56-472: Kowloon East Cluster (Chinese: 九龍東醫院聯網 ) is one of the seven hospital clusters managed by Hospital Authority in Hong Kong. It consists of three public hospitals and eight general outpatient clinics to provide public healthcare services for the population of Kwun Tong and part of Sai Kung Districts (including Tseung Kwan O ). In mid-2012, the population was 1,012,000. The current Cluster Chief Executive
112-549: A "potential infectious source." The virus was also later found in raccoon dogs ( Nyctereuteus sp.), ferret badgers ( Melogale spp.), and domestic cats. In 2005, two studies identified a number of SARS-like coronaviruses in Chinese bats. Phylogenetic analysis of these viruses indicated a high probability that SARS coronavirus originated in bats and spread to humans either directly or through animals held in Chinese markets. The bats did not show any visible signs of disease, but are
168-626: A Guangdong doctor who was treating patients at Sun Yat-Sen Memorial Hospital . He arrived in February and stayed on the ninth floor of the Metropole Hotel in Kowloon , infecting 16 of the hotel visitors. Those visitors traveled to Canada, Singapore, Taiwan, and Vietnam, spreading SARS to those locations. Another larger cluster of cases in Hong Kong centred on the Amoy Gardens housing estate. Its spread
224-559: A farmer from Shunde , Foshan , Guangdong, was treated in the First People's Hospital of Foshan. The patient died soon after, and no definite diagnosis was made on his cause of death. Despite taking some action to control it, Chinese government officials did not inform the World Health Organization of the outbreak until February 2003. This lack of openness caused delays in efforts to control the epidemic, resulting in criticism of
280-565: A flight to Singapore. The plane stopped in Hanoi , Vietnam, where the patient died in Hanoi French Hospital . Several of the medical staff who treated him soon developed the same disease despite basic hospital procedures. Italian doctor Carlo Urbani identified the threat and communicated it to WHO and the Vietnamese government; he later died from the disease. The severity of the symptoms and
336-405: A netizen. Falling down of other objects such as surgical light had also been reported. All posts from the instagram account that disclosing the issue are no longer accessible since 14 March 2023 after being ratted on. SARS Severe acute respiratory syndrome ( SARS ) is a viral respiratory disease of zoonotic origin caused by the virus SARS-CoV-1 , the first identified strain of
392-577: A new health administration system was introduced as part of the 1989 reforms. The establishment of the Authority served to rebuild state capacity amid the emergence of party politics in Hong Kong. The department became the Department of Health and in 1991, the management of all the public hospitals was passed to a new statutory body, the Hospital Authority, which was established on 1 December 1990 under
448-770: A risk of side effects like arm pain, fever, and headache. According to research papers published in 2005 and 2006, the identification and development of novel vaccines and medicines to treat SARS was a priority for governments and public health agencies around the world. In early 2004, an early clinical trial on volunteers was planned. A major researcher's 2016 request, however, demonstrated that no field-ready SARS vaccine had been completed because likely market-driven priorities had ended funding. Several consequent reports from China on some recovered SARS patients showed severe long-time sequelae . The most typical diseases include, among other things, pulmonary fibrosis , osteoporosis , and femoral necrosis , which have led in some cases to
504-565: A workforce of about 79,000 and some 28,000 beds. These facilities are organised into seven hospital clusters according to their geographical locations, as shown in the table below. Each hospital cluster comprises a mix of acute and convalescent or rehabilitation hospitals to provide a full range of healthcare services. According to the Hospital Authority Ordinance (Cap 113), the Chief Executive of Hong Kong appoints members of
560-527: Is Dr Tom Kam-tim. Kowloon East Cluster operates the following three hospitals of various capabilities to provide a range of acute, convalescent, rehabilitation, and infirmary inpatient and ambulatory care services to the public in the areas of Kwun Tong and part of Sai Kung Districts (including Tseung Kwan O). In mid-2012, the population of the areas was 1,012,000. As of March 2013, the cluster has 2,371 in-patient beds and 6,483 full-time equivalent staff . Hospital Authority The Hospital Authority
616-622: Is a statutory body managing all the government hospitals and institutes in Hong Kong . It is under the governance of its board and is under the monitor of the Secretary for Health of the Hong Kong Government . Its chairman is Henry Fan . Before the establishment of the Hospital Authority, all health and medical issues were under the management of the Medical and Health Department . In 1990,
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#1732908875796672-590: Is a vaccine for SARS, although in March 2020 immunologist Anthony Fauci said the CDC developed one and placed it in the Strategic National Stockpile . That vaccine is a final product and field-ready as of March 2022. Clinical isolation and vaccination remain the most effective means to prevent the spread of SARS. Other preventive measures include: Many public health interventions were made to try to control
728-537: Is common in people with SARS, the fecal–oral route does not appear to be a common mode of transmission. The basic reproduction number of SARS-CoV, R 0 , ranges from 2 to 4 depending on different analyses. Control measures introduced in April 2003 reduced the R to 0.4. SARS-CoV may be suspected in a patient who has: For a case to be considered probable, a chest X-ray must be indicative for atypical pneumonia or acute respiratory distress syndrome . The WHO has added
784-795: Is commonly used to treat SARS, there seems to have little to no effect on SARS-CoV, and no impact on patient's outcomes. There is currently no proven antiviral therapy. Tested substances, include ribavirin , lopinavir , ritonavir , type I interferon , that have thus far shown no conclusive contribution to the disease's course. Administration of corticosteroids , is recommended by the British Thoracic Society / British Infection Society / Health Protection Agency in patients with severe disease and O2 saturation of <90%. People with SARS-CoV must be isolated, preferably in negative-pressure rooms , with complete barrier nursing precautions taken for any necessary contact with these patients, to limit
840-433: Is four to six days, although it is rarely as short as one day or as long as 14 days. The primary route of transmission for SARS-CoV is contact of the mucous membranes with respiratory droplets or fomites . As with all respiratory pathogens once presumed to transmit via respiratory droplets, it is highly likely to be carried by the aerosols generated during routine breathing, talking, and even singing. While diarrhea
896-457: Is quite high. The average waiting time for cataract surgery in 2014 was 22 months. In September 2022, Henry Fan Hung Ling , chairman of the Hospital Authority, lobbied for a "significant expansion" of traditional Chinese medicine used in Hong Kong's public healthcare. Days later, the Hospital Authority released information from a study it conducted, showing that traditional Chinese medicine could be used to cure long COVID . Rowena Wong Hau-wan,
952-412: Is suspected to have been facilitated by defects in its bathroom drainage system that allowed sewer gases including virus particles to vent into the room. Bathroom fans exhausted the gases and wind carried the contagion to adjacent downwind complexes. Concerned citizens in Hong Kong worried that information was not reaching people quickly enough and created a website called sosick.org, which eventually forced
1008-537: The Hospital Authority Ordinance . In 2003, the General Outpatient Clinics of Department of Health were transferred to the authority. Hospital Authority has been providing services to the public under a cluster-based structure since 1993. It currently manages 43 public hospitals and institutions, 49 specialist outpatient clinics and 73 general outpatient clinics. As of 31 March 2019, it has
1064-623: The SARS-related coronavirus . The first known cases occurred in November 2002, and the syndrome caused the 2002–2004 SARS outbreak . In the 2010s, Chinese scientists traced the virus through the intermediary of Asian palm civets to cave-dwelling horseshoe bats in Xiyang Yi Ethnic Township , Yunnan . SARS was a relatively rare disease; at the end of the epidemic in June 2003, the incidence
1120-452: The Hong Kong government to provide information related to SARS in a timely manner. The first cohort of affected people were discharged from hospital on 29 March 2003. The first case of SARS in Toronto was identified on 23 February 2003. Beginning with an elderly woman, Kwan Sui-Chu, who had returned from a trip to Hong Kong and died on 5 March, the virus eventually infected 257 individuals in
1176-480: The Hospital Authority Board governing the authority. The present board consists of 27 members, including the chairman. Membership of the authority comprises 23 non-public officers, three public officers and the chief executive of the authority. Apart from the chief executive of the authority, other members are not remunerated in their capacity as board members. To perform its roles and exercise its powers,
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#17329088757961232-424: The Hospital Authority was reportedly overwhelmed when over 100 parents demanding check-ups for their children at Princess Margaret amids confusion about referrals and registration procedures, causing Secretary for Food and Health , York Chow to grovel for having underestimated the problem. Chow pledged 18 additional facilities around Hong Kong would be operational the next day. Waiting time for elective treatment
1288-668: The Hospital Authority's chief manager (Chinese medicine), said "The research has served as evidence on treatment of Covid residual symptoms with Chinese medicine." However, Professor Bian Zhaoxian admitted that the patients could have recovered naturally rather than because of the Chinese medicine, and that the study was not conducted using a scientific randomized controlled trial. On 27 August 2022, Health Secretary Lo Chung-mau suggested that private hospitals were slacking and could be punished for not taking in non-COVID patients from public hospitals due to potential overcrowding at public hospitals, though Dr. Siddharth Sridhar of HKU said that
1344-609: The People's Republic of China from the international community. China officially apologized for early slowness in dealing with the SARS epidemic. In 2003, when the virus broke out in China, a 72 year old with SARS infected multiple people on board an Air China Boeing 737 , causing 5 deaths. The viral outbreak was subsequently genetically traced to a colony of cave-dwelling horseshoe bats in Xiyang Yi Ethnic Township , Yunnan. The outbreak first came to
1400-517: The SARS genome in April 2003. Scientists at Erasmus University in Rotterdam , the Netherlands demonstrated that the SARS coronavirus fulfilled Koch's postulates thereby suggesting it as the causative agent. In the experiments, macaques infected with the virus developed the same symptoms as human SARS patients. In late May 2003, a study was conducted using samples of wild animals sold as food in
1456-456: The age group of the patient. Patients under 24 were least likely to die (less than 1%); those 65 and older were most likely to die (over 55%). As with MERS and COVID-19 , SARS resulted in significantly more deaths of males than females. The SARS epidemic began in the Guangdong province of China in November 2002. The earliest case developed symptoms on 16 November 2002. The index patient ,
1512-567: The attention of the international medical community on 27 November 2002, when Canada's Global Public Health Intelligence Network (GPHIN), an electronic warning system that is part of the World Health Organization's Global Outbreak Alert and Response Network (GOARN), picked up reports of a "flu outbreak" in China through Internet media monitoring and analysis and sent them to the WHO. While GPHIN's capability had recently been upgraded to enable Arabic, Chinese, English, French, Russian, and Spanish translation,
1568-502: The authority with advice on the healthcare needs for specific regions of Hong Kong, the authority has established three Regional Advisory Committees. Each of the committees meets four times a year. The authority is funded primarily by Hong Kong Government subvention, which amounted to HK$ 42.5 billion for 2012–2013, equating to over 90% of the authority's total income. Its other incomes include hospital and clinic fees and charges, donations, and investment. The authority's total expenditure
1624-507: The board has established 11 functional committees: To enhance community participation and governance of public hospitals, the authority has established 31 Hospital Governing Committees in 38 hospitals and institutions. These committees received regular management reports from the hospital chief executives, monitored operational and financial performance of the hospitals, participated in human resources and procurement functions, as well as hospital and community partnership activities. To provide
1680-489: The category of "laboratory confirmed SARS" which means patients who would otherwise be considered "probable" and have tested positive for SARS based on one of the approved tests ( ELISA , immunofluorescence or PCR ) but whose chest X-ray findings do not show SARS-CoV infection (e.g. ground glass opacities, patchy consolidations unilateral). The appearance of SARS-CoV in chest X-rays is not always uniform but generally appears as an abnormality with patchy infiltrates. There
1736-434: The chances of getting sick up to 80% compared to no mask. A screening process was also put in place at airports to monitor air travel to and from affected countries. SARS-CoV is most infectious in severely ill patients, which usually occurs during the second week of illness. This delayed infectious period meant that quarantine was highly effective; people who were isolated before day five of their illness rarely transmitted
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1792-415: The chances of medical personnel becoming infected. In certain cases, natural ventilation by opening doors and windows is documented to help decreasing indoor concentration of virus particles. Some of the more serious damage caused by SARS may be due to the body's own immune system reacting in what is known as cytokine storm . Vaccines can help the immune system to create enough antibodies and decrease
1848-489: The complete loss of working ability or even self-care ability of people who have recovered from SARS. As a result of quarantine procedures, some of the post-SARS patients have been diagnosed with post-traumatic stress disorder (PTSD) and major depressive disorder . SARS was a relatively rare disease; at the end of the epidemic in June 2003, the incidence was 8,422 cases with a case fatality rate (CFR) of 11%. The case fatality rate (CFR) ranges from 0% to 50% depending on
1904-532: The danger to China, there appeared to be a change in official policy when SARS began to receive a much greater prominence in the official media. Some have directly attributed this to the death of an American teacher, James Earl Salisbury , in Hong Kong. It was around this same time that Jiang Yanyong made accusations regarding the undercounting of cases in Beijing military hospitals. After intense pressure, Chinese officials allowed international officials to investigate
1960-431: The day off. Deputy Director of Health Gloria Tam said that it was "not something so urgent that it needs to be dealt with in 24 hours... They can go during office hours tomorrow". Medical sector legislator Leung Ka-lau said the lack of daily cover during the crisis was "insensitive". While the first victim left hospital after successful treatment one day later, two more children were admitted to hospital on 22 September;
2016-488: The disease to others. As of 2017, the CDC was still working to make federal and local rapid-response guidelines and recommendations in the event of a reappearance of the virus. As SARS is a viral disease, antibiotics do not have direct effect but may be used against bacterial secondary infection. Treatment of SARS is mainly supportive with antipyretics , supplemental oxygen and mechanical ventilation as needed. While ribavirin
2072-506: The early pace of the epidemic. He subsequently contracted the disease himself, and died in March 2003. Malik Peiris and his colleagues became the first to isolate the virus that causes SARS, a novel coronavirus now known as SARS-CoV-1 . By June 2003, Peiris, together with his long-time collaborators Leo Poon and Guan Yi , has developed a rapid diagnostic test for SARS-CoV-1 using real-time polymerase chain reaction . The CDC and Canada's National Microbiology Laboratory identified
2128-459: The end of June 2003. The official response by the Ontario provincial government and Canadian federal government has been widely criticized in the years following the outbreak. Brian Schwartz, vice-chair of Ontario's SARS Scientific Advisory Committee, described public health officials' preparedness and emergency response at the time of the outbreak as "very, very basic and minimal at best". Critics of
2184-664: The infection among hospital staff alarmed global health authorities, who were fearful of another emergent pneumonia epidemic. On 12 March 2003, the WHO issued a global alert , followed by a health alert by the United States Centers for Disease Control and Prevention (CDC). Local transmission of SARS took place in Toronto , Ottawa, San Francisco, Ulaanbaatar , Manila , Singapore, Taiwan, Hanoi and Hong Kong whereas within China it spread to Guangdong, Jilin , Hebei, Hubei , Shaanxi, Jiangsu , Shanxi, Tianjin , and Inner Mongolia . The disease spread in Hong Kong from Liu Jianlun,
2240-550: The likely natural reservoirs of SARS-like coronaviruses. In late 2006, scientists from the Chinese Centre for Disease Control and Prevention of Hong Kong University and the Guangzhou Centre for Disease Control and Prevention established a genetic link between the SARS coronavirus appearing in civets and in the second, 2004 human outbreak, bearing out claims that the disease had jumped across species. It took 14 years to find
2296-595: The local market in Guangdong, China. The study found that "SARS-like" coronaviruses could be isolated from masked palm civets ( Paguma sp.). Genomic sequencing determined that these animal viruses were very similar to human SARS viruses, however they were phylogenetically distinct, and so the study concluded that it was unclear whether they were the natural reservoir in the wild. Still, more than 10,000 masked palm civets were killed in Guangdong Province since they were
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2352-418: The original bat population likely responsible for the SARS pandemic. In December 2017, "after years of searching across China, where the disease first emerged, researchers reported ... that they had found a remote cave in Xiyang Yi Ethnic Township , Yunnan province, which is home to horseshoe bats that carry a strain of a particular virus known as a coronavirus. This strain has all the genetic building blocks of
2408-511: The overcrowding was because elderly patients with COVID-19 were often sent to public hospitals even if the severity of their symptoms was low. Months later in November 2022, Lau Ka-hin of the Hospital Authority said that public hospitals would be allowed to have COVID-19 positive patients with low symptoms to isolate at home instead of being treated at the hospital. Lau said that 60% of accident and emergency patients were taken in solely because of their COVID-19 positive result. Concrete slab about
2464-585: The province of Ontario. The trajectory of this outbreak is typically divided into two phases, the first centring around her son Tse Chi Kwai, who infected other patients at the Scarborough Grace Hospital and died on 13 March. The second major wave of cases was clustered around accidental exposure among patients, visitors, and staff within the North York General Hospital . The WHO officially removed Toronto from its list of infected areas by
2520-440: The response often cite poorly outlined and enforced protocol for protecting healthcare workers and identifying infected patients as a major contributing factor to the continued spread of the virus. The atmosphere of fear and uncertainty surrounding the outbreak resulted in staffing issues in area hospitals when healthcare workers elected to resign rather than risk exposure to SARS. In late February 2003, Italian doctor Carlo Urbani
2576-540: The situation there. This revealed problems plaguing the aging mainland Chinese healthcare system, including increasing decentralization, red tape , and inadequate communication. Many healthcare workers in the affected nations risked their lives and died by treating patients, and trying to contain the infection before ways to prevent infection were known. The epidemic reached the public spotlight in February 2003, when an American businessman traveling from China, Johnny Chen, became affected by pneumonia-like symptoms while on
2632-464: The size of a small backpack, had fallen onto an empty bed at Castle Peak Hospital in Tuen Mun in November 2022. The Hospital Authority had not disclosed the incident until after it came to light on 5 Mar, 2023. Slabs of concrete, with the biggest one sized at about 30 x 30 centimeters, falling from the ceiling inside a consultation room of Kwai Chung Hospital on 8 Mar destroying a printer, as disclosed by
2688-507: The spread of the disease, which is mainly spread through respiratory droplets in the air, either inhaled or deposited on surfaces and subsequently transferred to a body's mucous membranes. These interventions included earlier detection of the disease; isolation of people who are infected; droplet and contact precautions; and the use of personal protective equipment (PPE), including masks and isolation gowns. A 2017 meta-analysis found that for medical professionals wearing N-95 masks could reduce
2744-575: The system was limited to English or French in presenting this information. Thus, while the first reports of an unusual outbreak were in Chinese, an English report was not generated until 21 January 2003. The first super-spreader was admitted to the Sun Yat-sen Memorial Hospital in Guangzhou on 31 January, which soon spread the disease to nearby hospitals. In early April 2003, after a prominent physician, Jiang Yanyong , pushed to report
2800-510: The treatment of highly contagious diseases. In the early phase of the outbreak, public hospitals placed SARS patients in non-quarantined rooms that severely increased the chance of infection. On the day when a Hong Kong girl was diagnosed as the territory's first victim of the 2008 Chinese milk scandal , anxious parents were frustrated to discover that doctors at the special unit set up at the Princess Margaret Hospital were taking
2856-526: The type that triggered the global outbreak of SARS in 2002." The research was performed by Shi Zhengli , Cui Jie, and co-workers at the Wuhan Institute of Virology , China, and published in PLOS Pathogens . The authors are quoted as stating that "another deadly outbreak of SARS could emerge at any time. The cave where they discovered their strain is only a kilometre from the nearest village." The virus
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#17329088757962912-677: Was 8,422 cases with a case fatality rate (CFR) of 11%. No cases of SARS-CoV-1 have been reported worldwide since 2004. In December 2019, a second strain of SARS-CoV was identified: SARS-CoV-2 . This strain causes coronavirus disease 2019 ( COVID-19 ), the disease behind the COVID-19 pandemic . SARS produces flu-like symptoms which may include fever, muscle pain , lethargy , cough, sore throat , and other nonspecific symptoms . SARS often leads to shortness of breath and pneumonia , which may be direct viral pneumonia or secondary bacterial pneumonia . The average incubation period for SARS
2968-509: Was HK$ 46.1 billion for 2012–2013, with 70% used to pay staff, and 14% to pay for drugs and other supplies. In 2003, Hong Kong suffered from the outbreak of SARS and recorded considerable number of patients and casualties. The slow and delayed response of Hospital Authority was criticized. Believing that Hong Kong was safe from infectious diseases, the HA had inadequate preparation for facilities like isolated wards and single rooms that are important for
3024-563: Was achieved through successful public health measures. In the following months, four SARS cases were reported in China between December 2003 and January 2004. While SARS-CoV-1 probably persists as a potential zoonotic threat in its original animal reservoir, human-to-human transmission of this virus may be considered eradicated because no human case has been documented since four minor, brief, subsequent outbreaks in 2004. After containment, there were four laboratory accidents that resulted in infections. Study of live SARS specimens requires
3080-474: Was called into The French Hospital of Hanoi to look at Johnny Chen, an American businessman who had fallen ill with what doctors thought was a bad case of influenza . Urbani realized that Chen's ailment was probably a new and highly contagious disease. He immediately notified the WHO. He also persuaded the Vietnamese Health Ministry to begin isolating patients and screening travelers, thus slowing
3136-560: Was ephemeral and seasonal in bats. In 2019, a similar virus to SARS caused a cluster of infections in Wuhan , eventually leading to the COVID-19 pandemic. A small number of cats and dogs tested positive for the virus during the outbreak. However, these animals did not transmit the virus to other animals of the same species or to humans. The World Health Organization declared severe acute respiratory syndrome contained on 5 July 2003. The containment
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