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How the coronavirus is affecting Hong Kong hospital patients with other conditions

South China Morning Post

發布於 2020年02月22日04:02 • Laura Westbrooklaura.westbrook@scmp.com
  • Visitation ban and lack of manpower are spillover effects of outbreak, as pregnant women are unable to see their partners, while family members can only talk to loved ones on video call
  • Hospital Authority says measures are to enhance infection control and focus resources
A fully masked hospital staff member stops visitors from entering Queen Elizabeth Hospital in Jordan. Photo: Nora Tam
A fully masked hospital staff member stops visitors from entering Queen Elizabeth Hospital in Jordan. Photo: Nora Tam

Gemmarie Ho Pui-lum knew she would be alone when she gave birth. It was not by choice. Just a couple of weeks before her due date, Ho found out that public hospitals across the city had banned partners from labour wards, because of the coronavirus outbreak.

"It was a mental challenge in the build-up to the birth. I felt like, I don't know if I can do this alone," says Ho, 35, a teacher at Little Gems Playgroup in Discovery Bay.

"But you do just get on with it, because there isn't really an option."

After her daughter, Margot Cawston, was born at Queen Mary Hospital on February 11, at 7.15am, Gemmarie called her husband.

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"It was definitely the moment that she came out when I felt really sad that Dave (my husband) had missed that part of it. It was very emotional. I cried," Ho says.

"Then it was another 24 hours at least before I was able to see him."

Gemmarie Ho, with her baby Margot. Photo: Jonathan Wong
Gemmarie Ho, with her baby Margot. Photo: Jonathan Wong

On January 25, the Hospital Authority announced that visiting arrangements at public hospitals were suspended, unless on special permission, as the city battled the coronavirus, which causes the Covid-19 disease.

The isolation ward at Queen Elizabeth Hospital. Photo: Sam Tsang
The isolation ward at Queen Elizabeth Hospital. Photo: Sam Tsang

As of Friday morning, Hong Kong had recorded 69 confirmed cases of infection, with two related deaths. Globally, Covid-19 cases rose to more than 76,700, mostly in mainland China, while the death toll stood at more than 2,200.

Locally, resources and manpower are being diverted towards containing the outbreak, and this may be affecting patients with other conditions. In January health officials apologised for putting a Covid-19 patient in the wrong ward, raising fears for the safety of others.

Accident and emergency units at public hospitals treat about 3,000 people daily, while general outpatient clinics serve 10,000 patients a day.

Luk, a brother of a stroke patient, has not seen his sibling in weeks. His brother, in his mid-40s, suffered a stroke in the middle of January and was transferred to Tung Wah Hospital, shortly before visitations were cancelled. Luk, who only gave his surname, says he received updates from a social worker, but has not been able to speak to his brother.

"I feel like the patient is being ignored. I'm very worried. As no family members can visit or take care of him, I feel like his condition and his recovery are being affected," he adds.

"The nurses are too busy to help. I don't even know who is the doctor treating him. I feel like there's no one taking care of him."

Pamela Youde Nethersole Eastern Hospital in Chai Wan. Photo: Martin Chan
Pamela Youde Nethersole Eastern Hospital in Chai Wan. Photo: Martin Chan

It was a similar feeling for Wong, the daughter of a dementia patient at Pamela Youde Nethersole Eastern Hospital. Wong, who also wished to be identified only by her surname, says she found out from news reports that she could not visit her father.

"It was a surprise, because it came in with immediate effect," she adds. "The hospital did not notify us at all."

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Wong's 79-year-old father was sent to the hospital in January. She says his doctor has been updating the family on the man's progress.

"He's in the psychiatric ward so he's allowed to call us via FaceTime. He calls us almost every day … At least we know what's going on with him."

Public hospital staff are being stretched to their limits amid the outbreak. Photo: Nora Tam
Public hospital staff are being stretched to their limits amid the outbreak. Photo: Nora Tam

In a statement to the Post, the Hospital Authority says special measures were put in place to "enhance infection control measures, and focus the resources" in light of the Covid-19 outbreak.

While the visitations are suspended in all public hospitals, "compassionate arrangement will be made for clinical consideration," it states. "For example, hospitals might provide mobile phones with video conference functions to long-stay patients in an emergency response level."

However, the Hospital Authority does not say whether such a system was in place in all wards.

Patients' families are not the only ones with an emotional toll, as some medical staff have expressed frustration over limited resources.

Samantha (not her real name) is a nurse at Prince of Wales Hospital. The 29-year-old admits there is frustration among patients and their family members, but there is just not enough manpower.

"Most of us are quite stressed at the moment. There is a lot of uncertainty around the virus," she says.

"We are very busy dealing with the winter surge of patients who have influenza A and B, as well as, general pneumonia. They have long hospital stays that can last months.

"I am also in contact with a confirmed case of the coronavirus. So, I have to take extra precautions."

Samantha says the current issue is unprecedented and a proper system, such as routine phone calls to update family members, has to be established. She also says nurses in intensive care units regularly update family members, but this is not done in other wards.

"In the general ward, it is busier and people have a higher workload, so it's not easy for them to update a family member on the patient's condition every day, or every two days."

Experts have raised concerns about the impact of prolonged isolation from family members on patients' mental health and recovery.

Dr Brent Horner, a clinical psychologist at the London Medical Clinic in Hong Kong, says family members are a crucial pillar of support for patients alone in hospital, and warns that the unpredictability of the situation presents a risk factor.

"Uncertainty is a recipe for worry and stress. That develops into anxiety, and anxiety puts stress on your body physically," he says.

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"Anxiety is not just a mental condition, it has the potential to increase your blood pressure, and over the long term it can weaken your immune system. It also affects things like your sleep, and lack of sleep leads to other potential physical and mental challenges. And so, it can potentially be a snowball effect."

Horner recommends regular phone calls with family members, if physical contact is not possible.

As for Gemmarie Ho, she echoes the sentiments of some expectant Hong Kong mothers: "I think the fact I was so close to my due date meant I didn't feel like there were any other options."

Studies as far back as 1991 have also shown that mothers who have the support of a companion during labour and delivery experience fewer complications and less post-partum depression.

But Ho adds: "I thought I was just going to get on with it, this is the reality."

Copyright (c) 2020. South China Morning Post Publishers Ltd. All rights reserved.

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