COVID-19: new regulations and the procedural requirements for medical practitioners in Hong Kong
As this is a fast moving topic, please note that this article is current as at 08/04/2020. For further information, please contact Richard Bates.
In this article we consider some of the key regulations currently in place in Hong Kong to assist with preventing the further spread of Coronavirus (COVID-19) and highlight some of the key procedural requirements that these place on medical practitioners during this particularly challenging time for the profession.
The Hong Kong Government first took action with respect to COVID-19 in January 2020. This was as soon as it first came to light in Wuhan in Mainland China. The Government immediately included “Severe Respiratory Disease associated with a Novel Infectious Agent” as a scheduled infectious disease under the Prevention and Control of Disease Ordinance (the Infectious Diseases Ordinance). In addition, COVID-19 was added as a statutorily notifiable infectious disease under its main subsidiary legislation, the Prevention and Control of Disease Regulation (Cap.599A).
The Infectious Diseases Ordinance empowers the Chief Executive in Council to make public health emergency regulations for the purpose of preventing, combating or alleviating the effects of a public health emergency and protecting public health. This power was then exercised in early February to introduce the Prevention and Control of Disease (Disclosure of Information) Regulation (Cap.599D) (the Disclosure of Disease Information Regulation) and will remain in force until at least 7 May 2020.
Disclosure of Disease Information Regulation
A health officer has the power to require a person to disclose or furnish any information, such as their travel history and who they have been in contact with, which is relevant to the handling of a state of public health emergency. This power is now extended to medical practitioners who have dealings with a person involved in such a public health emergency.
It is a criminal offence for a person to provide false or misleading information to a health officer/medical practitioner where that information is relevant to the risk of exposure to or the contracting of an infectious disease. The maximum penalty is a fine of up to HK$10,000 and imprisonment of up to six months.
Given the reporting requirements for suspected COVID-19 cases referred to above, medical practitioners should remind their patients, perhaps through a suitably worded notice in personal data collection forms or in their other information collecton forms that providing false information is an offence.
This regulation provides for various control measures for infectious diseases, including:
- the notification of cases of scheduled infectious disease;
- disease prevention measures;
- medical surveillance requirements;
- examination and tests; and
- the quarantine and isolation of persons.
Notification, testing and disease prevention measures
The Communicable Disease Branch of the Centre for Health Protection (CHP) (which is the professional arm of the Hong Kong Department of Health responsible for disease protection and control) has written to medical practitioners in private practice:
- reminding them to report to the CHP anyone showing symptoms of COVID-19 (a fever, acute respiratory illness or pneumonia) and who has a travel history outside Hong Kong or who has had close contact with a confirmed case of COVID-19;
- informing them of the free testing facilities for SARS-CoV-2 virus, the enhanced specimen collection requirements from patients suspected of having COVID-19 and how SARS-CoV-2 virus tests will be carried out (and how the medical practitioner and patient will be notified of the result); and
- confirming to them that healthcare workers/clinic staff who have worn adequate personal protective equipment will not be considered to have been in contact with a patient confirmed as having COVID-19 (and so will not be required to be put into quarantine or placed under medical surveilance).
Private practice medical practitioners should be mindful of these requirements and procedures and ensure compliance with the infection prevention and control measures set out in the CHP guidelines (see https://www.chp.gov.hk/files/pdf/ic_advice_for_nid_in_healthcare_setting.pdf), particularly when taking respiratory specimens from patients. All supporting staff must also be made aware of and comply with these requirements.
Under the Quarantine and Isolation of Persons section of the Prevention and Control of Disease Regulation:
- if a health officer has reason to believe that a person is infected with a specified infectious disease, they may make an order placing that person under isolation (for suspected infection), or quarantine (for contact) until that person is considered not infectious or their isolation or quarantine can be replaced by medical surveillance;
- the quarantine and isolation order must specify the reason for and terms of quarantine or isolation;
- a health officer is given power to remove and detain persons for quarantine and isolation;
- a person escaping from quarantine or isolation in hospital or another establishment may be stopped, detained and/or conveyed to a place of quarantine or isolation; and
- leaving a place of quarantine is a criminal offence punishable on conviction with a small fine of up to HK$5,000 but also imprisonment of up to six months.
Medical practitioners in Hong Kong will be well aware of these provisions, but they may have patients who are made subject to isolation or quarantine orders. If so, they may be required to explain why these steps have been taken and why, both from an infection control perspective and to avoid criminal sanctions, it is important that their patient complies.