Hong Kong is again facing the same situation people in the city feared earlier this year: COVID-19 is spreading rapidly; hospitals are strained; and several chains of infection are developing within communities. But the good news is that Chinese mainland genome laboratories are applying their expertise to help the city combat its third and more-severe wave of the coronavirus outbreak.

Ng Man-hin, a local taxi driver, was one of the first to take a newly offered free COVID-19 test at Yau Ma Tei Car Park on July 23.

When the 29-year-old cabbie heard the news that he was eligible for free COVID-19 testing, Ng admitted he wasn’t too keen on the idea. “Even though I may test negative for the virus, when I drive an asymptomatic patient in my cab the next day, I may still get infected,” Ng said. “So I just shrugged off the idea as not likely to be useful.” But that night, the idea occurred to Ng that maybe he himself was asymptomatic, and that he could have been spreading the virus to his parents, his friends and his passengers.

Ng can’t work at home like most white-collar employees. Ng believes his job is at great risk of contracting the coronavirus. “When you are a taxi driver, you meet people from all walks of life throughout the day,” Ng said. “The last thing I’d ever want to do is to expose my aging parents to this deadly disease.” Prompted by a deep sense of duty, Ng registered for his first COVID-19 test. “I have nothing to lose, after all,” he said.

Confirmed COVID-19 cases soared to over 3,000 on Wednesday and the number of deaths continued to mount. The Hong Kong Special Administrative Region government has been offering a massive number of free nucleic acid tests for people in elderly care homes, as well as taxi drivers, restaurant workers and property-management employees. All were classified as high risk of contracting COVID-19 on July 17. The government announced on Monday that testing gradually will be extended to minibus drivers, vendors in wet markets, and employees of special-needs schools.

When Ng recalled his experience of the test, he described the process as “exceptionally efficient and well-organized”. “Not only is ventilation good because it is located in an open area, but all the nurses wore full sets of protective gear, which made me feel safe,” he said.

Ng said it was a great relief to him to know that he doesn’t have the virus. “Beforehand, the test may have cost me HK$2,000 (US$258) and the results might have taken two weeks. Now it is free, and results take only 48 hours,” he said.

According to the Transport Department, as of Saturday, the government has received about 10,600 registrations from taxi drivers and collected about 8,280 samples. The throat swab samples of taxi drivers, minibus drivers and senior caregivers will be sent to the Huo-Yan Laboratory, operated by BGI-Hong Kong, for testing.

During an interview with China Daily, Aldo Wong Sai-wah, manager of BGI’s genetic laboratory in Hong Kong, said 5,000 tests are being carried out daily at the company laboratory in Tai Po.

Wong said the testing capacity is only half-occupied as the lab wants to play it safe.

He said the laboratory is able handle up to 10,000 samples daily for virus testing, and its testing capacity can be further ramped up to 30,000 a day in one to two weeks.

Wong said the laboratory’s Shenzhen-based parent company, BGI Group, can offer the mainland’s anti-epidemic experience, which is most valuable for inspiring the city’s battle against the third wave of COVID-19.

“Our headquarters has offered the local research center immense support in areas such as manpower, machinery, and experience, which has greatly increased our testing capacity,” he said.

Established in 1999, BGI has a long history of coping with international public health crises, including decoding the genome of the SARS virus in 2003, and fighting the Ebola outbreak in West Africa in 2014. In April, the genomics company had tripled its previous daily production of coronavirus detection kits to 2 million per day, meeting the orders from more than 80 countries, including France, Germany, Italy, the United Kingdom and Sweden.

The virus-testing Huo-Yan laboratories, initiated and designed by BGI, have now been set up in Asia, US, Europe, and the Middle East. Construction and discussions for 40 additional Huo-Yan laboratories are currently underway in more than 10 countries and regions, the company said on its official website.

Wong recalled that the company’s laboratory technicians had already received continuous anti-pandemic training from the Shenzhen parent company, starting in January. The workers were trained before the local team had to deal with testing actual samples for the novel coronavirus.

“They offered us all-around support, ranging from sampling techniques, experimental methods and coronavirus reagent test kit reviews,” Wong said. “That is the reason why when the HKSAR government reached out to us and gave us the patients’ samples, we could begin our work, immediately.”

Wong also said that the engineering scientists at the Shenzhen headquarters had worked tirelessly to help them ramp up their testing capacity. “Without their early-stage support, we could never complete this task,” he added.

Amid the spike in confirmed infections in the past three weeks, BGI-Hong Kong is one of several private labs commissioned by the SAR government to conduct the city’s first-ever mass testing. The testing will engage over 400,000 people from the four hardest-hit sectors.

Promise of a helping hand

Mass testing at this level is believed to be a key for the city to identify asymptomatic patients to cut off transmission chains in the community. Through Wednesday, Hong Kong had seen 1,637 infections since July 10, over 54 percent of the total tally of 3,002.

Monday remains the highest daily jump since January, with 145 confirmed cases, and over 40 percent were not traceable.

Chief Secretary Matthew Cheung Kin-chung confirmed on Monday that the central government has promised to extend a helping hand to the SAR at Chief Executive Carrie Lam Cheng Yuet-ngor’s request.

Cheung said the central government will send a team of experts to the city to help build a mobile-cabin hospital of 2,000 beds, as well as help the city buy vaccines once it is ready for purchase. It has also agreed to help the city expand its capacity in mass virus testing.

Former secretary for food and health Ko Wing-man said it would be a “natural step” for the local government to consider seeking assistance from across the boundary when the public and private medical sectors in the city are both exhausted.

Ko told China Daily he also thinks the mainland’s support to build temporary isolation facilities such as the mobile-cabin hospitals will help the city contain the virus amid a strained medical system.

“There is a limit on the facilities of the Hospital Authority,” Ko said. For patients in the communities with no or less-severe symptoms, the authorities now need to resort to building temporary isolation facilities for them.

“These buildings can be constructed unit by unit,” Ko said. “If they can be constructed in Shenzhen, and then transported to Hong Kong for them to be assembled into a hospital, that would shorten the construction cycle.”

Ko said he was not too worried about standards across the boundary, since the laboratories there have proved during the previous few months to have succeeded in helping the mainland to control the COVID-19 epidemic. “We have the University of Hong Kong-Shenzhen Hospital,” Ko added. “It can be one of the sites where we can send specimens to be tested.”

The first group of samples done by Wong’s lab was from elderly homes and taxi drivers. Many clusters were found and traced from the initial tests. While taxi drivers can have their samples collected at five Temporary Specimen Collection Centers, scattered in Sheung Wan, Yau Ma Tei, Kwai Chung, Tseung Wan and the Hong Kong Port of the Hong Kong-Zhuhai-Macao Bridge, nurses hired by the lab will collect the samples directly from elderly homes.

Wanting the tests

Li Fai, CEO of Altru Nursing Home, said many caregivers working in elderly homes were eager to take the tests.

Li explained that this is because many workers have reached retirement age in the elder-care sector. “Amid this worsening pandemic, their grown-up sons and daughters do not allow their caregiver mothers to go to work anymore, fearing they would catch the virus and transmit it to the grandchildren.” Li, who is also a member of the Elderly Commission, which advises on elderly-related policies, said this is why all workers want to take the tests as soon as possible. The testing will provide proof that they are healthy and can continue working.

“Rapid coronavirus testing is exactly what the elderly home sector needs now,” Li continued.

She said many caregivers have resigned during the third wave of the pandemic, and many seniors at the centers do not have the ability to care for themselves, and that has substantially increased the workload of employees.

Li said that the caregivers are also grateful to the government for providing timely anti-epidemic assistance to the elder-care sector. The assistance includes distributing surgical masks. If the mass COVID-19 testing helps quickly to identify, isolate and treat asymptomatic patients, it could save the industry from collapsing, she added.

“The tests are effectively carried out,” Li said. “One of my elderly homes is located at Sau Mau Ping and has around 80 staff members. All of their samples are collected in two to three hours.”

As of Saturday, 73 residential care homes in Kowloon East, New Territories East, and Hong Kong Island had been visited by the outreach team, according to the Social Welfare Department. Throat swab samples of over 12,250 employees for the COVID-19 tests were collected. As of Monday, one test result was found positive, and the case has already been referred to the Department of Health for follow-up.

Some worry that the genetic laboratory poses a risk of a personal data breach for local residents. Wong, the laboratory manager, clarified that each specimen collected will have only a bar code, and the lab won’t know who the specimen belongs to.

“If the sample were positive, we would send the bar code to notify the health authorities about it, and the government would contact the patient,” Wong said. “The rest of the negative samples are destroyed within a few days.”

Wong said he and his colleagues feel confident providing citywide screenings for COVID-19 in Hong Kong. He said they have gained valuable insights after studying major mainland cities’ experiences with conducting rapid, large-scale coronavirus testing. “We could learn from Wuhan and Beijing’s experience in screening almost 10 million people for the coronavirus in a short period of time,” Wong said. He added that the laboratory is currently looking for suitable venues for further expansion. “We ultimately hope to help the city do 100,000 tests per day.”