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[Wuhan nCov] First Death Confirmed in Hong Kong

39yo men, resident with his mother in Whampoa Garden, a patient of the Wuhan Coronavirus has passed away this morning at the Princess Margaret Hospital in Hong Kong. Dr (?) Ka-Hin LAU, Chief Manager (Quality and Standard Division) of the Hospital Authority, stated that this patient was transferred to the Princess Margaret Hospital on 31 January with stable conditions. However, his conditions deteriorate over the past two days and symptoms including shortness of breath arose. He had a sudden cardiac attack this morning and died shortly after. The medical team could not explain the sudden death. Reports pending from the appointed coroner.

39yo Mr. Lam died of sudden cardiac arrest this morning (4 February) at the Princess Margaret Hospital. He was the 13th confirmed cases of the deadly Coronavirus, resident of Block 1 of the Whampoa Garden (Phase 11). He suffered from type 2 diabetes and required to take oral diabetic medicines (note: not insulin injections). He had aching muscles on 29 January, fever two days after, and was hospitalized in the quarantine ward at the Queen Elizabeth Hospital. His report results showed positive to the Coronavirus and thus was transferred to the Princess Margaret Hospital on the same night (10 pm on 31 January).

There was only a total of six days from his first symptom to his death. The Department of Health has not published his deteriorated conditions. Press release has only confirmed two severe cases and one critical case. The critical patient is a 68yo woman, 7th confirmed case in Hong Kong, currently in the ICU; the two other severe cases are 56yo and 72yo men, 2nd and 10th confirmed cases respectively, none of them required intubation.

Hong Kong’s first death to the Coronavirus came about after merely 4 days from diagnosis. Lau stated, Mr Lam had difficulty in breathing and cardiac arrest at 6 am and passed away at 10 am. Regular medical treatments against viruses are used for Coronavirus patients, medicines used have referenced different countries’ procedures. This patient was comparatively young, with no records of cardiac diseases but long-term diabetes, which had been monitored and treated through oral medicines. There are currently no established links between his diabetic conditions to his eventual death, a coroner has been appointed for further investigation.

Lam went on the high-speed train G306 from HK to Wuhan o 21 January and returned to HK after two days on the high-speed train G79 from Changsha South station. He did not go to any medical organizations, wet markets; or been in contact with any wildlife. The Centre has commenced researches on epidemiology and contact tracing. None of the deceased’s families, including his 72yo mother, wife, children and domestic worker. His 72yo mother was diagnosed with catching the Coronavirus on 2 February, the 15th confirmed case in HK. She also has a long-term illness.

The Head of the Communicable Disease, Dr Shuk-kwan CHUANG, reported that she has not travelled overseas and therefore is believed to have infected by her son. She started coughing and had a temperature since 1 February in the quarantine centre, with the confirmed diagnosis the following day. She has been transferred to the Princess Margaret Hospital for further treatment, currently stable.

Lam’s families are in quarantine – except for brothers who live on different floors

According to the Centre for Health Protection, Lam’s mother, wife, children and domestic worker (a total of five individuals in the same household) are currently in quarantine in Lei Yue Mun Park and Holiday Village, except from Lam’s brother, who resides in the same block on 8/F. Chuang stated that Lam was confined at his own home prior to his death, and immediately went to the hospital when symptoms first arose. He had therefore not been in touch with other people. However, he did travel to Wuhan on 21 January and was only hospitalised on 31st.

The subsequent contact of a confirmed patient to other people are used by the Department of Health in order to decide whether a certain individual should be quarantined, Chuang explained. She emphasised that he did not ‘roam around’ after he fell ill and that anyone with ‘close contact’ to the patient is already in quarantine. His mother only fell ill when she was in quarantine, and thus did not come into contact with anyone else. None of the other families is therefore required to be quarantined.

The whole of Block E of Amoy Gardens had been in quarantine in 2003 during SARS. When asked whether she thinks it is necessary to quarantine the whole of Whampoa Gardens Block 11, Chuang stated that given the current circumstances, she does not think so as Lam’s mother is someone with ‘close contact’ to the deceased, unless there are unexplainable transmission routes within the building in the future.

When asked whether Coronavirus would be transmitted during the incubation period, Chuang admitted that ‘it is possible’, but emphasised that there are currently no scientific bases on this claim. ‘We cannot detect the viral load every day’, therefore cannot quarantine every single person in contact with a patient during the incubation period. She was challenged on whether a quarantine order is required as there were already two known cases in the building, she said that as the cases are from the same family, as opposed to transmission within the building, it will not be necessary at this stage. However, a quarantine order might be considered if there are confirmed cases without clear transmission link in the building.

Death in mainland China – also diabetic

The doctor explained that although there is no direct link between heart failure and pneumonia, there are precedents where Coronavirus patient also got myocarditis. The Chinese government has previously published the details of 17 deaths caused by the Coronavirus, whereby one patient died six days after the onset. He was 89yo, also had high blood pressure and diabetes, onset on 13 January; shortness of breaths but no fever caught the Coronavirus and chlamydia pneumonia, and eventually died of viral pneumonia on 19 January.

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