Short thread on #COVID19 vaccines and vaccine hesitancy in Hong Kong. tl;dr summary: vaccines work, we should all choose to get vaccinated so that Hong Kong can get back to normal (1/17)
In Hong Kong, #COVID19 poses just as much threat now as it did a year ago. We have done well to control surges in transmission so far, and have recorded just 11,749 confirmed cases cumulatively (0.15% of the population) covid19.sph.hku.hk (2/17)
High uptake of #COVID19vaccines will allow us to relax the public health measures that have been used either intermittently or continuously in the past year – quarantines, social distancing, mass gathering bans, work-at-home, school closures, mandatory face masks, etc. (3/17)
Ideally high vaccine coverage will lead to “herd immunity”, where #COVID19 is no longer able to spread in the community. It looks like Israel is the first place in the world to achieve herd immunity through vaccination (4/17) bbc.com/news/world-mid…
With high vaccine coverage, even if we don’t reach “herd immunity” in Hong Kong, people who have been vaccinated will be protected against severe #COVID19, blunting the public health impact of any epidemic that does subsequently occur (5/17)
However, there is considerable vaccine hesitancy in Hong Kong. The latest data from our regular random-digit-dialling population surveys indicate that, as of last week, projected vaccine uptake is only around 50%. The most recent data point here is from April 19-22 (6/17)
We also analysed intention-to-receive vaccination by age, the data here are from our survey from April 12-15, when around 20% of unvaccinated adults responded that they never intend to receive COVID vaccination (in red). (7/17)
In the previous figure, the blue and green bars, maybe even the orange bars, indicate that there is quite a high proportion of the population that could probably be persuaded to get vaccinated (8/17)
A major factor in vaccine hesitancy is the low perceived risk of #COVID19 given we have been so successful in limiting infections to less than 1% of the population in the past year. Fear of side-effects of vaccination also contributes to the hesitancy (9/17)
At the same time, there are relatively few incentives to receive vaccination. Vaccinated people here are mostly required to behave in the same way as unvaccinated people, perhaps giving the impression that vaccination doesn't make much difference? (10/17)
Please don't @ me for citing this quote from a republican politician, whether or not we agree with all of his policies I think the sentiment expressed here is spot on (11/17) news.yahoo.com/desantis-vacci…
All residents of this housing block in Hong Kong were recently sent to quarantine for 21 days, regardless of whether any of them had been fully vaccinated (12/17) scmp.com/news/hong-kong…
Under current social distancing rules here, a group of 5 or more fully-vaccinated people could be fined for sitting together on a beach (13/17) scmp.com/news/hong-kong…
In an interview this morning I suggested that on-arrival quarantine could be relaxed for fully vaccinated persons. Close-contact quarantine could be relaxed as well. Vaccination works, we should act accordingly (14/17) news.rthk.hk/rthk/en/compon…
Vaccination passports are not ideal particularly in the long run, and I recognise that not everybody is able to be vaccinated, but vaccines are now available and accessible for residents down to 16 years of age, with many unfilled slots every day (15/17) covidvaccine.gov.hk/en/
Without high vaccine coverage, Hong Kong could choose to continue being almost hermetically sealed from the rest of the world and sustain elimination for years, as I explained here hkcnews.com/article/39405/…
But there would be considerable social and economic consequences (16/17)
In conclusion, #COVID19Vaccines are safe and effective, and provide our pathway back to pre-COVID normality. I really hope we will see increasing vaccination uptake here in the coming weeks and months (17/17)

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More from @bencowling88

18 Mar
Hong Kong Citizen News have kindly agreed to publish my commentary on herd immunity. It's a long read, available here, grab a coffee: hkcnews.com/article/39405/… I published a similar commentary a few weeks ago in Chinese in Mingpao. I'll give a short summary in a new thread below
Herd immunity describes the situation where a high enough fraction of the population are immune that a large epidemic is no longer possible. Immunity can be acquired through infection or through vaccination (2/10)
In some parts of the world, herd immunity will be reached mainly through large numbers of infections. In other places like Hong Kong where infection rates have been kept low by successful public health measures, herd immunity could be achieved through vaccination (3/10)
Read 11 tweets
16 Mar
As more and more people received #COVID19 vaccines in Hong Kong, it will soon be time to think about how immune status could modify our test-and-trace procedures locally (1/17)
tl;dr summary: I think vaccinated persons should still be isolated if testing positive, while quarantine duration could be reduced or even converted to medical surveillance for some fully vaccinated persons (2/17)
If you have respiratory symptoms, you should be tested for COVID, whether or not you have previously been infected, and whether or not you have been vaccinated. Testing is also done on contacts of known cases, as well as people living or working near known cases (3/17)
Read 17 tweets
17 Sep 20
Our work on superspreading has just been published nature.com/articles/s4159…, the preprint was posted a few months ago.
Key finding - between 23 January and 28 April 2020 in Hong Kong, we analysed contact tracing data and estimated that 19% of cases seeded 80% of all local transmission. For those interested in the dispersion parameter k it was 0.33 (95% CI: 0.14–0.98). nature.com/articles/s4159…
Read 5 tweets
6 Aug 20
Here is an update on the #COVID19 situation in Hong Kong, following from my thread last week covid19.sph.hku.hk (1/18)
(2/18) We have seen daily case numbers decline in the past few days, and hopefully we have now passed the peak in our "third wave" (which is really a second wave here, because what is being referred to as the "first wave" in Hong Kong was not a wave ...). hk.appledaily.com/local/20200730…
(3/18) However, the local reproductive number has not dipped very far below 1. A reproductive number of exactly 1 would mean on average one case is infecting one further person, and daily numbers of cases would stay the same from week to week. The lower R is below 1, the better.
Read 18 tweets
30 Jul 20
(1/9) Good news about COVID-19 suppression in Hong Kong, today we estimate that the daily reproductive number Rt dropped below 1 on 22 July, around a week ago covid19.sph.hku.hk
(2/9) There is a delay in estimates of Rt due to a 10-day lag between infections and laboratory confirmations, including an average of 5 days incubation period (time from infection to illness onset) and another 5 days on average between illness onset and laboratory confirmation.
(3/9) Since Rt fell below 1 on 22 July, we would expect the epidemic curve of cases by illness onset to reach a peak approximately 5 days after that (27 July), and the daily number of laboratory-confirmed cases to reach a peak within 7-14 days after 22 July.
Read 9 tweets
10 Jul 20
(1/7) Worrying indications that the second wave of COVID-19 has now begun in Hong Kong, with more than 50 local infections being identified in the past few days and a large number expected to be reported later today.
(2/7) Our estimate of the effective reproductive number "Rt" for local infections is close to 3, which is concerning covid19.sph.hku.hk It will take a lot of effort to bring down such a high reproductive number.
(3/7) Clusters have been identified in an elderly home, a public housing estate, and linked with some restaurants. Test+trace has not prevented this. Mask-wearing in public is still universal, and has not prevented this. scmp.com/news/hong-kong…
Read 7 tweets

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