Here’s how this Hong Kong hospital achieved zero hospital acquired COVID-19 infections

We take a look at how the stringent infection control measures put in place by Gleneagles Hospital Hong Kong are protecting both patients and staff from COVID-19 at their hospital.

As a result of Hong Kong’s strict zero-COVID approach, the city has largely been able to contain and manage the pandemic effectively to date.

The highly-transmissible Omicron variant, however, has put the city back on high alert, and its authorities have since announced a tightening of infection control measures in a bid to eliminate the spread of the virus.

A part of Hong Kong’s strategy to manage COVID-19 is to have all positive cases be treated in public hospitals, so as to reduces the risk of widespread infection. This means the onus is on the city’s private hospitals – like that of Gleneagles Hospital Hong Kong – to maintain a robust infection management strategy, so as to prevent the transmission of COVID-19 within their facilities.

Patients who are found to have COVID-19 are immediately transferred to the Department of Health’s (HKDH) dedicated isolation facilities.

Dr Kenneth Tsang, Chief Operating Officer of Gleneagles Hospital Hong Kong, explains: “In Hong Kong, all patients who are diagnosed, or suspected to have contact with a COVID positive patient will be quarantined at a government facility.

“The government has attributed more capacity to quarantine COVID cases and their close contacts. Private hospitals like us cannot see these patients – what we have to focus on is to ensure that patients who are COVID-negative will be able to receive quality care from us.”

A study on the risk management measures employed by three private hospitals in Hong Kong – including Gleneagles – that was published last month in the medical journal, Infection Control & Hospital Epidemiology, found that they were able to achieve zero secondary hospital-acquired COVID-19 infections, largely as a result of their strict two-stage admission strategy.

The first stage of the strategy revolves around the thorough screening of all incoming patients for the virus.

This includes assessing patients according to the relevant clinical and epidemiological criteria, such as whether they have a fever, their travel history, occupation, any prior contact with positive cases, or cluster exposure (FTOCC).

Patients who pass that initial assessment are then tested for COVID-19 using nucleic acid amplification testing (NAAT).

Only after a patient is tested negative for COVID-19, is he or she allowed to be admitted to the hospital. Those who meet one or more of the FTOCC criteria, or fails the NAAT, are transported to a HKDH COVID facility.

The second stage of their strategy is focused on mitigating the risks of cross-infections within the hospital itself.

This includes isolating suspected cases – such as those whose FTOCC status is still ambiguous – in single rooms, until a definite conclusion about whether a patient is COVID positive is reached.

Patients who urgently require admission, and are therefore unable to complete the first stage of the inpatient procedures, are likewise isolated in single rooms until their COVID-19 status is determined.

COVID-19 patient that are inadvertently admitted to the hospital, however, will have their close contacts immediately quarantined.

As a result of these stringent measures, the hospitals were able to prevent COVID positive patients from being admitted – 77 cases were detected at the first stage, while only one patient was found to have had COVID at the second stage.

Despite the success that Gleneagles Hospital has had in preventing hospital-acquired COVID-19 infection, Dr Tsang believes it will still take some time before their workflow and processes go back to how it was before the pandemic.

He said: “We are beginning to transition to working as per normal. But we don’t expect that to transition fully soon, because people are still scared of COVID-19, especially with Omicron. So, if we come out and say we’re operating normally once again, despite the demand for services, people will still be hesitant.

“So, I guess this transition will be gradual, and I think it’s going to take one or two more years before things will really get back to normal.”

Dr Tsang also expressed his opinion that, despite the concern over the Omicron variant, the COVID-19 situation will improve sooner rather than later.

“From an evolutionary standpoint, all viruses want to survive long-term. The fittest survive, and that means that it shouldn’t be killing the host,” explained Dr Tsang.

“When the virus kills its host, it means that it stops transmitting, and if this continues, eventually it will die out. So, viruses evolve to become more infectious, but less severe, and this is something that we’re seeing in Omicron.

“Whether Omicron is going to be the version that will be endemic but not be fatal remains to be seen…maybe there will be another variant coming up in future. But at the end of the day, this will be the natural flow of events… there will be a variant, or change in the virus structure, such that it will become less lethal, or very mild in terms of symptoms, and it will be so endemic that it will be like the flu.”

Nonetheless, Dr Tsang believes hospitals should look towards improving their infection control measures moving forward.

“From an engineering point of view, maybe hospitals should be even more equipped to manage droplets or airborne infections,” Dr Tsang mused. “Previously, not all hospitals, or not all wards are prepared for that, but if COVID-19 is going to be so commonplace, then maybe this is an area that more hospitals should look into.”