Table 1.
Laboratory Surveillance and Monitoring Programs in Hong Kong and in the Kowloon Central Cluster Hospitals
| Surveillance/Monitoring Program | Specimen Type(s) | Target Population | Launch Date | |
|---|---|---|---|---|
| Hong Kong wide surveillance | Tier 1 (inpatient) | Upper ± lower respiratory specimens | Symptomatic patients with epidemiological risk factors. | 31 December 2019 |
| Tier 2 (inpatient) | Upper ± lower respiratory specimens | Enhanced laboratory surveillance for patients with pneumonia with (i) unknown cause, or (ii) requiring intensive care support; or (iii) occurring in cluster, or (iv) in healthcare workers. | 13 January 2020 | |
| Tier 3 (inpatient) | Upper ± lower respiratory specimens | Enhanced laboratory surveillance in all patients admitted to hospital with pneumonia. | 31 January 2020 | |
| Tier 4 (outpatient) | Posterior oropharyngeal saliva | AED or general outpatient clinic attendees with fever or acute onset mild respiratory symptoms. | 19 February 2020 | |
| Tier 5 (outpatient) | Posterior oropharyngeal saliva | Private outpatient clinic attendees with fever or acute onset mild respiratory symptoms. | 6 March 2020 | |
| Tier 6 (outpatient) | Posterior oropharyngeal saliva | Asymptomatic returned traveler | 25 March 2020 | |
| Temporary testing centers for symptomatic returned travelers (outpatient) | NPS/T | Symptomatic returned travelers arriving Hong Kong International Airport. | 20 March 2020 | |
| Triage and test (T&T, outpatient) | NPS/T | Symptomatic patients with epidemiological factors attending AED. | 28 March 2020 | |
| Cluster-based surveillance in KCC hospitals | Patient undergoing nonemergency AGP (in and outpatient) |
Posterior oropharyngeal saliva | Asymptomatic patients undergoing nonemergency AGP. | 10 February 2020 |
| Staff with travel history (outpatient) |
Posterior oropharyngeal saliva | Asymptomatic hospital staff with travel history | 16 March 2020 | |
| Confirmed patient monitoring | Confirmed COVID-19 patients (inpatient) |
Respiratory specimens and/or posterior oropharyngeal saliva | Monitoring of patients with confirmed COVID-19 infection in hospital AIIR until discharge criteriaa is achieved. | 13 February 2020 |
Abbreviations: AED, accident and emergency department; AGP, aerosol generating procedure; AIIR, airborne infection isolation room; COVID-19, coronavirus disease 2019; KCC, Kowloon Central Cluster; NPS/T, pooled nasopharyngeal swab and throat swab.
aThe local clinical practice guideline at the time of the study advised that all confirmed cases must be hospitalized and could only be released from isolation when two clinical specimens were tested negative for SARS-CoV-2, taken at least 24 hours apart, and the consensus was all previous positive sites needed to meet the criteria.