Government continues adopting risk-based testing strategy

     In view of the current risk assessment and testing resources of Hong Kong Special Administrative Region (HKSAR), the Government has updated the priorities and channels of testing services starting from today (February 25), including: distributing rapid test kits base on the risk levels of districts instead of issuing compulsory testing notices (CTN), targeting more higher-risk buildings to conduct restriction-testing declaration (RTD) operations, and streamlining follow-up procedures for confirming positive results in nucleic acid tests and rapid antigen tests (RAT). These aim to focus resources in expediting overall testing process, with a view to confirming positive cases and offering assistance as early as practicable.
 
     The recent epidemic situation of Hong Kong is very dire, with the number of new cases staying high on a daily basis. Although testing resources have now been gradually enhanced, evidenced by more than 4.6 million tests conducted in February so far with an average of more than 200 000 persons tested daily over the past seven days, the demand for testing services keeps on growing due to the upsurge of epidemic. This has put immense pressure on the work in testing samples collected for nucleic acid tests, with a mass number of samples pending processing. Some citizens (including those who test positive using RAT earlier) may not be able to obtain results after having provided their samples for days, and thus feel anxious during the period.  This is clearly not a desirable situation.
 
Testing strategy
 
     The general community in Hong Kong is now exposed to higher infection risks. While rapid test kits are less sensitive than nucleic acid tests, they may identify infected persons with a higher viral load in a prompt and relatively accurate manner. They have the advantages of being able to use in mass scale, easy for self-administering and convenient to use, etc. Citizens have also become very accustomed to conducting self-testing by RAT over the past few weeks. The Food and Health Bureau, the Environmental Protection Department and the Home Affairs Department have been evaluating the risks through methods such as sewage surveillance, and distributing more than 1.3 million sets of rapid test kits to households, cleansing workers and property management staff in relevant residential buildings in a targeted manner with the assistance of property management companies and district organisations, etc. This initiative is well received by citizens, and greatly contribute to the early identification of potential cases. 
 
     With the support of the Central Authorities, the HKSAR Government has procured a mass number of rapid test kits. In view of this, the Government has decided to revise the compulsory testing strategy under the risk-based principle as follows, with effect from today until further notice:
 

1. The Government will continue to conduct RTD operations targeting higher-risk buildings, with plans to cover more buildings.  The compulsory testing requirements upon completion of RTD operations will be replaced with RAT conducted by the residents. 
2. For places with higher infection risks (such as buildings and catering premises recording multiple cases etc.), the Government will distribute rapid test kits to relevant persons (such as staff and residents etc.) instead of issuing CTNs as in past practice.  In other words, relevant persons no longer need to conduct tests at community testing centres (CTC) / mobile specimen collection stations, and may conduct RAT on their own.  The CTNs which had already been issued will also be cancelled.  The Government will continue to distribute rapid test kits to residents, cleansing workers and property management staff in relevant districts where positive results are detected in sewage surveillance; and
3. As for practitioners in high-risk and high-exposure groups (including staff of quarantine centres / hotels / facilities and designated transport, airport staff (Orange Zone and Green Zone), staff of container terminals and shipping services, cold store practitioners, etc.), the compulsory testing frequency will be reduced from once in every two / three days to once in every seven days.  The Government will also distribute rapid test kits to relevant practitioners through the trades, such that they may perform more frequent tests in a testing cycle. 

     Apart from continuing to service those who are subject to compulsory testing, the Government will also maintain free testing services at CTCs / mobile specimen collection stations for persons who wish to undergo voluntary testing in order to reduce transmission risk in the community.   The number of mobile specimen collection stations will be suitably reduced in respect of the updated priorities as described above.
 
Avoid repeated testing
 
     In the past, RAT positive persons need to submit samples (such as deep throat saliva samples etc.) again for conducting nucleic acid tests to confirm the results.  To avoid resource duplication and time delay, the Government plans to allow RAT positive persons to register their positive results through an online system such that they may be followed up as positive cases without seeking confirmation in nucleic acid tests.  This will allow more speedy assistance to persons tested positive.  Relevant arrangements and system are now under preparation.  Details will be announced in due course.
 
     Furthermore, a sample tested preliminarily positive by testing contractors will be sent to the Public Health Laboratory Services Branch (PHLSB) of the Department of Health (DH) at present for further review in order to confirm the result.  On the same agenda, with a view to avoiding resource duplication, the Government will dispense with the review procedure by DH’s PHLSB with effect from today until further notice.  Preliminarily positive cases detected by testing contractors will now be followed up forthwith, and positive cases detected in nucleic acid tests by testing contractors will be directly deemed as confirmed cases in future.
 
     A Government spokesperson said, “The HKSAR Government will continue to leverage on the support rendered by the Central Authorities and make its best endeavours to contain the epidemic, with a view to protecting the health of every single citizen in Hong Kong.  The Government will continue to raise its testing capacities and review the priorities of its testing services at a suitable juncture, so as to provide the most suitable support to our citizens in overcoming the challenges brought by the epidemic.”