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政府承擔不足 致流感高峰期出現混亂

遲來的冬季流感高峰期，以致香港於近月爆發流感潮，無論私家醫生診所或公立醫院的普通科門診和急症室均大排長籠，輪候的市民已令全港醫療服務不勝負荷。公立醫院和私家醫院的病床也出現供不應求的情況，連帶私家醫生的流感疫苗存量也出現短缺。這些情況的出現，均顯示政府的承擔不足。流感疫症的爆發可能難以完全避免，但減低疫症的嚴重性和每年於流感高峰期間醫院醫護人員的超額工作量及醫院「迫爆」問題，確是可以做得到。

過去兩年，香港政府將五十歲以上人士列為高危群組，建議他們優先接種流感疫苗，預防感染流感。但政府卻一直未有為此群組人士提供資助或免費疫苗接種的機會。另外，有見小學生在學校內的流感交叉感染比率極高，而且今年因流感而死亡的十八歲以下個案正是一名小學生，香港醫學會建議政府免費為/資助小學生接種流感疫苗。事實上，投資在防疫工作上的開支遠低於政府在流感高峰期所投放的額外公共開支。若果政府能擴大接種疫苗的免費/資助群組、增加資源於公眾教育及確保有足夠流感疫苗輸入量，現時因流感高峰期而出現的混亂情況必有所改善。

香港醫學會提醒市民，流感是可以致命的疾病。世界衞生組織指出，根據各地的數據，每年患上嚴重流感估計有三至五百萬人，而由於流感而死亡的人口則高達二十五至五十萬人。香港去年流感季節便錄得六百四十一宗十八歲以上成人與流感相關而需入住深切治療部或死亡的嚴重個案，其中死亡人數為四百九十五。而今年一月至三月九日，已出現一百九十八宗十八歲以上成人與流感相關而需入住深切治療部或死亡的嚴重個案，其中死亡人數為七十三。同期亦錄得十一宗兒童流感相關而需入住深切治療部或死亡的嚴重個案，其中一人死亡。預計流感高峰期會延至四月下旬。而最有效的預防流感及其併發症的方法仍然是接種流感疫苗。

當然，要有效預防流感疫症爆發，市民必須提高預防意識，包括積極地接種流感疫苗，令社區產生免疫力以防止疫症爆發。每年市民的流感疫苗接種率只有約14%，顯示政府在有關流感疾病和疫苗的公眾教育工作仍然非常不足。

香港醫學會再次向政府建議：

1.      免費為/資助所有高危群組人士接種流感疫苗，特別是全港小學生及五十歲以上人士；

2.      積極地教育公眾人士預防流感和接種流感疫苗的重要性和向市民解釋流感疫苗的安全；

3.      確保本港能輸入足夠流感疫苗，以應付市民所需。

二零一六年三月十五日

編輯備忘：

香港醫學會成立於一九二零年，旨在聯繫政府、各公立醫療機構、大學及私人執業的醫務工作者，交流意見，團結一心。醫學會致力將最新的醫療資訊及醫務發展傳遞與會員，提倡會員遵行專業操守，進而服務社會，維護民康。

PRESS

RELEASE

15 March 2016

The Government’s Lack of Liability Leads to the Current Chaotic Influenza Peak

The delayed winter influenza peak has led to recent influenza outbreak.  Long queues were found no matter in private medical clinics or General Outpatient Clinics and Accident & Emergency department of the public hospitals.  All of these services were overloading.  In addition, the supply of hospital beds is unable to meet the continuous demand from patients in both private and public hospitals.  Influenza vaccines are also found to be insufficient in the private market.  The abovementioned conditions indicating that the Government is lacking of liability on prevention of the influenza epidemic.  The outbreak of influenza may be unavoidable, while we can definitely reduce the seriousness and effect of the epidemic, the overloaded works of healthcare professionals during each year’s influenza peak and the overcrowded hospitals by implementing the following measures.

In the past 2 years, the Government has recommended people over the aged of 50 as a priority group for influenza vaccination to prevent influenza infection.  However, such priority group was not being subsidized or free for the vaccination.  In addition, primary school students are susceptible to cross infection in schools, the only fatal case aged under 18 due to influenza related infection so far was a primary school student.  The HKMA proposes the Government to provide vaccinations to primary school students.  Indeed the expenditure on preventive medicine is far lower than those additional manpower and resources spend during each year’s influenza peak seasons.  If the Government can expand the groups on free/subsidized influenza vaccination, increase the resources on public education and ensure sufficient supply of influenza vaccines in the market, the current chaotic during influenza peak must be improved.    

The HKMA would like to remind the public that influenza can be fatal.  The World Health Organization estimated that influenza can result in about 3 to 5 million cases of severe illness, and about 250,000 to 500,000 deaths worldwide annually.  In Hong Kong, there were a total no. of 641 severe cases of adults aged 18 or above of influenza-associated admissions to an intensive care unit or death, with 495 deaths in the last influenza season.  As at 9 March this year, there were 198 adult severe cases (including 73 deaths), and 11 cases of severe paediatric influenza-associated complication/death among patients aged below 18 years (including 1 death) was recorded.  It was expected that the influenza peak would be ceased by end of April.  Vaccination is still the most effective way to protect one from influenza infection and its complications. 

To effectively tackle the influenza outbreak, the public must raise their prevention awareness by actively participating in influenza vaccination so as to ensure the herd immunity can be created.  The overall vaccination uptake rate of 14% each year indicating that the Government’s ineffective work on the public education of influenza prevention and vaccination.     

The HKMA suggests the following proposals to the Government:

1. To offer free/subsidized influenza vaccination to all priority groups, especially the primary school students and those aged 50 or above;
2. To proactively educate the public on influenza prevention and the importance of vaccination, and to explain the safety of vaccination;
3. To ensure there is sufficient supply of influenza vaccines in the market to fulfil the demand.

Notes to editors:

The Hong Kong Medical Association, founded in 1920, aims to bring together Hong Kong's government, institutional, university and private medical practitioners for an effective exchange of views and co-ordination of efforts.  The foremost objective of the Association is to safeguard and promote public health.  The Association speaks collectively for its members and aims to keep its members abreast of medical ethics, issues and advances around the world.  In fulfilling these goals, the association hopes to better serve the people of Hong Kong.