For any parents who are unsure as to which Covid vaccination would be be most suitable for their child our paediatricians and family doctors are able to offer further support and information.

Covid-19 antiviral treatment
There are two novel oral antiviral therapies for Covid-19 now available to patients in Hong Kong. Studies show that early initiation of antivirals was associated with reduced risks of hospitalization, mortality and in-hospital disease progression. Both Molnupiravir and Paxlovid can be prescribed by Central Health doctors for eligible patients who test positive and register their infections in Hong Kong via the online system: www.chp.gov.hk/ratp/

The private sector is helping to reduce the burden on the Hospital Authority by treating community cases and preventing severe infections. After paying for an online consultation, your doctor can prescribe antiviral therapy for free if this is deemed to be appropriate. Although in the majority of cases, healthy adults and children make a normal recovery without the need for antivirals.

We have secured a private stock of Molnupiravir which can be prescribed outside of the government reporting system to individuals who are high risk of progression to severe disease. People at higher risk of severe Covid-19 include those who are obese, have chronic illnesses or are immunosuppressed. We understand that many patients are also concerned about upcoming travel and catching Covid-19 in a country without access to antiviral treatment.

If you feel you are high risk and want to have prompt access to Molnupiravir should you test positive for Covid-19, please book an appointment with your GP.

Central Health Team

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As the Covid-19 cases stabilize, we are no longer requesting our patients to do RAT before entering the clinic. We do however continue to ask patients experiencing respiratory symptoms and fevers to do a RAT before attending their appointment in our isolation area.

The government has reiterated in the news that they have approved BioNTech vaccination against Covid-19 for 6 months and above, however we understand that no delivery time has been announced for this special formulation. We will keep you informed once we know more on timing.

Mind HK

MindHK is raising money to support their newly trained youth therapists to be able to continue to provide free face to face therapy in some of Hong Kong’s poorest local schools.
Please support the restaurant’s supporting MindHK ‘s initiative details below.

It’s time to dine out for a better cause.

Hong Kong’s first-ever Mind HK Mental Health Restaurant Week is here for you to enjoy the pleasure of eating together while supporting the mental health of yourself and the community. From Oct 15 – 30, bring your loved ones with you to any of the 50+ participating restaurants to help promote mental health awareness!

The proceeds raised from the campaign will be donated to support Mind HK, a local mental health charity, in improving accessibility to complimentary or low-cost community-based mental health services for people in need.

Pick your favourite restaurant to support mental health! https://www.mind.org.hk/

參與餐廳 Restaurant Offerings

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With Covid-19 cases persisting in the community and in anticipation of case numbers increasing as we approach winter, it’s important to consider the risks and benefits of vaccinating younger children. Hong Kong’s Centre for Health Protection has recently released new interim guidelines recommending Covid-19 vaccinations for children from 6 months of age.

While Covid-19 vaccines may not always prevent the development of Covid-19 symptoms, studies show they are effective at significantly reducing the risk of severe disease and death in the paediatric population.

In Hong Kong the CoronaVac (Sinovac) vaccine is currently available for babies from 6 months old, with plans to also introduce the BioNTech vaccine from 6 months of age when stock becomes available in Hong Kong (the paediatric BioNTech vaccine is not currently available in Hong Kong due to a supply issue at the time of this update).

The vaccines are available at government vaccine centers and also the following private clinics, www.covidvaccine.gov.hk/en/VSS

SinoVac:
In children aged 6 months to 3 years old, the same dose as older children and adults is used. Three vaccine doses are recommended, with a 28-day interval between the first 2 doses, and 3 months between dose 2 and 3. You can book a Sinovac vaccine for babies 6 months and older at Central Health by calling reception.

BioNTech (Not available as yet):
When available, a paediatric formulation which is 1/10 of an adult dose will be given for ages 6 months to 5 years. A 3-dose regimen will be recommended with the first 2 doses being given 8 weeks apart. The second and third doses will be spaced 3 months apart to minimise the very small risk of vaccine side effects.

Co-Administration with other Vaccines:
The guidelines no longer recommend spacing out the Covid-19 vaccination from other vaccines, which means the Covid-19 vaccination can be given anytime.

Previous Covid-19 Infections:
For children who have previously had Covid-19, it is recommended to delay vaccination for one month post infection. Two vaccine doses are recommended, with a 3-month interval between doses for both BioNTech and Sinovac vaccines. The guidelines vary slightly for immunocompromised children.

What’s Happening around the World?
In the US, the CDC recommends Covid-19 vaccination for everyone aged 6 months or older, and are offering Moderna and BioNTech vaccines to this age group.
From September Australia will be offering the Moderna vaccine to children 6 months – 4 years with pre-existing health conditions.
The UK continues to only vaccinate children 5 and above.

If you need help making decisions about your child’s vaccine, we suggest you request a consultation with one of our paediatrician who can go through the pros and cons of vaccination specifically for your child. Please email enquiries@centralhealth.com.hk to make an appointment.

For those returning from overseas and wishing to complete their Day 4, 6, 9 compulsory PCR test with us, feel free to make an appointment with one of our GPs at enquiries@centralhealth.com.hk

Further information about Covid-19 vaccines can be found www.covidvaccine.gov.hk/en/faq

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• Changes in current Hospital Authority (HA) policies about children admitted with Covid.
• A new updated emergency and out of hours advice pamphlet; please print and read carefully.
• Easier access to the clinic for Covid recovered patients, how to document past infection and what tests can provide proof of past infection with Covid.

HA policies on children admitted with Covid.
The HA issued a statement on Tuesday which appeared to reverse its previous policy on not allowing parents to accompany children who are admitted with Covid.  It says it will seek permission from the CHP for Covid negative parents to be allowed to stay with their Covid positive children.  This change by the HA was in a large part due to work and advocacy by Central Health doctors alongside lobbying by legislators Hon. Ambrose Lam, Hon Stephen Wong, our Hong Kong Foundation and the Hong Kong Committee on Children’s Rights. However this will now be a decision for the CHP and as far as we are aware they have not yet issued any new guidance.

Written resources on how to manage Covid in children are detailed in our previous updates and are available on our website.

www.rthk.hk/radio/radio3/programme/backchat

www.theguardian.com/world/2022/mar/29/hong-kong-hospitals-separate-covid-children-parents-u-turn-china

Central Health’s charitable foundation has been advocating for better healthcare for vulnerable populations since 2015. We work with Pathfinders and Christian action to provide free urgent healthcare for refugees and non entitled domestic workers. Donations to the patient care foundation allow us to provide free medication and fund essential investigations. If you are interested in knowing more about what we do please email the contacts on the link below.

www.patientcarefoundation.com.hk/2015/05/07/charter-for-childrens-hospital/

Whilst we advocate for the rights of all parents and children, our out of hours service is only available to patients currently registered with Central Health.  It would not be safe for us to provide this service for anyone who does not have up to date medical records with Central Health. Given the current pandemic situation we have a introduced a system for registering new patients remotely. Please note this can only be done during office hours by one of our family doctors who will need to ensure adequate information is recorded.

Our paediatricians and family doctors are now providing an out of hours Zoom consult service to central health patients.

Monday to Friday from 6 pm until 10pm
Saturday 2pm until 6pm and
Sundays from 9am to 4pm.

Please email them at:

childconsult@centralhealth.com.hk

gpconsult@centralhealth.com.hk

Outside of these hours, or if our paediatrician or family doctor does not respond promptly (they may be dealing with another emergency) you should phone the 24hr urgent/emergency/OPD phone line of of one the private hospitals. Our paediatricians are often on call at the Matilda hospital and will usually be able to see Central Health patients there when they are on call.

Procedures for obstetric advice and mental health emergencies remain unchanged and are detailed below.

Easier access to the clinic for covid recovered patients, how to document past infection and what tests can provide proof of past infection with covid.

 Access to the clinic
For those of you have tested positive please email us with the dates of your positive tests and we will update your notes which will allow you to access Central Health clinics without needing to fill in any forms or undergo further RAT testing.
For everyone else thank you for continuing to perform RAT tests at home or in the clinic. This has allowed us to protect vulnerable groups or those ineligible for vaccination.

SARS-CoV-2 recovery certificates
The tests detailed below can provide proof of past infection which may be accepted in the future by airlines, immigration and infection control authorities potentially increasing access to travel and possibly reducing the risk of quarantine. Proof of recovery certificates giving details of tests performed and signed by our doctors have already been helpful for our patients travelling to Malaysia.  We are unsure as to if or when other countries/jurisdictions will recognise these certificates or which tests they will require. Understandably many of our patients have been requesting information on their options on this going forward and this is currently our best guess! We will of course update you as the situation evolves.

Proof of past infection by positive antigen tests
For those of you who have had a supervised positive RAT test or positive PCR
we can provide a certificate of recovery detailing the date and nature of the test.

Proof of past infection by positive SARS-CoV-2 antibody tests
For anyone who has had has tested positive for Covid or thinks they may have had Covid but have not undergone either of the above antigen tests there are antibody tests available that can prove past infection.

SARS-CoV-2 IgG sequential antibody tests
This requires a blood test pre and post Covid infection and unrelated to vaccination.
This test can be helpful for unvaccinated or vaccinated (Sinovac or BioNTec) patients. It requires you to have had a baseline antibody for SARS-CoV-2 IgG test prior to catching Covid.

SARS-CoV-2 nucleocapsid antibody tests
This post infection blood test checks for antibodies to the SARS-CoV-2 nucleocapsid protein. As the spike protein is the only immunogen in the BioNTech vaccine, detection of antibodies against viral nucleocapsid can be used as an indicator of previous natural infection. Early data suggests nucleocapsid antibody levels decrease over time, with 50% of people having undetectable levels 3 months following infection. Given this, it is best to have this test within 3 months of your being PCR/Antigen positive.
This test is not helpful for those patients who have received Sinovac as SARS-CoV-2 nucleocapsid antibodies can be produced in response to the vaccination with Sinovac.

For those of you who would like a certificate of recovery, for adults this can be done by our nurses.  Cost of antibody blood test is $950 and certificates/exemption letter is $500.

You can make an appointment by emailing:  enquiries@centralhealth.com.hk

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For anyone who is in need and not able to get out for a physio appointment, we wanted to let you know that our physio here at Central Health is offering on-line tele-health consultations, whilst also continuing to see patients in person at our Central clinic.

Tele-physio can be a great way to get advice with pain management, exercises, and stretches without having to leave the comfort of your own home!

Working from home?
If you are working from home, tele-physio is also a great way to have a professional assess your work-from-home set up.  We can give advice on desk ergonomics and posture which can help to you to identify and correct issues that may be leading to back and neck problems.

Post Natal?
Similarly for new mums who want to get exercising and are not sure where to start, or those who would like advice on alleviating post-natal pelvic floor issues or aches and pains, tele-physio with our women’s health physio specialist can start you on the journey to recovery from right in your living room!

Whilst we recognize that an on-line consultation does not have the obvious benefit of hands-on treatment, education about your injury or condition, lifestyle advice and exercise guidance can go a long way to empowering you to manage and even recover from your injury.

For appointments, please contact reception on 2824 0822 and be sure to confirm whether you would like to book your session on Zoom or in-person at the clinic.

The post Introducing Tele-physio! appeared first on Central Health Medical Practice.

In order to better support these services, we are temporarily suspending face to face GP and paediatrician visits at One Island South and transferring staff to our Duddell Street clinic in Central. Please email enquiries@centralhealth.com.hk for appointments enquiries.

Child psychology services provided at One Island South by our child development team will continue as normal but with more options for remote consultations.

To keep everyone safe

From Monday 7th March, all patients will need to have a negative RAT (Rapid Antigen Test) that morning in order to visit the clinic. You will be asked to present a photo with an date identifier when you arrive.

Exceptions considered on a case-by-case basis, please email your doctor if you feel you cannot do the RAT.

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Covid-19 booster shots and primary vaccine series
Our previous update in November 2021 urged anyone who was eligible to complete the two dose schedule to become fully vaccinated because “if an outbreak occurs in Hong Kong, or there is an urgent need to travel, you may not have time to become fully protected”. Given the current community transmission, this is now urgent. The Omicron variant is more infectious, possibly milder but still poses a significant threat of severe disease. We have already seen community transmission and many experts are suggesting a significant outbreak is possible. We should all manage this risk.
Our current advice is:
1- Everyone eligible should first complete the two-dose schedule to become fully vaccinated.
2- If you have already received your 2-dose Covid-19 vaccination at least 180 days ago and are over 18 years old, you are now strongly recommended to receive your 3rd dose or booster. This advice includes those who are pregnant, breastfeeding or trying to conceive. It also includes non-Hong Kong residents.
https://www.covidvaccine.gov.hk/pdf/Poster_recommend_third_dose.pdf

Data shows that even the best performing mRNA shots waned in efficacy after six months, and that a 2-dose series is less effective against the Omicron variant. But the news is much more positive with respect to the prevention of severe disease due to Omicron infection after three doses of the Pfizer-BioNTech vaccine. The data also suggests that those who had 2 doses of Sinovac should take Pfizer-BioNTech as a booster.
If you require further discussion about your vaccination choices, please don’t hesitate to book an appointment with your doctor.

Changes to our Covid-19 safety measures
In order to protect our patients, Central Health will be making some changes to our Covid-19 policy from 10th January 2021. We are very aware that for many of our patients (especially those with young children), the risk of a compulsory quarantine order at Penny’s Bay is causing more anxiety than the threat of a Covid-19 infection.
With this in mind, we ask that anyone who has travelled outside of Hong Kong in the past 14 days not to attend the clinic in person. This includes those given shortened forms of quarantine such as pilots and travelers under the Return2hk travel scheme. Remote consultations done online or via the telephone remain available to all our patients and can be booked on the same day. For any patients who need to be seen urgently during their 14 days we can arrange an appropriate assessment in a hospital setting. Medication delivery or pick up by a friend can also be arranged.
Exceptions can usually be made for a pregnant household member (who needs to be seen) and has had a negative Covid-19 PCR test within 48 hours of their appointment. For details, pregnant patients should email our midwives at midwives@centralhealth.com.hk or speak to them before making an appointment.
For any further details or clarifications, please contact us at enquiries@centralhealth.com.hk or speak with one of our clinical staff at Duddell Street clinic 2824 0822 and Southside clinic 2592 9000.

Discovery Bay Clinic
For our clinic in Discovery Bay, patients who have travelled within 14 days and their families may still be able to be seen in person. Please phone 2987 7575 and speak to the clinical staff if you are in any doubt about whether you can safely attend the clinic.

Fee increase for psychologists, speech and occupational therapists
After several years of static pricing some of our psychologists, speech and occupational therapists will be increasing their fees broadly in line with inflation. The increases will be introduced after Chinese New Year. For details of new fees please contact enquiries@centralhealth.com.hk

And finally for some good news!
For the first time, we can make your most important new year health resolution come true. For most of us, achieving a healthy weight is the most significant contribution we can make to living longer healthier lives.
Finally, the billions of dollars that have been poured into research to address the epidemic of type 2 diabetes has resulted in the development of drugs that have been shown to be so safe and effective that they are now licensed to treat anyone who is at risk of developing diabetes or other health consequences because of their weight.

Our patients are generally both smart and well-motivated and most have tried the “move more and eat less”. We know for many patients this just doesn’t work and the diet/weight loss/regain-weight-plus-some cycle has caused to despair and give up. If that is the case for you and you would like to get more help, we have put together a plan that will help you succeed.

We now have an increasing number of drugs that have been used to successfully reverse diabetes that we are now able to use to prevent diabetes by achieving weight loss for patients before they develop health consequences.

The first of these drugs, semaglutide is a once weekly medication that has recently been approved for weight loss and it works; in the trials, more than half of patients lost 15% of their initial body weight and a third lost at least 20%, making it the most successful medical weight loss interventions we have at our disposal aside from surgery.

We expect there will be an explosion in the availability of drugs like semaglutide as it is a game changing development in weight management. We have been monitoring the development of these drugs and we now think it is safe and reasonable to offer them to all suitable patients who are overweight and wish to reduce their risk of weight related complications.

We also believe it is important to use these drugs responsibly and to ensure that once weight loss is achieved behavioural change can support a lifelong healthy weight using the minimum amount of pharmacological intervention. We also would like with your help to research and audit these results to show that they work. We are working with insurers to get more of them to cover costs of our full programs including personal training and gym membership. Patients will be guided through the process by a GP and have the option to be supported by either one of our two therapists; Kirti Tatiwala our dietician who specifically focuses on nutrition and Neelam Daswani a health coach with emphasis on wellbeing fitness and mentoring.

Learning Enhancement Specialist for our children in quarantine or home learning.
Our wonderful learning enhancement specialist, Sharmila Rodricks, is available to help your children learn via Zoom if you are stuck in quarantine or over the upcoming holidays such as Chinese New Year and Easter. She has over 18+ years of experience supporting students of all levels with various learning needs. She provides individualized learning support plans to cater to each child’s specific areas for growth.
To book a session with her or find out more information, please get in touch with enquiries.ss@centralhealth.com.hk

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Who can get a booster?
We have found the following flowchart to be the simplest way to check if you are officially eligible for a booster:

www.covidvaccine.gov.hk/pdf/Poster_recommend_third_dose.pdf

When to get a booster?  
Covid-19 boosters are probably most useful one month prior to travel outside of Hong Kong or as soon as there is any evidence that local cases are rising, suggesting the risk of a new outbreak. Those who belong to a high risk group and wish to get their booster as soon as possible can do so from now on. The government will likely include more groups of people as eligible for booster doses in the coming weeks.

Pfizer-BioTech or Sinovac?
Currently the evidence shows that the Pfizer-BioTech vaccine elicits a better immune response, whether you had the Pfizer or Sinovac as a primary vaccination course. Pfizer’s booster dose is the same formulation and strength as the initial doses. Data shows the side effects of the booster are very similar to the symptoms some people experienced after the initial vaccines, and possibly even milder.

If you have a special consideration such as a medical condition, previous infection or vaccination overseas, then our family doctors, obstetricians and paediatricians can give you more individualised advice based on current evidence.We continue to offer Covid-19 antibody tests and general health checkups to guide us in making the best decision for you and your family.
Also note that it is recommended to have a minimal interval of at least 14 days between administration of COVID-19 vaccine (Comirnaty or CoronaVac) and any other vaccine.

Other Central Health Updates
A warm welcome to our new psychiatrist Dr. Maxine Cheung.  She will be available to see patients at both our Duddell Street and Southside clinics. For bookings and enquiries please email enquiries@centralhealth.com.hk

This month we say goodbye to our part time psychiatrist Dr Christian Chui who is leaving to spend more time pursuing his interest in another medical specialty.  We all wish him well and thank him for his time at Central Health.

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