How the past waves of infection shaped this Hong Kong hospital’s Omicron measures

The General Manager of Clinical Operations at Matilda International Hospital, Rajwinder Kaur, explains the reasoning behind the protocols that her hospital has put in place to counter the threat of Omicron.

With the number of Omicron infections around the world continuing to rise at an exponential rate on a daily basis, hospitals everywhere have prepared themselves for the inevitable battle against the highly-transmissible variant.

Omicron has even managed to find its way into Hong Kong – which adopts a strict zero-COVID approach – with 140 new cases reported on Jan 23. This is the highest daily number of COVID-19 cases that Hong Kong has recorded since July 30, 2020.

But amidst the backdrop of uncertainty surrounding Omicron, Hong Kong’s Matilda International Hospital is staying alert and focused, and is poised to continue operating at an optimum level.

The reason for their confidence stems from the early and rigorous preparations that they have made in response to the threat of Omicron.

Rajwinder Kaur, General Manager of Clinical Operations at Matilda International Hospital, told Hospital Management Asia (HMA): “Infection control and prevention work in relation to the COVID-19 pandemic is overseen by our Outbreak Management Team (OMT), which consists of our CEO, executives, honorary consultants, Chief Medical Executive as well as our infection control staff.

“Prior to the government announcement of the commencement of the fifth wave in early January, our OMT…had a meeting in December last year to commence preparation for the imminent Omicron’s presence in Hong Kong.”

One of the many steps that Matilda took in December to prepare for Omicron was to attain feedback from the manufacturers of reagent and antigen tests, to assess the tests’ sensitivity to the variant.

Key medical and logistical supplies, which might affect the items in the Outbreak Management Stock in the event of an outbreak, were also reassessed to take into consideration of possible supply chain constraints.

And, once the Hong Kong government announced the commencement of the fifth wave of infections earlier this month, Matilda’s OMT immediately reinstated the stringent infection control measures that were used – to great success – at the hospital during the previous wave.

These measures included having anyone – be it patients, visitors or contractors – who were entering the hospital go through PCR or antigen testing, regardless of their vaccination status.

Ms Kaur explained: “As the Omicron variant has a shorter incubation period (as compared to previous variants), it was necessary to reinstate PCR and antigen testing requirements for all clients, while a person’s vaccination status became secondary.”

A COVID-19 application, which was developed late last year to assist in tracking the vaccination and testing status of their clients and staff, was also updated, as Ms Kaur elaborated: “This will facilitate for effective contact tracing if the need arises. Any clusters of staff sick leave or government testing can also be mapped out to allow for infection control surveillance.”

Other measures that Matilda have implemented to keep Omicron at bay include limiting the number of visitors at their hospital, while also ensuring that all their staff and clinicians have their temperatures taken daily.

Ms Kaur added: “All government requests for PCR testing have to be reported through the already established online Staff Early Sickness Alert System. Education (about COVID-19) was also reinforced, while communication to all our stakeholders was kept open and transparent to alleviate any concerns.”

The comprehensive Omicron protocols that Matilda have put in place were derived from the lessons they learnt from the first four waves of infections, which allowed them to stay ‘ahead of the curve’.

She said: “Many lessons were learned through each wave, such as – but not limited to – constraints in the supply of PPE stock during the first wave, and readiness of in-house PCR testing during the second wave.

“From the third wave, we learnt how to overcome communication challenges with external stakeholders on sudden changes in PCR requirement for all inpatients, while the fourth wave saw the introduction of innovative antigen testing.

“The OMT team also took a strong stance to highly encourage staff to get the COVID-19 vaccines. All in all, these experiences and the remedial measures proved to be valuable in facing the fifth wave, and this time the team was very much ahead of the curve.”

Indeed, Ms Kaur is certain that patients will continue to visit Matilda despite the overall uncertainty surrounding the Omicron situation in Hong Kong.

This, she says, is not only because of the infection control measures at the hospital, but also because of the ‘resilience’ of the people in Hong Kong.

“We do not expect a decrease in clients in the fifth wave, as this was not seen even during the fourth wave in Hong Kong,” Ms Kaur revealed. “People in Hong Kong have proven that they are resilient over the many waves we have experienced here (in Hong Kong), and the clientele we do see are mostly vaccinated.

“Most importantly, however, is that they feel reassured, because we are testing visitors and inpatients prior to receiving medical services at Matilda.”

Ms Kaur also emphasised that the OMT team at Matilda had recognised early on the importance of keeping their staff and clinicians safe, while making them feel supported and appreciated.

After all, Ms Kaur says it is through the “dedication, discipline and patience” of all their staff that Matilda was able to overcome all the previous waves of infection.

“In determining different measures for each of the COVID-19 waves, much thought was placed by OMT on ensuring that Matilda staff are supported and their well-being is sustained,” said Ms Kaur.

“The infection control staff spend much time educating frontline staff, but most importantly being there for them answering questions or mitigating any risks and challenges that arise. It has to be said that Matilda’s unique culture –  where staff are encouraged to verbalise their concerns, to assess risks, to proactively reach out for support in order to mitigate COVID-19 risks has allowed the hospital to successfully ride out the waves.”

And Ms Kaur believes that it is ultimately this cooperation among the staff, clinicians and management at Matilda that will allow the hospital to thrive during the Omicron wave.

“The foundation that has been built over the different waves allows Matilda staff to competently perform their duties while OMT continues to mitigate risks and adopt a transformational management approach,” said Ms Kaur.

“Matilda’s open, caring and supportive culture binds all as one to overcome these uncertain times.”