Hong Kong

At the time of this writing, the Novel Coronavirus outbreak is still in its early days and could soon become a global pandemic. Its exponential growth continues in China and has now spread to 28 countries. It can be transmitted by symptomatic and possibly asymptomatic carriers.

Our family takes the threat seriously.

Novel Coronavirus GrowthMany people compare the 2% mortality rate to that of SARS (10%) and MERS (40%), or the number of deaths (493) to the flu (500,000), and conclude that there’s nothing to worry about. But my family takes it very seriously for a few reasons. Below is how I see it (I’m not a doctor or an epidemiologist!)

  • While just 2% of those diagnosed with Coronavirus seems like a small number, that’s four times greater than the mortality rate associated with the flu, which is responsible for hundreds of thousands of deaths.
  • An alarming 13% of all those diagnosed are now in critical condition.
  • People with pre-existing conditions are especially at risk. In my family, 3 out of four of us have asthma and one of us has Reactive Airways Disease. We’re not sure if these qualify as pre-existing conditions. Doctors, please weigh in here.
  • Putting the dangers of the virus aside, the accompanying panic could be very dangerous if it leads to overwhelmed hospitals or food shortages.

Of course there are valid reasons not to panic.cialis générique

  • An unknown number of people get infected but experience symptoms minor enough that they don’t go to the doctor. If this is a common occurrence, then the rates of hospitalization and mortality are even lower than reported.
  • It’s currently estimated that only one in five people need to be hospitalized, and these are usually people who are immunocompromised.
  • Steps the World Health Organization (WHO) suggests to avoid the virus all seem feasible, if boring: wash hands frequently, avoid crowds, avoid touching your face.
  • That same chart of a rise in cases, shown on a logarithmic scale, shows a slowing of the rate of growth in both new cases and mortality:

Novel Coronavirus Logarithmic

We could leave but we choose not to. 

We have US citizenship and could be on a plane back to NYC today. We have friends and family in other cities across Asia as well, and our work is flexible enough that we can act on any of these options. Nonetheless, we have chosen to stay put and I’ll try to explain why here.

Getting on a plane and going anywhere could be bad for us and others. If we are already infected but in the incubation period, then the last thing we should do is get on a plane because we’ll only accelerate the spread. If we are worried about getting infected, then getting on a plane might not be the best idea (though the World Health Organization doesn’t explicitly advise against it).

If we were to leave, how long would we be gone for? A global pandemic or even local epidemic can take months to play itself out. Air travel home to Hong Kong could be banned. If we were to leave, the right thing to do is to leave permanently. That’s not something we’re willing to do yet, given that we can take steps to avoid getting sick and given that if we do get sick, we’re likely to all survive.

We are responsible for other people here.  My wife is a director of a medium sized trading company, and we, like many HK families, have housekeeping staff here who, in turn, have families back home to feed. How would it look if my wife were to leave the country but expect her staff to continue showing up to work? And we are fully responsible for the well being of our house staff; we cannot leave them to fend for themselves.

Hong Kong is better prepared than other cities. 

Hong Kong takes hygiene seriously. Yes, the government here is far from perfect, but I trust Hong Kong’s medical professionals and even the general population’s ability to take precautionary measures. Ever since SARS, Hong Kong has taken many steps to minimize the spread of illnesses. For example, buildings routinely sterilize elevator buttons.

Elevator button

Travelers have their temperatures checked at every border. With or without a pandemic, people wear face masks whenever they have a cough to avoid getting others sick. Most businesses are letting their employees work from home. To get into my office, I must wear a mask and a friendly security guard takes my temperature.

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Most toilets here have seat covers and are activated by sensors. Bathrooms are cleaned hourly in many public spaces. This may matter as some sources report post-flush fecal clouds can transmit disease.

toilet in HK

Food remains available. Yes, Hong Kong imports 95% of its food. However, even as flights are being banned, there is no sign of cargo being banned. So we may see fewer imported fruits and vegetables available, but all the non-perishable goods will still be here.

The medical system is very good. My local private hospital, Gleneagles, is incredible. I stopped in yesterday to get (late) flu and pneumococcal vaccines in case we decided to go to the US, and the process was seamless. I was surprised to learn that, to get a vaccine, I had to go through the emergency room. But then I was amazed to see that the whole process took about 20 minutes! This was the emergency room: clean, efficient and empty.

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And this is the lobby. It looks more like a high-end mall than a hospital.

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If anyone in my family were to get sick, I would much rather they be treated at this resort-of-a-hospital than at the depressing, overworked, overcrowded, underfunded hospitals in the US, where every visit triggers huge bills and fights with the insurance company. Plus in HK everyone speaks English and I understand the system, which is not the case in other Asian countries where we were considering going to. One massive caveat: at this time, if someone is found to have coronavirus, they’ll be transferred to designated (public) hospitals, so the hospital above is where we’d go if we have anything other than coronavirus.

I do have to travel for work in the coming weeks and I worry about the risks mentioned above. The WHO recommends taking “usual precautionary measures” when flying but does not advise against it altogether. I mostly worry about being separated from my family if more flights to Hong Kong are banned. This, to me, is currently the most pressing risk we face, but not one that I’m convinced is worth relocating my family indefinitely.

We might still change our minds and we’ll take it day-by-day. 

The changes that we’re looking out for include:

  • Systematic failures in the medical system by way of hospitals being overwhelmed
  • Shortages of food or fuel

Of course every family has to make their own decision, and there are valid reasons to leave. I’m writing this partially to convince myself and to share our thinking with other families who might be in the same boat. Finally, may we all extend compassion and resources to one another, especially to those living in China, and especially to those near the the epicenter of the outbreak – Wuhan stay strong! We will get past this and the efforts taken today will make us better prepared for new threats tomorrow.

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  • miguad98

    Good luck and positive energy to you and your family. After this all gets settled – I do hope we’ll be able to see you soon!

  • http://arshadchowdhury.com/ Arshad Chowdhury

    Thank you, Miguel! Looking forward to it

  • Aileen Payumo

    Sending you, Anika and the fam much love and strength arsh marsh

  • http://arshadchowdhury.com/ Arshad Chowdhury

    Thanks, Aileen! I hope it doesn’t spread too far in the Philippines or in the US.

  • Evan C. Newell

    I have been thinking about you guys and following news on the virus. I feel far away from China physically but imagining being in China seems like it might be scary. And then I think maybe the danger is overblown. And then I think maybe this situation is far worse then people comprehend. So I don’t really know what to think about it. I really appreciated hearing your perspective from Hong Kong. Thank you. It is clear you’ve given this a lot of thought and your thought process seems reasonable. Keep us posted.

  • http://arshadchowdhury.com/ Arshad Chowdhury

    Who knows… maybe we’ll see you sooner than later as there have been a few panic runs on food items like rice. It’s going to get worse before our gets better.