A lack of clear guidelines for Hong Kong doctors tasked with determining if restaurant employees qualify for exemption from new Covid-19 vaccine requirements has led to confusion ahead of Thursday’s planned updating of social-distancing measures, local health experts have complained.
Hong Kong took the wraps off the newly relaxed rules for restaurants, bars and entertainment venues on Tuesday. The multi-tiered “vaccine bubble” system, which requires both customers and staff to be inoculated in some instances, is intended to boost the city’s flagging Covid-19 inoculation drive. Employees seeking to avoid getting a jab, however, must obtain a medical certificate.
On Wednesday, with the city confirming seven new Covid-19 cases, Hong Kong Medical Association president Dr Gabriel Choi Kin said doctors had yet to receive any communication from the government about who should be eligible for exemption or how long the medical certificates should be valid for.
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Six of the latest coronavirus infections were imported – three from Nepal, two from the Philippines and the other from India. Two of the Philippines cases carried the N501Y mutation, which is linked to several variants deemed more transmissive. The day’s sole locally transmitted case was linked to Kwai Chung Estate in Kwai Chung. Citywide, more than 20 people tested preliminary-positive.
In another development, the government apologised to those affected when Covid-19 testing firm BGI last week reported 30 – mostly false – preliminary-positive cases in a day. It also said it would follow up if an investigation found any violations of professional conduct. Twenty-six of the cases were later confirmed as false positives.
Raising concerns over the vaccine exemption system, Choi told a radio show: “Of course we could write our own letters, but we hope there are clearer guidelines. The situation now is very confusing.
“We hope to clear this up within the next two days, and have sent a letter to the government. The responsibility should not lie entirely on private doctors.”
On Wednesday, with the city expecting just a handful of new coronavirus cases, Hong Kong Medical Association president Dr Gabriel Choi Kin said doctors had yet to receive any communication from the government about who should be eligible for exemption or how long the medical certificates should be valid.
Choi said private doctors could certify patients with high blood pressure, blood sugar or cholesterol, as they were at higher risk of suffering from adverse symptoms after receiving a Covid-19 jab. But for those who were simply anxious about getting shots, giving them time to lie down after the jab would be enough to alleviate any reactions such as dizziness.
University of Hong Kong microbiologist Dr Ho Pak-leung, meanwhile, said doctors would only issue medical certificates based on their professional judgment, but it was still difficult to determine exactly what groups of people should be excused from vaccination as the conditions Choi cited were not listed as risk factors for either the Sinovac or BioNTech vaccines.
“Without scientific evidence or government guidelines, it will be hard, and could lead to medical disputes,” he said.
Asked if authorities would be providing guidelines for private doctors on how to issue the required medical certification, Irene Young Bick-kwan, director of food and environmental hygiene, said the government would defer to the doctors’ professional judgment.
Restaurant industry representatives also expressed surprise at the medical certification requirement on Wednesday, with Federation of Restaurant and Related Trades president Simon Wong Ka-wo and Institute of Dining Art chairman Ray Chui both saying it had not been discussed in meetings with the authorities.
“We were taken aback at the announcement. We hope the government can be a bit more forgiving with this requirement, as restaurant workers have suffered economically, and consulting a doctor will generate an extra cost for them,” Chui said.
Wong said implementing the requirement would be difficult, but that the industry would try its best to comply.
Meanwhile, Ho and respiratory health expert Dr Leung Chi-chiu said authorities were hoping the looming changes would push the city’s low vaccination rates higher.
Currently, only about 11.6 per cent of Hong Kong’s 7.5 million population has received at least one jab since the vaccine roll-out began in late February.
But while Ho said allowing different numbers of people per table at each restaurant would provide flexibility and risks would be low for fully vaccinated people, Leung questioned rules requiring staff – but not customers – to be vaccinated as “lacking scientific basis”.
“Among people present in restaurants, staff make up only a small number, and infection sources are usually the patrons,” he said.
Instead, social-distancing measures should be made based on how close the city was to achieving zero new infections, Leung said.
Hong Kong’s tally of confirmed infections now stands at 11,755, with 209 related deaths.
Additional reporting by Lilian Cheng
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