公共醫生協會都不建議病人戴銅心口罩看病

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創新及科技局於五月五日宣布，政府將向全港市民免費派發可重用的「銅芯抗疫口罩＋™」。根據政府新聞網公布，於五月七日總登記人數已達200萬人。據悉，局方在對外公布前更已預先安排派發給安老院舍長者事宜，部分長者更在剛過去的一個星期收到「銅芯抗疫口罩＋™」。

然而，食物及衞生局局長陳肇始在五月八日的立法會一個委員會會議上表示，重用口罩並非醫學用途，而是一般用途，如要到醫院或醫療機構，應該使用外科口罩或N95。由於居住在安老院舍的長者大都有長期病患，亦常到醫院和診所留醫和求診，因此安老院舍亦屬感染風險高的地方。再者，「銅芯抗疫口罩＋™」用後的清洗程序複雜，院舍長者難以自行處理；院舍人手長期緊拙，根本未能替每位院友定期妥善清洗。如院友長期配戴未經妥善清洗的重用口罩，有機會感染各種呼吸道傳染病，亦有可能在院舍內做成大規模爆發。最後，在政府公布的測試報告顯示，「銅芯抗疫口罩＋™」反映透氣度的降壓平均值高於4，60次清洗後更接近5，不符合美國ASTM及歐洲EN14683的標準，長者、呼吸道疾病或心血管疾病患者配戴後容易感到呼吸困難。

因為以上各種原因，香港公共醫療醫生協會並不建議 1. 求診者和訪客在醫院和普通科診所內；2. 安老院舍長者，配戴重用「銅芯抗疫口罩＋™」。 本會亦於二〇二〇年五月十日分別致函醫院管理局及社會福利署，詢問以下事項：
1. 如求診者和訪客在醫院和普通科診所內配戴重用「銅芯抗疫口罩＋™」，局方會否勸喻他們即時更換外科口罩？如市民要求，局方會否為他們提供新的外科口罩以作更換?
2. 署方有沒有向安老院舍發出有關使用「銅芯抗疫口罩＋™」的正確指引？公院醫生到安老院舍探訪時經常發現院友並未配戴外科口罩，院舍職員反映他們未能為院友準備足夠口罩。安老院舍的探訪安排放寬在即，院友從社區感染到新型冠狀病毒肺炎的風險亦隨之而増加，請問署方會否為全港安老院舍提供外科手術口罩？

*English Version*

The Innovation and Technology Bureau (ITB) announced on May 5 that the government will distribute free reusable CuMask+™ to all Hong Kong citizens. According to news.gov.hk, they had received over 2,000,000 registrations in total on May 7. It is noted that before the government announced to the general public, they had already made arrangements on distributing them to the residential care homes for the elderly (RCHs), some of the older adults have already received CuMask+™ during the past week.

However, Professor Chan, Secretary for Food and Health Bureau, announced on a LegCo Committee meeting on May 8 that the reusable CuMask+™ is not for medical usage but only for general usage. If anyone is going to hospitals or medical institutions, they should instead use surgical masks or N95s respirator masks. Most of the older adults living in the RCHs have chronic illnesses that require them to visit or stay at hospitals and clinics frequently. Therefore, RCHs are considered as places with high risks of infection. Furthermore, the cleaning process of CuMask+™ is complicated that older adults will find it hard to do it themselves. In addition to the tight manpower situation in RCHs, it is impossible to help all residents to clean their masks properly and thoroughly every day. If older adults wear the unclean reusable masks for a long period of time, they will have high chances of being infected with various respiratory tract infections, resulting in massive outbreak within the RCHs presumably. Lastly, in the test report published by the government, the Air Exchange Pressure of CuMask+™ is 4 in average, and it even reaches almost 5 after 60 times of washes, which is not up to the standard of American Society for Testing and Materials (ASTM) as well as European Standards EN14683. Older adults and people with existing respiratory illnesses or cardiovascular diseases can easily experience breathing difficulties after wearing CuMask+™.

In view of the above, Hong Kong Public Doctors' Association does not recommend, 1) Patients or visitors in hospitals or general out-patient clinics; 2) Older adults in RCHs, to wear or reuse the CuMask+™. We have already written to the Hospital Authority (HA) and Social Welfare Department (SWD) representatively for the followings:

1. If patients or visitors wear reusable marks in hospitals or general out-patient clinics, will HA ask them to wear surgical masks immediately? If upon the request of the public, will HA provide them with surgical masks to change for?

2. Has SWD provided clear guidance regarding the proper use of CuMask+™ for all RCHs? When the public hospital doctors visit the RCHs, they observe that most of the older adults do not wear surgical masks. The staff also reflected that they do not have sufficient stock of surgical masks. With the relaxation of RCHs visit arrangements, the chance of the elderly getting inflected with COVID-19 will accordingly increase. We would like to ask if SWD has made any arrangement on providing surgical masks to all RCHs in Hong Kong.