OT&P Healthcare Podcast

Over the course of the pandemic, Dr David Owens has written a series of articles analysing the Hong Kong Covid response. As China begins to shift away from the strategy of ‘dynamic zero Covid', this article considers how lessons learned from the different strategies in Hong Kong and Singapore can best be applied when considering the current challenges facing the mainland. 

The recent increase in case numbers and tightening of social distancing policies has again reminded Hong Kong residents that although the rest of the world has moved on to other things, our city continues to march to the dynamic zero Covid beat. In our latest podcast, Doctor David Owens and Professor Ben Cowling discuss a wide range of issues around the science of Covid including the emerging 6th wave, the evidence for vaccines and masks and lessons from the Russian flu pandemic of 1889. They also discuss Long Covid and answer questions from you our listeners.

The fifth wave of Omicron BA.2 is currently having a significant impact on our city. Hong Kong is in the unenviable position of having the highest mortality rate in the world. In our latest podcast, Dr David Owens and Professor Ben Cowling discuss the current situation. They also discuss the factors driving the high mortality. They explain that we are already at herd immunity and ask what that means for Hong Kong over the next few months. They also answer questions submitted by you, our listeners. 

In this episode Dr David Owens and Professor Ben Cowling discuss the evolving fifth wave in Hong Kong. In a change from our previous episodes, we asked our listeners to submit questions, we were overwhelmed with the response and apologise that we were not able to cover all issues. This episode covers amongst other topics, the transmission of Covid, elimination or mitigation as a strategy, vaccinations in children and the potential impact on physical and psychological well-being as a result of the public health measures.

After 6 months without a community case of Covid, we are now seeing sporadic community cases with clusters of both Omicron and Delta infections in Hong Kong. In our latest podcast Doctor David Owens and Professor Ben Cowling discuss the current situation. They discuss the dilemma of a Zero Covid strategy without a plan for exit. They consider what a plan B may look like. They also discuss the costs of the public health policy on physical and mental health and hamsters.

It is now two months since the last community case in Hong Kong and the bubble with the mainland is due to open in the next few weeks. In our latest podcast Doctor David Owens and Professor Ben Cowling discuss the current situation in Hong Kong and the potential implications of the Omicron variant recently identified in South Africa. They discuss the dilemmas around vaccine hesitancy in the context of zero covid and specifically the threat of low vaccination rates in the vulnerable elderly. They also discuss the role of booster doses and the philosophical arguments around vaccine mandates. 

Whilst much of the world begins the transition to normality Hong Kong has doubled down on a zero COVID strategy in an attempt to achieve the as yet undefined criteria which will allow an open border with China. In our latest podcast, Dr David Owens and Professor Ben Cowling discuss the brittle nature of Zero Covid and the lack of evidence and potential harm caused by recent public health decisions around quarantine. They also discuss the dilemma around decisions on vaccinating children and giving booster doses. The risk-benefit calculations of both these interventions change depending upon the long term public health strategy.

Hong Kong has removed objective benefits for vaccinated travellers and doubled down on a Zero Covid strategy. Doctor David Owens and Professor Ben Cowling discuss the recent changes. They discuss the evidence for the reduced incubation period and increased infectivity of the delta variant and the importance of positive messaging to increase vaccination uptake in high-risk groups. They both see living with Covid as the only long-term effective strategy. 

In our latest podcast, Dr David Owens and Professor Ben Cowling discuss the evolving Covid public health strategies playing out in different parts of the world. They also discuss the role of booster doses and the challenges of maximising the population benefit of the available vaccines in the context of vaccine inequity. 

Dr David Owens and Professor Ben Cowling discuss the recent government decision to reduce quarantine for vaccinated individuals provided they have proof of positive antibodies. They discuss the evolving evidence for a strong antibody response, especially with the BioNTech vaccine and the curious case of the recent alpha cluster in Hong Kong. In particular whether the crocodile was guilty or not guilty.

Dr Owens and Gira Patel discuss the psychological and social impact of COVID-19. Gira discusses her recent compulsory quarantine in Penny's Bay. She describes the personal impact and the tools and strategies from her practice which helped her to navigate both quarantine and COVID-19.

The fourth wave in Hong Kong has finally been brought under control and we have seen a number of days of zero COVID cases. What does zero COVID mean and is it a sustainable strategy? In this month's OT&P podcast, Dr David Owens and Professor Ben Cowling discuss the current zero COVID strategy and the difficulty of managing the transition to normal in the context of high vaccine hesitancy. They both argue that vaccinated individuals should be treated as if they are immune.  They also argue that risk can never be totally eliminated and policy decisions should be based upon the evidence-based management of risk. 

In this month's episode, Dr David Owens and Professor Ben Cowling discuss the recent cases involving variants of concern, in Hong Kong. These cases have resulted in an increase in numbers of people being quarantined and subject to compulsory testing orders including those who have already completed vaccination.The vaccination program in Hong Kong is efficient, free and vaccines are widely available, however the percentage of the overall population taking the vaccine continues to be low. In this podcast they discuss the factors which influence such a high level of vaccine hesitancy and contrast this with the high vaccine uptake in a recent survey of OT&P patients which showed 88.9% of patients to have had at least one vaccine in comparison to 13.4% in the population overall. They both make a case for relaxing quarantine restrictions for vaccinated individuals in order to create carrots and nudges for boosting vaccination rates.

In our experience, the majority of OT&P patients are significantly more worried about the personal implications of the public health regulations than they are about the disease itself. This is especially the case for families with young children. In our latest Podcast, Dr David Owens sat down with Professor Ben Cowling. They discussed the Hong Kong public health strategy in comparison to that used in other countries. They also discussed the increasing evidence of effectiveness for COVID vaccines and the challenges of vaccine hesitancy in Hong Kong.

In Hong Kong, the fourth wave of COVID-19 infection continues to settle and the government has commenced the rollout of the vaccination program. The situation in Hong Kong is very different to that in Europe and the US, in that we have very low levels of infection but also very low levels of population immunity. In our latest Podcast, Dr Owens again sat down with Professor Ben Cowling to discuss this dilemma and specifically the role of COVID-19 vaccinations in the normalization of life in Hong Kong.

When dealing with the inevitable frustrations of social distancing measures, it is easy to lose sight of how well the epidemic has been managed in our densely populated city. COVID-19 is a mild disease in the majority of circumstances, but it has the potential to overwhelm health systems because of a potentially rapid increase in the numbers of infected patients. Avoiding excessive strain on the hospital system is one of the main goals of the public health controls.In this episode, OT&P talks to a Hong Kong doctor who has spent the last year working as a front line emergency doctor in London. He discusses his personal experience of the first wave, an intensive care unit working at triple its normal capacity and the impact of being called upon to ventilate fellow healthcare workers including colleagues and friends. More recently ambulances take up to 6 hours to offload patients as the hospital strains under the stress of the epidemic surge. Ultimately though, he remains positive, both about the arrival of vaccines and that, although under strain, the system is, and will continue, to cope.

In response to the feedback from our first podcast in December, we have produced a follow-up interview with Professor Ben Cowling, the division head of the department of epidemiology and biostatistics in the School of Public Health at the University of Hong Kong. In this podcast, we discuss the expectations of the fourth wave in Hong Kong, the evolving new viral mutations and the outlook for immunization. Professor Cowling expressed his concerns about the early reports of the effectiveness of one of the vaccines currently proposed for Hong Kong.

In Hong Kong, we are again seeing an increase in social distancing regulations in response to the fourth wave of infections. The incidence of silent community transmission and evolving clusters makes it likely that enhanced social distancing measures will remain in place for some weeks.Communicating risk in evolving epidemics is challenging. Uncertainty and lack of control are key factors in stress and there is a natural tendency to focus on difference, rather than consensus, when faced with opinion from experts. Hong Kong is fortunate to have world-class expertise in the management of infectious disease and particularly in the fields of epidemiology and virology.Professor Ben Cowling is the division head of the department of epidemiology and biostatistics in the School of Public Health at the University of Hong Kong. OT&P interviews him to discuss the transmission of COVID-19, whether we should close schools and consider the public health dilemma of balancing the impact of a disease against the impact of the public health measures used to control the disease.