區,有流感報告國家的流感活躍程度均處於低水平。在東南亞地區,老撾和菲律賓的流感活躍程度在最近數周有所上升。在南半球溫帶地區,大部分國家的流感活躍程度均處於低水平,而智利繼續檢測到乙型流感。全球的流感檢測中,儘管乙型流感病毒比例在最近數周有所上升,甲型流感病毒仍繼續佔大部分。  在美國,流感活躍程度輕微上升,但在仍處於低水平。流感樣病例求診比率為1.7%,低於2.4%的基線水平。流感病毒檢測陽性百分比為2.4%,低於前一周水平(截至2019年10月19日的一周)。  在加拿大,流感活躍程度維持在非季節性水平。流感病毒檢測陽性百分比在第42周為1.9%。最流行的流感病毒為甲型(H3N2)流感 (截至2019年10月19日的一周)。  在英國,所有流感活躍程度指標均低於基線水平。流感陽性百分比為2.2%,低於9.7%的基線水平。最多檢測到的流感病毒為甲型(H3)流感 (截至2019年10月20日的一周)。  在歐洲,流感活躍程度處於低水平。在有呼吸道感染的求診病人中,有零星的樣本檢驗出流感病毒。檢測出的流感病毒有甲型和乙型流感(截至2019年10月20日的一周)。  在中國內地,南北方省份流感活躍程度處於非流行季節水平。在南北方省份僅能檢測到少量甲型(H3N2)和乙型(維多利亞系)流感病毒(截至2019年 10月20日的一周)。  在澳門,流感樣病例和流感病毒陽性檢測呈上升趨勢。最流行的流感病毒為甲型(H3)流感(截至2019年 10月19日的一周)。  在台灣,流感疫情略降,並低於流行閾值。最近四週社區以甲型(H1N1)流感病毒為主(佔82.8%)(截至2019年 10月19日的一周)。  在日本,定點監測單位呈報的流感樣疾病平均數目由前一周的0.90下降至上周的0.72,低於基線水平。在過去五周,最多檢測到的流感病毒為甲型(H1)pdm09流感 (90%),其次是甲型(H3)流感(5%)和乙型流感(5%) (截至2019年10月20日的一周)。  在韓國,每周流感樣病例求診比率為4.6,高於前一周的4.2。流感陽性百分比為3.4%,而主要檢測到的流感病毒為甲型(H1)pdm09流感(截至2019年10月19日的一周)。 &nbsp; 資料來源: 資料節錄自以下內容已更新之來源:世界衞生組織、美國疾病控制及預防中心、加拿大公共衞生局、英格蘭公共衞生局、歐洲疾病預防控制中心及世界衞生組織/歐洲流感資訊、中國國家流感中心、澳門特別行政區政府衞生局、台灣衛生福利部疾病管制署、日本厚生勞動省及韓國疾病預防控制中心。