RTHK Interview : Start Covid medicines even before hospitalisation

'Start Covid medicines even before hospitalisation'   The Hong Kong Doctors Union has called for early treatment for Covid-19 patients, saying they should be prescribed medication even before being admitted to hospital. The union’s president, Henry Yeung, made the comment as authorities said some 100 confirmed cases are still waiting to be admitted, with the public health system under great pressure. Yeung said timely treatment is essential in reducing the mortality rate associated with Covid-19. He told RTHK’s Priscilla Ng that it is important to prescribe patients with the right medication as soon as possible to reduce their viral load and ease their symptoms. “If we cannot admit the patient to hospital, why should he wait until he goes to the hospital to get the treatment? The doctors in the community can prescribe the drugs for the patients to take inside his home and the patient can be visited by the community doctor either physically or by telemedicine. We have to get the patient to have early treatment to get the best results,” Yeung said. He added that treating patients early is also conducive to severing the transmission chain in their household and the community. “If you can give the early treatment, then we can decrease his viral load and decrease the chance of cross-infection in the community,” he added. A top microbiologist from the University of Hong Kong, Ho Pak-leung, also told an RTHK programme that the situation is “far from ideal”, saying the long wait could lead to delayed treatment and could greatly increase the risk of cross-infection. His comment was echoed by a Sha Tin district councillor, Yau Man-chun, who told the same programme that an infected resident’s condition deteriorated significantly after having waited for more than three days before being taken to the hospital.   Click here for the recording


會長通訊:新辦公室需要您的幫助 | President's Message : New office needs your help

新辦公室需要您的幫助         自2020年2月以來,大家在社交距離方面的表現良好,我們減少在外消遣及聚餐的表現良好,包括通過暫停本會的所有非必要的社交活動。正因如此,香港是抗擊2019冠狀病毒病的主要成功的地區之一。無論如何,即使我們沒有遇到任何患有冠狀病毒疾病的病人,我們也已經對該病毒有深入了解。對不對?   本會一直努力通過延續醫學進修網絡研討會向大家提供有關2019冠狀病毒病和其他疾病的最新醫學資訊。自2020年4月1日以來,截至2020年7月11日,本會已組織了33個日間及晚上的延續醫學進修網絡研討會和面書直播延續醫學進修,並且將會舉辦更多。本會除了加強引入ZOOM網絡研討會和面書直播延續醫學進修的軟件和硬件外,我們還要感謝網絡研討會的演講嘉賓,主持醫生,延續醫學進修委員會和本會工作人員的辛勤工作,他們大部分時間不得不離開工會辦公室前往以外其他場所設置網絡研討會。我們可以 肯定,隨著時間的流逝,即使最終2019冠狀病毒病受到控制,為了方便大家參與醫學進修,本會仍會繼續舉辦網上直播的延續醫學進修研討會。我深信製藥公司將十分樂意在這方面繼續支持我們。   除了舉辦網絡研討會之外,建立香港西醫工會的電子藥品平台是本會近來第二重要的活動。我們已於2018年12月就該平台計劃與Vital Base International Limited簽署了協議。我們對平台的製作及設計已經花費了超過一年的時間。特別感謝資訊科技委員會的鄧權恩醫生及鄧偉材醫生的辛勤工作,我們已經獲得了多家製藥公司的讚助,該項目將於不久將來啟動。上述的電子藥品平台是本會的一個網站,其中包含有關藥物研究和產品,處方藥物和診斷工具方面的最新進展的文章及更新。我們希望這能加快您們對藥物知識的了解,並以此方式幫助您和您的病人一起治理疾病。在建立此電子藥品平台時,包含延續醫學進修資訊,延續醫學進修視頻,註冊醫生名單也將會更新。當然,在適當的時間,您們會收到登入的詳細信息和通知。   我已經在前面提到,由於本會辦公室的空間不足,我們需要在辦公室以外的場所舉行網絡研討會。現在我想提及西醫工會的另一項活動,而這活動已經進行了13年,即是由我們的道德科研委員會批核並進行的臨床研究。到目前為止,我們已批核及跟進了32項第二階段和第三階段來自私營機構主要研究人員的研究。相關研究包括骨質疏鬆症,心臟病和各種癌症中的藥物使用等問題,這些研究對於我們未來預防和管理此類疾病至關重要。我了解到,為了符合美國食品藥品監督管理局的標準,委員會將研究的文件、患者的同意書、不良反應報告、接受研究的患者的結果及研究報告的文件等…必須保留在整個研究過程中以及結束後至少3年。隨著愈來愈多的研究和其他的辦公室記錄,本會現在應該探討新的儲藏空間。在最近的幹事會會議上我們提出並討論了此問題。為了增加辦公室空間,我們得出了以下兩個選擇。   1. 選擇一: 是在我們現有辦公室以外租用一些存儲空間來存儲文件記錄; 2. 選擇二: 是租用一個更大的辦公室,以存儲所有研究記錄文件,並組織更多新活動,例如我剛才提到的網絡研討會。   無論那一個選擇,我們必須在租金上花費更多的金錢。幹事會已經研究了這兩個選擇的利弊,並決定採用選擇二 — 即是租用更大的辦公室,預計會員亦會為此感到自豪與榮幸。   本會更成立了新辦公室特別工作小組,並由本人擔任主席去處理新辦公室的事宜。新辦公室確實需要額外的財務資源,我們將非常感謝您的慷慨捐助。新辦公室特別工作組將很快制定有關捐贈方法及表揚方式。我希望你們每個人都能以一種或多種方法為我們的新辦公室作出貢獻。畢竟,我們的辦公室會為所有會員開放。我敢肯定,當您最近來收集口罩時,你們當中的大多數人都明白我們現有辦公室的空間不足。非常感謝您的關注和慷慨。   楊超發醫生     New office needs your help   Since February 2020, we have behaved well in social distancing. We have behaved well by eating less and spending less outside. We have behaved well by stopping all non-essential social contacts including Union activities. As such, Hong Kong is among the top areas in combating the COVID-19 coronavirus. Anyway, even we have not encountered any patient suffering from coronavirus disease, we know a lot about the virus already. Don’t you? We have been struggling hard to bring to you the new medical news on COVID-19 and other diseases through e-Live CMEs. Since April 1, 2020, we have organized a total of 33 Webinars and Facebook Live CMEs, day and night up to 11 July, 2020, and there are more to come. Apart from strengthening the standard of software and hardware for bringing in the ZOOM Webinars and Facebook Live CMEs, we are indebted to the hard work of our webinar speakers, moderators, our CME committee and Union staff who had to travel out of the Union office most of the time to other venues in town for setting up the Webinars. We are certain that with the passage of time and even when the COVID-19 is under control eventually, e-Live CMEs would still be organized in the future for the convenience that we all have experienced. I am sure the pharmaceutical companies would be most happy to continue to support us in this regard.   Apart from holding Webinars, the second most important activity of our Union recently is the setting up of an e-Pharm platform. We have signed a collaboration plan with the Vital Base International Limited for setting the platform in December 2018. We have worked on the design and set up for more than a year. Thanks to the hard work of both Drs. Tang Kuen Yan and Tang Wai Choi of our Information Technology Committee, we have secured sponsors from various drug firms, and the project will be launched soon. The e-Pharm platform as said is a website with articles and updates on advances in pharmaceutical research and products, prescribing aids, and diagnostic tools. We hope that would speed up your updates in the knowledge of pharmaceuticals and in such a way help you and your patients together in the management of their illnesses. At the time of setting up of this e-Pharm platform, our union website embracing CME facilities, CME videos, Doctors’ directory will be updated as well. Of course, you will be informed of your login details when the time comes. I have mentioned previously that we need to hold the webinars in other venues in town as there is not enough space in our Union office. I would like to mention another Union activity which has been going on for 13 years, i.e., the approval and follow up of clinical studies by our Ethics Research Committee. We have so far approved and been continuously monitoring a total of 32 Phase 2 and Phase 3 research studies with Principal Investigators mostly from practitioners in the private sector. Research studies include topics like drug usage in osteoporosis, heart diseases, and various cancers which by and large are important to our future endeavors in preventing and managing such diseases. I was given to understand that in order to meet the criteria of U.S. Food and Drug Administration, the documents of the research plans, patient consent forms, reports of adverse reactions, the outcome of patients under study, Research study reports, etc .. should have to be kept in our office throughout the period of studies and at least for another 3 more years after completion of studies. As the piles of study materials and other records of the Union are getting higher and higher, it is about time for the Union to explore new spaces for storage. This issue was brought up and discussed in our recent Council Meeting. To increase office space, we are left with the following 2 options. 1. Option one is to rent some storage space outside our existing office for storage of records; 2. Option two is to rent a bigger office for the Union to cater for the storage of all the records of research studies and for organizing newer and other activities of the Union like the Webinars that I have just mentioned. By both options, we have to spend more money on the rentals. The council has worked out the pros and cons of the two options and has decided on Option two to rent a bigger office space which is predicted to be more fruitful and prestige to our members. A new Taskforce on New Premises was set up to look into the matters of the New Premises with myself as Chairman. As additional financial resources are indeed necessary, we would be most grateful for your generous donations. The format of donations and means of recognition would be worked out and rolled out by the Taskforce soon. I hope that each one of you can contribute to our new office in one way or the other. After all, our office is open to all our members. I am sure most of you are aware of the inadequate space of our present office when you come up to collect masks yourself recently. Many thanks for your attention and generosity.   Dr. Yeung Chiu Fat Henry


會長通訊:有關援助及延續醫學進修活動 | President's Message :All about relief and CME

有關援助及延續醫學進修活動     繼香港西醫工會於二零二零年五月四日發布“呼籲地產商立即採取措施,幫助私家診所的租戶”的新聞稿(請參閱本會訊第10-11頁)後,於二零二零年五月八日的下午,我們與領展物業有限公司的管理層舉行了一次ZOOM特別會議。本會幹事會代表,包括江炎輝醫生、陳培光醫生,我本人,以及在領展物業有限公司執業的三名會員出席了會議。領展物業有限公司代表則是其租務助理總經理張先生、租務經理黃先生、公司事務總經理溫先生及公司事務高級經理陳先生。   在會議上,我們詳述了我們會員,包括在領展轄下的屋邨診所執業的醫生的困難。我們再次詳細說明自今年二月以來的疫症大流行期間,屋邨診所的營業額大幅下降七至九成。並重申我們願意通過為診所配備適當的個人防護設備來幫助社區抗擊二零一九年冠狀病毒,而這亦花費不少。一些參會會員抱怨領展徵收高管理費,但換來的日常管理的標準則每況愈下。   領展答覆說,他們會考慮到二零一九年冠狀病毒大流行期間的因素而降低診所租戶的租金,唯一的條件是,診所租戶的醫生需提供在此期間診所業務下降了至少三成的數據。實際上,他們需要其診所租戶醫生向他們提供在過去二十四個月的每月總收入,然後才能計算在該困難時期能為他們提供的租金寬減幅度。   在會議期間,我們還要求領展管理層在今年內不要對續約的醫生加租。至少在會議後,我們立即知道,本會在新聞稿中提及一間天水圍的診所租金擬增加一成的事宜,並沒有兌現。對於那些在領展下執業的醫生來說,這是個好消息。   我們希望在領展執業的所有診所租戶醫生在二零一九年冠狀病毒大流行期間而面臨嚴重的業務下滑時,都申請租金寬減。我們已與領展一起制定指引(請參閱本會訊第11頁)為有興趣申請的會員提供協助,以簡化程序並加快審批速度。我們希望申請租金寬減的會員能夠在兩個月內收到領展的回覆。如果您認為需要減少租金,請盡快進行。此外,我強烈建議您通過電子郵件hkdumail@gmai l.com通知本會有關您的申請(無需提供相關“資料”),以便我們與領展跟進你的情況。   在此大流行期間本會通過ZOOM及面書直播舉辦的延續醫學進修網絡研討會得到成功且受到各會員的支持,本會會在六月繼續組織更多的實時網上延續醫學進修活動。請各會員仔細閱讀本會訊第6頁上六月至七月份網上延續醫學進修活動的時間表。   由於政府將於二零二零年六月宣布停止限聚令及其措施,因此,我們於瑪嘉烈醫院舉行的週日下午研討會將在二零二零年七月再次開辦,有關細節將盡快宣布。對於已購買我們瑪嘉烈醫院週日下午研討會一年期延續醫學進修活動計劃的醫 生,由於自二零二零年二月以來本會的週日下午研討會已停止了五個月,因此幹事會決定將一年期延續醫學進修活動計劃的有效期延長至二零二一年六月。有關詳細資料,請致電秘書處2388 2728。   我收到了一些會員的查詢,他們希望得到有關申請防疫抗疫基金,保就業計劃(ESS)的申請詳情及幫助。我實際上已經親自申請了ESS,發現申請過程亦相當簡易。申請網址為,申請日期為二零二零年五月二十五日至二零二零年六月十四日(包括首尾兩天)。如果申請成功,則可以在二零二零年六月獲得資助。在網上申請之前,必須準備最新銀行月結單的檔案(pdf/ jpg)以供上載,商業登記證編號,強積金受託人姓名,強積金名稱、計劃、僱主參與編號及其他相關資料。我的會計師建議我選用於二零十九年十二月至二零二零年三月期間診所工作人員薪金最高的月份提交。為此我花費了兩分鐘於網上完成申請,我相信您會比我更快完成申請。祝各位一切順利。   楊超發醫生     All about relief and CME   Subsequent to the release of the HKDU Press Statement on the topic of “Call Upon Estate Tycoons for Immediate Measures To Help Private Clinic Tenants” on 4th May 2020 (Please see page 10-11 of this Bulletin), we held a special meeting with the LINK management in the afternoon on 8th May 2020 by ZOOM. HKDU council representatives, including Drs. Kong Yim Fai Albert, Chan Pui Kwong and myself, and 3 members practicing in LINK estates attended the meeting. The LINK representatives are Claudio Cheung, Assistant General Manager of Leasing Department of LINK, Sampson Wong, Manager of Leasing Department of LINK, YC Wan, General Manager of Corporate Affairs of LINK and Patrick Chan, Senior Manager of Corporate Affairs of LINK.   During the meeting, we stated the difficulties of our members practicing in estate clinics including those under LINK. We elaborated once more on the severe drop of 70 to 90% of business turn over in estate clinics in this Pandemic period since February this year. We reiterated our readiness to help the community to fight against the COVID-19 by fully equipping our clinics with appropriate PPE which costed money. Some of the members in the meeting complained on the high management fee but with poor standard of management of the estates in return. LINK replied that they would consider rental reduction for clinic tenants in this COVID-19 pandemic on ONE AND ONLY ONE CONDITION that when there are figures showing drop of business of at least 30% in the estate clinics during this Pandemic period. In fact, they need estate doctors to present to them monthly gross income in the past 24 months before they would look into figures to calculate how much reduction that they would offer to help estate doctors in this difficult period.   During the meeting, we have also asked the LINK management not to increase clinic rental for those doctors on renewal within this year. At least we knew immediately after the meeting that what we quoted the intended 10% increase in one estate clinic rental in Tin Shui Wan in the press statement was not realized subsequently. I think this is good news for those doctors practicing under LINK. We hope that every estate doctor practicing under LINK should apply for rental reduction if they face the severe drop of business in this period due to COVID-19 pandemic. We have worked with the LINK on the following steps (Please refer to Page 11 of this Bulletin) for those interested members to follow so as to streamline the application procedures and expedite approval. We hope that members who apply for rental relief will get reply from LINK within 2 months. Please do go ahead as soon as possible.if you feel you need the rental reduction. Furthermore, you are strongly advised to report your application (No need for THE INFORMATION) to the Union by email to so that we can follow up your case with the LINK.   Building on the successful and strongly supported presentations of live e-CMEs through ZOOM Webinars and Facebook live during this Pandemic period, we are encouraged to continue organizing more live e-CMEs in June. Please find the scheduled time table for live e-CMEs for June and July on page 6 of this Bulletin for your perusal. As the Government will announce to end gathering restriction measures in June 2020, our Princess Margaret Hospital Sunday Afternoon Symposium will start again in July 2020, details of which will be announced as soon as possible. For our HKDU one-year CME package subscriber for PMH Sunday Afternoon Symposia, since we have stopped the symposia for 5 months since February 2020, our Council decided to extend the period of entitlement of free 12 symposia up to June 2021. Please ask our secretariat at 2388 2728 for details.   I have received calls from members asking for help in application for Employment Support Scheme (ESS) offered by the Government through the Anti-Epidemic Fund. I have actually applied for the ESS myself and found the application process quite user friendly. The website for application is and the application dates are from 25th May 2020 to 14th June 2020 (all inclusive). If the application is successful, one can get the relief fund in June 2020. Before application in the web, one has to prepare a soft copy of the latest bank statement for upload, Business Registration certificate number, name of MPF Trustee, name of MPF Scheme, MPF participation number and other relevant information. My accountant advised me to choose the month with the highest figure of salaries of the clinic staffs from December 2019 to March 2020 to apply. As such, I have taken 2 minutes to complete the application in the web, I trust you may take less time than that. Wish you all the best. Dr. Yeung Chiu Fat Henry


會長通訊:新型冠狀病毒 IV | President's Message:WARS IV

新型冠狀病毒 IV       鑑於2019冠狀病毒病疫情大流行,所有常規的延續醫學進修活動將暫停,直到另行通知。 作為延續醫學進修活動的提供和執行機構,香港西醫工會一直積極透過各種方式提供延續醫學進修活動,鼓勵醫生會員參加並獲得延續醫學進修學分。 我們已於2020年3月向香港醫務委員會(醫委會)申請,為參加由香港西醫工會舉辦的網上直播延續醫學進修活動的醫生授予延續醫學進修學分。我們感謝醫委會迅速並令人鼓舞的的回覆,於2020年4月1日確認本會透過ZOOM和Facebook直播的延續醫學進修的認證資格並即時生效,這是我們通過共同努力而得到的成果。(醫委會的回覆請參閱本月刊第6頁)。從現在開始,我們將為會員提供更多網上直播延續醫學進修的學習機會。我們知道一些會員在參加這些網上直播延續醫學進修活動時會遇到困難,因此我們在前兩期的月刊中給會員分享了一些提示。我們在本月刊第7頁亦準備了一個專欄列出會員參加網上直播延續醫學進修活動時會遇到其他的問題及指引以供大家閱讀。請各會員參考一下,若您仍然在參與網上直播延續醫學進修時遇到困難,歡迎致電2388 2728與秘書處聯繫。 我於2020年4月10日上午9時40分左右在香港電台第1台就第二輪防疫抗疫基金發言。 首先我說我們感謝政府豁免三年的年度執業證書費,金額高達$1,350港元。然而,隨著2019冠狀病毒病疫情大流行的發展,封關和社區隔離的實施,我們私營診所的業務損失高達七成至九成,而一些同業每月更淨虧損$100,000至$200,000港元,並在倒閉的邊緣。我說過,我們已經於2020年3月4日與食物及衞生局交談,要求第二輪的防疫抗疫基金為醫生提供補貼,但徒勞無功。 第二,我還於香港電台第1台說過,我們私家醫生必須通過檢測來遏制該病毒,並與政府並肩對抗2019冠狀病毒病。因此,我們為診所配備了完整的個人防護裝備,每月費用約為$10,000港元,而這筆額外開支應透過政府補貼資助。我說過,政府至少對私家醫生的個人防護裝備補貼資助六個月,我們才會接受。 第三,我談到本會已要求領展減租,正如17年前的沙士時期一樣。我們已經跟領展提及有關在與2019冠狀病毒病的抗疫中處於最前線的公共屋邨醫生的業務損失。我們對領展的租務管理態度感到失望。 我們將盡快尋求其他大業主的幫助。 我也曾與食物及衞生局副局長徐德義醫生及食物及衞生局常任秘書長謝曼怡女士談過第二輪防疫抗疫基金處理強積金的問題。我想知道為何對於65歲以上的自僱在職醫生會存在歧視的問題,他們因無法像65歲以下的一般醫生參加強積金計劃而無法在第二輪防疫抗疫基金中受惠。他們答應會調查這個問題,並儘快給我們答覆。 在過去的兩個半月中,香港和全球在2019冠狀病毒病的抗疫中都遭受了沉重打擊。於2020年4月22日,香港的2019年冠狀病毒的新病例降至零,但現在還不是鬆懈自滿的時候,因為世界各地都在湧現新病例。根據微生物學家的說法,可能會出現第三波新冠病毒感染。 因此,為保護我們自己和市民,醫生同業們應在臨床工作場所使用適當的個人防護裝備保護自己,直到冠狀病毒結束。由於2019年冠狀病毒仍在流行,許多會員亦擔心患有慢性疾病的病人可能無法前往診所進行治療和補充藥物。 然而,醫院管理局的普通科門診公私營協作計劃的諮詢小組已針對慢性病患者的臨時藥物補充作出安排,計劃下經醫生對患者的最新醫療狀況進行遙距審查後,病人便可以得到短期的藥物補充,而無需進行面對面診症。該計劃已於2020年2月25日生效。 本會於2020年3月6日致信醫委會(請參閱本月刊第10頁),詢問該計劃的安排是否適用於私家醫生、是否合乎道德並可以接受的,我們於2020年4月17日已收到了答覆,請仔細閱讀本月刊第11-12頁。 醫委會的回覆大致上指出:醫委會不能取代個別醫生的自主權,也不能向他們發出任何指引,說明在什麼情況下不進行面對面診症的藥物補充才是適當。醫生應該以他或她的病人的最大利益為大前提。此外,醫生應確保他/她處方給他/她的病人的任何藥物都適合該病人的醫療狀況。因此,個別醫生應考慮到每個患者的具體情況、及在沒有面對面診症下作出專業判斷去補充藥物是否合適。 在此,我要補充一點:我們應該考慮到在某種特殊環境下,例如當前的疫症大流行時期的任何個案的具體情況。 請各位老友記保重,維持身體健康和快樂!   楊超發醫生     WARS IV   In view of the COVID-19 Pandemic, all regular CME activites would be suspended until further notice. As CME provider and Administrator, HKDU has been thriving hard to organize CME activities through various means, encouraging doctor members to join and gain CME points.   We have applied to the Medical Council of Hong Kong (MCHK) in March 2020 for granting CME points for doctors attending CME live activities organized by HKDU. We are grateful to MCHK for their swift encouraging reply for approving our live CME activities through ZOOM and Facbook Live realized through our concerted hard efforts to meet with their Accreditation requirements with immediate effect from 1st April 2020. (Please see page 6 of this Bulletin for the reply from MCHK). From now on, we shall provide more e-CME learning opportunities for members. We are aware that there are hiccups for some members joining these live CME activities, so we have shared some of the tips for members in the previous bulletins. We have prepared a dedicated column to tidy up the remaining difficulties encountered by some of the members in joining these activites on page 7 of this Bulletin. Please do have a look and in case you still find difficulties in joining e-CMEs, you are most welcome to call the secretariat at 2388 2728 for help.   I spoke on RTHK 1 in the morning of 10 April 2020 around 9:40am on the Anti-Epidemic Relief Fund 2.   I said, first of all, we appreciated the Government on exemption of our annual practising certificate fee for 3 years which amounts to a huge sum of HK$ 1,350.00. However, with the evolution of the COVID-19 pandemic, the implemenation of close border and Social Distancing, the business of our private clinics has dropped from 70 to 90 % and some colleagues are suffering a net loss of HK$ 100,000 to 200,000 per month and are on the verge of closing down soon. I said we had talked with the FHB on 4th March 2020 asking for relief fund help in the Anti-Epidemic Relief Fund 2 but in vain.   Secondly, I also told the RTHK 1 that we, private doctors, have to fight with the Government against the COVID-19 by containing the virus through detection. As such, we have equipped full PPE for our clinic operations which costs around HK$ 10,000 per month and this additional sum should be reimbursed by Government subsidies. I have told that at least 6 months Government subsidies on PPE is the least sum we accept from the Government.   Thirdly, I talked about our Union asking LINK on rental reduction 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 on this battle with COVID-19. We are disappointed with LINK on the attitude of her management. We shall seek other tycoon landlords for help soon.   I have talked to Dr. Chui Tak Yee, Undersecretary for Health and Food, and Ms. Elizabeth Tse, Permanent Secretary for Health and Food too on the MPF issue in the Anti-Epidemic Relief Fund 2. I am wondering why there is discrimination for working doctors age over 65 who are self employed and therefore not be enrolled in   MPF that they cannot benefit with this Anti-Epidemic Relief Fund 2 as in others below age of 65. They promised to look into the issue and give us reply soon.   The COVID-19 struck hard in Hong Kong and the world for the last 2 and half months. On 22nd April 2020, the number of new cases in Hong Kong came down to ZERO but it is NOT the time for complacency yet as there are emerging new cases elswhere around the world. There could be a third wave coming, according to expert microbiologists.   So, to protect ourselves and our citizens, colleagues should protect themselves in their clinical working places with appropriate PPE until the WARS is over. As the COVID-19 is still prevailing, many members are concerned about their private patients suffering from chronic diseases who may not be able to visit their clinics for treatment and drug refills.   However, the GOPC PPP Programme Advisory Group of the Hospital Authority has approved drug refilling arangement for public patients with chronic illesses without the requirement of face-to-face consultation, upon doctor’s review of the patient’s latest medical condition. This was enacted with effect from 25th Feburary, 2020.   We sent a letter to the Medical Council of Hong Kong on 6th March 2020 (Please see page 10 of this Bulletin for the letter) asking whether similar arrangement is ethical and acceptable in PURE PRIVATE SETTING and we got the reply on 17th April 2020 as printed out on page 11-12 of this Bulletin for your perusal.   In essence :“The Medical Council of Hong Kong cannot take over the autonomy of individual doctors and issue directive to them on when drug refilling without face-to-face consultation would be appropriate under the Code. A doctor should act in the best interest of his or her patients. Moreover, a doctor should ensure that any drug that he/she prescribes to his /her patient is appropriate for treatment of the patient’s medical condition(s). Individual doctor should therefore make his/her professional judgment on whether and when drug refilling without face-to-face consultation would be appropriate, taking into account the specificic circumstances of each patient.”   To this I would add: We should take into account of the specific circumstances of any individual case in such environment, like in this period of Pandemic. Take care, folks. Keep healthy and happy!   Dr. Yeung Chiu Fat Henry


會長通訊:新型冠狀病毒肺炎III | President's Message:WARS (III) 

新型冠狀病毒肺炎III       我於2020 年3月22日撰寫此會長通訊時,我同時在收聽著一位香港微生物學家在電台上發表有關許多香港市民從外地返港時傳播2019冠狀病毒病的危險的講話。我們是否真的處於戰爭狀態–第三次世界大戰,無形的敵人潛伏在我們的手,鼻子和嘴巴,通過與周圍的人的密切接觸而造成傷害和伏擊我們的身體?是的,我們確實處於戰爭狀態。我們確實生活在一個一生中從未見過的狀態。 那麼,除了基本服務,如醫療,食品和銀行設施外,是否應迫使所有商業活動關閉以保持社交距離,直到戰爭狀態消失了?我同意。當我們還沒有新的2019冠狀病毒病的任何針對性治療或預防措施時現在的確是生死攸關的時候。每個人都是一個士兵保衛自己,保衛香港。 儘管如此,在我們向局長陳肇始教授提交了一封與立法會議員陳沛然醫生、香港私人執業專科醫生協會會長郭寶賢醫生及香港牙醫學會會長曾憲紀醫生就私營醫生的嚴重業務損失的問題共同簽署的信件之後(會議照片及信件內容請參閱本月刊第11及12頁),已經與局長會面。於2020 年3月4日於政府總部舉行的會議上,我與局長談到,私營診所的平均業務損失起碼7成至9成,平均為8成。在這個關鍵時期,私家醫生在與政府一起抗擊2019冠狀病毒病方面一直做得很好。 私家醫生缺乏個人防護裝備,但局長回答說政府此刻亦無能為力。她說,我們應該期待新開將的本地口罩生產工廠的額外供應,而新的口罩來源應會於2020 年4月開始發售。我要求政府通過新成立的防疫抗疫基金,為每間私營診所提供十萬港元的資助,以協助這些私營診所。經過接近一小時的會議討論,我們達成共識,即政府應在第二輪抗疫基金中接受我們的要求。我們即將看看政府是否可以在這兩個月內完成。 在會議期間,局長進一步談到了為應對2019冠狀病毒病疫情的加強化驗室監察計劃,她亦要求私家醫生的配合。我們立即提醒政府,此監察計劃可能會給某些私營診所帶來污名化,擔心若相關醫生的患者在2019 冠狀病毒病的即時聚合酶連鎖反應檢測中呈陽性,那些醫生將會被隔離。然而,當該計劃於2020年3月10日推出時,我們注意到了一些後勤問題,這可能會增加社區交叉感染的機會。於2020 年3月10日之後,我不得不在媒體上多次發表,以至最終政府改變了收集樣本的方式。首先,私家醫生絕不需要尋求私人實驗室的幫助來收集患者的樣本以進行測試。第二,有一系列的政府門診診所可供 患者(或其家人及朋友)呈交樣本(深喉唾液或痰)進行2019冠狀病毒病的即時聚合酶連鎖反應檢測,以減少發生交叉感染的機會。我了解到,如果與確診患者的接觸時間少於15分鐘,而診所工作人員在諮詢期間穿戴了足夠適當的個人防護裝備,診所的工作人員可能不必隔離。因此,請各會員盡可能遵循此規則,以最大程度地減低患者感染自己的機會。到目前為止,我已經提交了30多個樣本用於2019冠狀病毒病的即時聚合酶連鎖反應檢測,幸運的是沒有人是呈陽性的。 幾乎在同一時間,我們代表一些領展物業的診所醫生提交了一封信給領展物業管理,要求領展可在這艱難時刻對診所作出減租安排。該信件於本月刊的第9頁,以供各位參考。我希望其他業主,如港鐵等也能聽我們的聲音。如果閣下對業主有類似的要求,歡迎提交到秘書處,以便我們可以更強烈地提出減租的要求。 如果我們可以團結一致,結果相信會更好。 我在上一期的會長通訊中提及,我的第一個男孫已於2020年2月於美國出生。我已於2020年2月19日返回香港。而我的妻子則於美國待了一段較長時間。她今天必須番回香港,亦必須接受檢疫。這讓我有點緊張。但是在大家的支持下,我認為我們的家人可以在未來的14或21天內承受這個巨大的挑戰。 感謝各位!   楊超發醫生     WARS (III)    While writing this message on 22nd March 2020, at the same time I was listening to a Hong Kong microbiologist speaking on the Radio about the imminent danger of many of the Hong Kong citizens spreading the COVID-19 on returning from outside. Are we really in the war time state – World War III - with invisible enemies lurking in our hands, noses and mouths, awaiting ambushes to hurt and kill through close contact with people around us? Yes, we are indeed in the war state. We are indeed living in a condition that we have never met before in a life time. Then should all commercial activities, except essential services like health, food and banking facilities, be forced to close down for social distancing until the war state is gone? I agree. It is now indeed a matter of life or death when we do not have any curative or preventive measure for this new COVID-19 virus. Everybody should be a soldier to defend oneself and to guard Hong Kong. Nonetheless, we have met with the Secretary for Food and Health on the issue of severe business loss of the private doctors, after we have issued a co-signed letter to Prof. Sophia Chan (Please refer to page 11 of this Bulletin for the photo of the meeting and page 12 of this Bulletin for the letter) with Dr. the Honorable Pierre Chan, Dr. Samuel Kwok of Hong Kong Association of Private Specialists and Dr. Century Tsang of the Hong Kong Dental Association. During the meeting on 4th March 2020 in the Government Headquarters, I told the Secretary that the average loss of business in private clinics was from 70 to 90% with an average of 80%. Private doctors had been doing their job well in this critical period in fighting together with the Government against the COVID-19 virus. The private doctors were short of PPE but the Secretary replied that at this moment the Government could not help. She said we should be looking forward to additional supplies from newly established local mask production factories. She said the new sources of masks should be available in April 2020. I asked the Government to assist the private clinics by implementing relief fund in the amount of HK$ 100,000 for each private clinic through the newly established Anti-Epidemic Fund set up by the Government. After nearly 1 hour of meeting, we had the consensus that the Government should entertain our request in the second round of Anti-Epidemic Fund. We shall see if that can be accomplished in a month or two. During the meeting, the Secretary further touched on the Enhanced Laboratory Surveillance programme of testing of COVID-19 and she requested the cooperation from private doctors. We immediately warned the Government on the potential stigmatization of certain private clinics by this test and the worries of some doctors for being quarantined if their patients are proved positive in the PCR test for COVID-19 virus. However, when the programme rolled out on 10th March 2020, we noticed some logistic problems which might increase the chance of cross infection in the community. I was obliged to voice out loudly in the media on several occasions after 10th March 2020 so much so that in the end there was a change in the specimen collection logistics by the Government. Firstly, there is no absolute need for private doctors to seek the help from private laboratories to collect the patients’ specimens for the test. Secondly, there is a list of Government outpatient clinics available for our patients (or their family members or friends) to hand in the specimens (either deep throat saliva or sputum) for COVID-19 PCR test so as to cut down the chance of cross infection. I was given to understand that if the contact time with a confirmed patient is less than 15 minutes, and the clinic staff have worn adequate and appropriate PPE during that period of consultation, the staff in the clinic may not have to be quarantined. So please follow this rule as much as possible to minimize the chance of getting yourself infected by your patients. Hitherto I have sent out more than 30 specimens for COVID-19 tests by now, and luckily no one is positive. Nearly at the same time, we had sent a request letter, on behalf of some public estate doctors working under Link, to the Link management asking for rental reduction with the similar reason of severe drop of business in this critical period. The letter is reproduced on Page 9 of this bulletin for members’ reference. I hope the Link management can listen to us. I hope other landlords like MTR etc can listen to our voice too. If you have similar requests to landlord, please submit to the secretariat so that we can request for rental reduction with a stronger voice. The outcome may be better if we can fight together with unity. I have told you in my last message that my first grandson was born in the United States of America in February 2020. I returned to Hong Kong on 19th February 2020. However, my wife has to stay behind a bit longer. She has to fly back to Hong Kong today and certainly has to undergo quarantine. This makes me a bit nervous. But with the support from all our friends here, I think our family can stand up to such a great challenge in the coming 14 or 21 days. Many thanks, Dr. Yeung Chiu Fat Henry  


會長通訊:武漢新型冠狀病毒肺炎II | President's Message:WARS II

武漢新型冠狀病毒肺炎II             春節假期過後,我本來打算於2020年2月7日返回香港。然而,由於我第一位孫兒的出生日期有所延誤,我改變了行程,我不得不延長逗留美國多12天。十分感謝我的親戚和同事的祝福,我家的新成員一切都順利。 他是一個足月正常分娩的男孩,體重為七磅半。 在美國逗留的24天中,我一直透過whatsapp和Zoom與幹事,工會工作人員,會員和傳媒保持良好的聯繫及進行會議。與2003年SARS時期一樣,我們立即為會員設立面書即時延續醫學進修課堂,以便在武漢新型冠狀病毒肺炎時期避免近距離接觸。本會十分抱歉將原定於2月舉行的星期日下午研討會推遲,以減少交叉感染的機會。由於武漢新型冠狀病毒肺炎仍於香港流行,我們別無選擇,只能暫時推遲將來在瑪嘉烈醫院舉行的星期日下午研討會,直到另行通知。同時,我們會透過ZOOM或Facebook Live的形式為會員安排“週日下午研討會”替代措施。有關延續醫學進修委員會的公告,請參閱本會通訊的P8-10頁。感謝閣位在這個困難時期的理解和體解。本會希望能夠為會員提供類似的平台令大家的醫療水平更上一層樓,以應對當前和未來的醫學挑戰。 我們得知,武漢新型冠狀病毒肺炎類似於嚴重呼吸系統綜合症(SARS)會在人與人之間傳播,並且類似於SARS時期,我們提倡所有香港市民佩戴口罩,尤其是當他們在巴士,火車,輪船,飛機,購物商場等擁擠的地方以防止交叉感染。但是與SARS時期不同的是,個人防護裝備在香港突然短缺,包括口罩,以至香港市民要求政府加強跨境控制,以減少有症狀或無症狀患者的湧入。與SARS時期相比,這次口罩短缺的原因有兩個。首先,在經歷SARS一疫之後,人們懂得從一開始就保護自己。第二,武漢新型冠狀病毒肺炎始於中國中部,並在很短的時間內傳播到中國各地,而SARS則始於中國南部,並要用較長的時間向北面及其他國家蔓延。 有見及此,當我在美國時,我嘗試在美國和加拿大為本會會員採購口罩。我訂購了多達80,000個口罩,但最終供應商用口罩缺貨的理由而告終。最後訂購的20,000個口罩仍在運送途中,希望這些能夠及時到達為我們的會員解決燃眉之急。在香港,感謝幹事會和工會工作人員的辛勤工作,我們設法為有需要的會員提供口罩以支持我們的會員抵禦武漢新型冠狀病毒肺炎。據我所知,仍然有許多會員需要口罩進行保護,我們仍在為此而努力。當口罩到貨時會通知大家。 我們十分感謝向我們的執業醫生捐贈口罩的社會人士。 本會於2020年2月19日已經發布了一份新聞稿,提醒公眾戴口罩的重要性,以糾正一些城內某些醫療人員提出使用口罩的謬論,有關本會的新聞稿請參閱本會通訊的P.6-7頁。能夠與其他醫療機構向傳媒發表了同一類似的觀點,希望我們能夠阻止災難在香港發生。 無論如何,現時會員最重要的工作是教育香港市民健康的生活方式,採取適當的預防措施,以減少患上武漢新型冠狀病毒肺炎或傳播的機會。在衞生署寫通訊的時候,令人難過的是,我們得知,一些市民還在各處參加社交聚會,而這會給我們的同事們在追踪武漢新型冠狀病毒肺炎病源帶來沉重的工作。我們仍然不知道這病毒的傳播方式,確診方法和治療方法。因此,我們作為家庭醫生,在預防疾病傳播以致徹底根除疾病方面具有重要的角色。否則,如果沒有基層醫療把關,那麼一次武漢新型冠狀病毒肺炎便可能會使過去所有社會的發展及投資都全部摧毀於一旦,而我們的醫療系統也將會立即癱瘓。我們十分希望,隨著溫暖炎熱的天氣的來臨,香港新型冠狀病毒的流行率和發病率會降低。我們亦希望,透過我們的不懈努力,香港所有市民都可以很快呼吸到新鮮空氣而無需戴口罩。   楊超發醫生     WARS II   After the Chinese New Year Holidays, I planned to come back to Hong Kong on 7th Feb 2020. However, due to some delay in the delivery of my first grandson, I changed my schedule so much so that I have to extend my stay in the United States for 12 more days. Thanks to blessings from my relatives and colleagues, everything went well with the new member of my family. He is a full term normal spontaneously delivered boy with body weight of seven and a half pounds. During my 24 days stay in United States, I have been connecting well with the council members, the Union staff, members and the media through whatsapp, and Zoom for meetings. As in 2003 SARS period, we have immediately set up Facebook Live for future CME sessions for our members so as to provide social distancing in this WARS period. We are sorry to postpone the scheduled Sunday Afternoon Symposium in February to decrease the chance of cross infection. As the WARS endemic is still going on, we have no choice but to postpone future Sunday Afternoon Symposia in Princess Margaret Hospital for the time being until further notice. In the mean time, we have arranged alternative measures in the form of Weekday Afternoon Symposia by ZOOM or Facebook Live for all members. Please refer to pages P.8-10 of this Bulletin for announcements from the CME committee. We thank you for your understanding and endurance in this difficult period. We hope we can manage to provide similar opportunities for members to update their medical knowledge to face the immediate and future medical challenges. We are told that, similar to SARS, the WARS would spread from person to person and similar to SARS, we are advocating mask wearing for all citizens of Hong Kong especially when they are in crowded areas like buses, trains, ships and planes, malls etc. to fight against cross infection. But unlike SARS period there is abrupt shortage of PPE including masks so much so that people are demanding the government to tighten cross border control to decrease influx of patients, symptomatic or asymptomatic alike. The reasons for such shortage of masks as compared with SARS period are two folds. Firstly, after the SARS experience, people are much more educated to protect themselves from the very first beginning. Secondly, The WARS started in Central China and spread to every part of China in very short time, unlike SARS which started in Southern part of China which took much more time spreading northwards and to other countries. In view of such, I have tried to source masks in the States, and Canada for members of our Union when I was in the States. I have ordered up to 80,000 masks but in vain at the end when the suppliers replied that the masks were out of stock. One last order of 20,000 masks was still on its way and hopefully these can arrive in time for our members. In Hong Kong, thanks to hard work of the council and the Union staff, we have managed to support our member’s protection against WARS by supplying masks to those members in need. As far as I know, there are still a number of members who need the masks for protection and we are still working very hard on that. You will be informed when the masks arrive. We are most thankful to those members of the society who donate masks to our practising doctors. We have sent out a press statement to warn the public on the importance of wearing masks on 19th Feb 2020 as a means to correct some of the misunderstanding of the use of masks created by some healthcare personnel in town. Please refer to pages P.6-7 of this Bulletin for our press statement. With the media coverage of the similar view expressed by many other medical bodies, we wish that we can stop some disaster.   Dr. Yeung Chiu Fat Henry