Continue to wear masks: This will be the last ‘Letter from Hong Kong’. I began back in April with a simple message, wear masks. I think the phase of relying on individual responsibility is over. In the first six months of the crisis Hong Kong had a total of four deaths and just over 1000 infections. I proudly and incorrectly attributed this to a greater sense of social responsibility in Asian culture. In retrospect I think it reflected the paths of penetration of a virus into a community. Today we have 7721 cases and 123 deaths. Still, with a population of 7.9 million packed together in one of the most densely populated urban regions, the response has been revealing. A recent cluster of over 400 cases was linked to an indulgence of the wealthy ladies in their 60s and 70s. These are the ‘Tai Tai’s’ and they like to dance with young gigolos. They organise afternoon Mahjong games, an evening dinner and then the dance floor opens up. The evening does not always conclude with the dancing! So, this group with roving gigolos and lonely old ladies created a string of outbreaks over the territory. There is so much information (and disinformation) out there that I think it is time for me to move on from commenting about the global pandemic. One last comment concerns the vaccination.
Vaccination: In Hong Kong several batches of vaccine have apparently been ordered. Amongst these is a 15 million shot contract with a Mainland Manufacturer. There is even talk of paying recipients of this vaccine HK$5000 each just to take it. The comments section is interesting and can be found here:
In the process of looking into the background of vaccination safety I came across a description of the Cutter Incident in the United States of America in 1955. The first live polio vaccine was given to 200,000 children; 40,000 developed polio, 200 children were permanently crippled and 10 died: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1383764/
It is open access and you can read about the politics of vaccination 65 years ago. Out of interest, I looked to see what was happening in China in 1955. The PRC was declared a sovereign nation in 1949. Within a year the PRC and the USSR were involved in a deadly conflict on the Korean peninsula (1950-1953). The USA just could not leave China alone and sided with the rebel Kuomintang army who fled to Taiwan, or as I like to think of it, Formosa. The USA forces were on the verge of launching a nuclear attack on China and Eisenhower had to be talked back from the brink by Winston Churchill and NATO foreign ministers.
Fast forward 65 years and what incredible accomplishments have been made by both the East and the West. How the world emerges from this global pandemic will be a reflection of collective human intelligence. This somewhat philosophical concept relates to the transition from an individual (subjective) responsibility to an externalised, objective, focus on social control. That sentence marks a watershed as I move into a new field as a patient advocate but also a consultant in medicolegal issues.
My specific are of interest is gross negligence manslaughter (GNM). This has become an issue in Hong Kong and I did declare my concerns in a letter published in the SCMP this weekend:
So, what I propose to do is to write a weekly blog under the very ambiguous title of ‘At War with Law’. The specific issue I shall be examining will be the role of a professional regulatory body when dealing with doctors who are undergoing a progressive decline in the competences required for them to safely perform their job. The majority of such doctors will be elderly, and how a profession deals with its senior members is very telling. The UK General Medical Council (GMC) has been very proactive in terms of revalidation. The Medical Council of Hong Kong is an anachronistic organisation resembling the early 1990s GMC. Years of arrogance and complacency had rendered the GMC ineffective as a protector of the public interest. Increasing public pressure to implement change was the background of the major changes that resulted after the Bristol Children’s Hospital Cardiac scandal. The GMC has changed, the MCHK has not. Yet.
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