Masks, Germs and other Covid Thoughts from an American Nurse Living in Asia

Photo Op for the Ronald McDonald House of Hong Kong

This post is especially for my US friends who have messaged me with questions about masks, quarantines, and other Covid questions. I haven't been compelled to write a post about this because 1) who needs yet one more virus article? and 2) I am no more qualified to give an opinion than any other average Joe on the street. But here goes.

The main reason we are asked frequent questions is that we have been working from home since February 3, or "dealing with this virus mess" longer than most of the world, and we are in Hong Kong, which, as most of you know, has an amazing track record of dealing with the virus. Our first confirmed case was January 23, and as of today, there are just 1040 cases and only 4 deaths. This is a city of 7.5 million people that shares a border with mainland China.  To put this in perspective, New York City has 8.4 million people, 170,000 cases and 13,168 deaths. They are also 8000 miles away from China and didn't have their first confirmed case until March 1. (I realize it is likely both cities had unconfirmed cases before then.) In other words, NYC had a big "heads up" regarding this. So why the differences? Here are my observations.

Back around the end of December/ (beginning of January?), I was at work--I'm a school nurse at an International School--when I saw an article about a strange new virus in China. Back then, it was believed to only be connected to one market in Wuhan and wasn't thought to be spreading person to person. Didn't seem so serious to me, but guess what? Within a week, Hong Kongers were wearing masks even more than normal during flu season. My colleague in purchasing asked me about our mask supply. When my husband asked his students about it, mentioning that the new virus was not believed to spread person to person, the students all said, "Nobody trusts China."

We already had plans to fly home to Maine for Chinese New Year, and we left Hong Kong January 22, the day before Wuhan closed its borders. When we returned to Hong Kong a couple weeks later, the whole city was wearing masks and there was a major run on them, toilet paper, and cleaning supplies, even though at the time, the government here, trying to thwart panic buying, told us masks were not necessary unless we were symptomatic. Again, Hong Kongers said, "We don't trust the government," and they wore their masks anyway, lining up for hours to buy them.

You also need to realize that in 2002, SARS hit Hong Kong in a big way, and that is in the collective memory of most of the city. They don't mess around. As I mentioned, even during a normal year, you will see a good portion of the population wearing masks during flu season. They are diligent about using hand sanitizer (they have little bottles hooked to their bags) and they use a tissue or their keys to push the elevator buttons. (They don't, as a rule, wear disposable gloves though.) Public areas like escalators and bathrooms are sanitized every hour or two. Temperatures are checked upon entering buildings. When the city had only a handful of cases, the decision was made to close schools (they still haven't reopened). All non-essential government agencies closed, and private businesses were encouraged to allow employees to work from home. No one had to tell them twice. The streets were pretty much empty for a month or so. But here's an interesting bit: parks, beaches, restaurants, hair salons, grocers, retail shops and public transportation were never shut down. Granted, these places were pretty much empty, because even without a mandatory "shelter at home" order, hardly anyone went out. What I'm trying to get at is this: Hong Kongers did on their own what most governments had to force upon their people.

So what happened? Through mid March, our cases remained very, very low. People got out and about more, and perhaps became a little less careful. But then as city residents, especially students, who were living abroad started coming home because cases were getting worse around the world, they brought a lot of imported cases with them, and our numbers rose. This brought on stricter measures: restaurants are only allowed to operate at 50% capacity, nail salons and bars are closed and groups of 4 or more are not allowed in public. (This is a tricky one, because public places have way more than 4 people, but I guess they aren't technically "together?") Most shops remain open and only those coming from abroad are quarantined.

Finding someone without a mask it not easy. A street in Mong Kok last week.

So that leaves us where we are now. For the last two weeks or so, we've had many days of zero or single digit new cases. People once again are out and about more. There is talk of possibly allowing some students to return to school by the end of May. It's looking good.

So what's my biggest take away? Hands down, I believe the biggest difference here is that everyone wears masks. They wear them because they don't know if they are silent carriers and they don't want to infect you. They wear them because they don't know if you are a silent carrier and they don't want your germs. They wear them because it is now a cultural norm and it is considered rude if you don't--not to mention the risk you run of getting the major side-eye (or worse) from a Cantonese grannie half your size. Wearing a mask is not a moral issue, so even though I have mixed feelings on the efficacy of them, I wear one, because, well, it can't hurt. 

I know that you can find scientific studies that say that masks aren't 100% effective in viral spread, and that is absolutely true. Viruses are tiny, tiny, tiny, and they can get through all but the most industrial grade N95 respirator masks. Even these are ineffective unless they are worn properly. (We had to have special training on how to wear these at the hospital where I worked in the US before we could care for isolation patients.) But let's face it, masks at least help somewhat or doctors and nurses wouldn't wear them. And any type of material will minimize the spray of a cough or sneeze; this is what we are going for. Viruses can be airborne, but they also are in droplets when you cough. It's the reason we teach little kids to "cover your cough;" germs spread more easily if you don't. Looking at Hong Kong, I have to believe that the vast majority of the population wearing masks before the virus really took hold, along with early social distancing measures, played a major role in keeping the numbers down.

We are not mask Nazis. We wear them when around people, but not when walking in open spaces. 

So these are my thoughts at the moment. I reserve the right to change my opinion at any time (trust me, it happens often)...and if your opinion is different, I still like you!! 

Travelling Tuesday: Lamma Island Adventure

One of the biggest perks of living in a new country is that nearly every day off can become an adventure, and we truly feel this living in HK. Because the city is relatively small in land mass size, it is easy to jump on public transport and get to where ever it is that you want to go quickly and inexpensivley. There are many outlying islands, most are uninhabited, and we have yet to explore the majority of them, but last spring, we jumped on the metro and then a ferry and ended up on Lamma Island, a little gem of a place. For me, there is something about striking out on a boat that just smacks of adventure--I absolutely love to be on the water! You can take the ferry to either end of the island and stay put, or hike the path in between the two ports, (about 60-70 minutes), which is exactly what we did, landing in Sok Kwu Wan and ending up in Yung Shue Wan:

The boat ride from the Central Ferry Station took about 30 minutes or so, but it was lovely and gave me a view of HK Island that I had never seen before:

The island is home to a major power plant; this is really an eyesore, but, you know, I do like my electricity and they have to build those buggers somewhere.

The Village at Sok Kwu Wan is a bit more rustic than the other side, and we loved checking out the goods at the market there, seafood in any shape and size, fresh or dried:

This "lobster ornatus" was HUGE:

We walked through a true country village (makes me feel like I am back in Maine, well, sort of):

And I loved that they had these labeled "doggy latrines" all along the way:

One of the photo ops is the "kamakazi cave," proportedly built by the Japanese during the war to hide who-knows-what, but it was never used. A bit spooky in there. This was as far as we went.

The trail is well marked and mostly cement or rock. There are several side trails and beaches along the way:

As always, flowers peak out at you from every corner:

At Yung Shue Wan there is more of a restaurant "strip." It is a strange phenomena that when you are living in any given country, you crave foods of where ever it is that you are not. We ate at the B&B, an Italian Cafe (you can see the sign if you look closely):

We were given a table for two right on the water:

and while the food was tasty, (I was starving), it had that Asian-Italian flavor that I can't quite explain. It makes me wonder: if I ever visit Italy, will the Chinese Restaurants there have an Italian-Asian flavor?

I did, however, get a very proper pot of "English" tea!