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A Look At COVID-19 Testing For Overseas Travelers In Hong Kong

The nurse warned that I was going to experience some discomfort and “itching” while she inserted the long Q-tip deep into my nasal passage. As it went deeper into my nostril, I felt like the edge of my brain was being violated, and instinctually, my eyes began to water as I felt that deep itch she was referring to. 

“I’m going to sneeze,” I told her. 

She took the swab out, handed me a tissue and said it would feel like that for a while. Then she told me to open my mouth wide, and stuck another Q-tip down my throat. It wasn’t pleasant. 

I arrived at the  Hong Kong International Airport from Los Angeles on March 30, 2020 at 6 a.m.. Before I even made it home, I was tested for COVID-19. Straight off the plane, airport staff gingerly reviewed my health declaration form and quarantine information before directing me to the “asymptomatic” line, even though I had declared symptoms of the virus. Confused, I approached a masked and gloved staff member to confirm that I was going the right way. She looked at my health form, and with wide eyes immediately backed away as she called for someone else to take me. 

I was taken to a lower-level of the airport, where a young nurse informed me that I was to be taken to the AsiaWorld-Expo, an exhibition center in Hong Kong that was converted into a COVID-19 testing facility in March as a means to free up hospital beds and ease stress on hospital staff in the city. Seated in the waiting area enclosed by plastic blue sheets, I waited for almost four hours before being transported to the Expo center in a makeshift ambulance. 

After testing, I waited nine hours before I received a negative test result. By then, I had been given two sandwiches, a box of saltine crackers and several small bottles of water. My mom had come to the airport to pick up my luggage for me, otherwise it would’ve taken three days for them to send it to my apartment. At 9 p.m., after a 31 hour journey from the U.S. to Hong Kong, I finally made it home.

My arrival in late March was during the peak of a second coronavirus wave that Hong Kong had been experiencing since mid-March. Before March 17, there had been less than 10 new cases a day for almost two months. Following an influx of foreign travellers returning to Hong Kong, the number of new cases in a day exponentially increased — there were 25 new cases on  April 18, 48 on April 20 and 65 on April 27. Realizing the source of the virus, the government promptly tightened up the security and screening procedures at the airport, even though the mandatory 14-day home quarantine for overseas travellers had already been enforced since early February. By the end of March, Hong Kong closed its borders to all non-residents, and on April 8, they implemented mandatory testing for all incoming travellers.

Victor Martin — a university student studying in the UK — was on a flight from Heathrow Airport in London when the Hong Kong government imposed the mandatory testing on April 8. As a measure to reduce exposure to the virus, he opted not to take his mask off during the whole journey, and didn’t eat the meal offered on his flight. As soon as the plane landed, he was taken by bus to a gate where everyone was split into groups to fill out paperwork, which took a lengthy four hours. 

After completing the home quarantine information sheet and setting up the QR code for the wristband tracker, Martin was taken to the AsiaWorld-Expo where he got tested for COVID-19. After two hours, it was announced that there would be an eight-to-14 hour wait time for the results. If the results were negative, then he would go home and complete his 14-day home quarantine. If the results were positive, he would be transferred directly to the public hospital for treatment. 

As he sat waiting in what was once an empty hall that was now packed with consecutive rows of white desks and chairs, a nurse handed him a small bottle of water and a sandwich — the first meal he had eaten in almost 26 hours. 

“I asked for a second serving, but was denied,” Martin said.

Hungry and thirsty, he waited another eight hours before he was discharged and went home.

Because Martin came from the U.K., it was mandatory for him to wait for his test results at the Expo. Since 248 of the 359 imported cases (69.1%) recorded from March 24 to April 7 involved people who had been to the U.K., the Department of Health decided that the U.K. was a “high-risk” country. Therefore, all incoming travellers from the U.K. had to wait for their results on the same day. All other passengers who arrived in Hong Kong after April 9 could go home after testing and wait for their results there. If it was positive, the center would notify the person and arrange for admission to a public hospital for treatment as early as possible. If no notification was received within three working days after testing, the test result was negative and no action was needed.

Jasmine Wright — another university student studying in the UK — sat alone on an entire row on her flight from Heathrow to Hong Kong on April 21. Passengers were spaced with at least one seat between each group of travellers as a safety precaution, something that I was not privileged enough to experience on my nearly-full flight from LAX. With her mask and gloves on, she observed other passengers in hazmat suits disinfect everything they touched on the plane. When she finally arrived in Hong Kong, she was transported straight off the plane onto a bus that took her to a hall in the airport where they filled out the necessary forms and home quarantine procedures. 

“When you gave your phone number, they’d check to see you weren’t giving them a fake one by calling it on the spot. I guess people were trying to avoid staying at home,” Wright said.

Afterwards she got on another bus to the AsiaWorld-Expo, despite the Hospital Authority’s announcement on April 19 that its temporary COVID-19 test center at AsiaWorld-Expo would be suspended due to the declining number of inbound travellers. When she arrived, staff explained the testing procedure and made travelers watch a tutorial. 

“They gave you two pieces of tissue paper: one to cover the table and place materials on, and one to wipe the outside of the bottle when you finished gathering your sample. You needed to sanitize your hands, spit into the bottle [and] then sanitize your hands again. Everyone had a number that corresponded to a cubicle where they did the test and handed it to a staff member,” Wright said.

She then waited in a hall as Martin and I did. After about 30 minutes of arriving, Wright received a small bottle of water, a sandwich and a trash bag. On the desk was a piece of paper with instructions and rules to store all trash in the bag, don’t get up to talk to other people and ask to use the bathroom. She followed all except the last, but noticed that no one seemed to care, or enforce this particular rule. In fact, it seemed evident that little enforcement was established in the hall, even though there was security. 

“Two guys kept getting up to play rugby at the far end of the hall, and of course kept getting in trouble. But they continued anyway. One of them said, ‘what are they gonna do, kick us out?’” Wright said.

After seven hours of waiting in the exam-like hall, Wright’s results were given to her privately. She tested negative, but was told that it didn’t mean she didn’t have the virus. She was instructed to go home and finish the 14-day home quarantine, so she got on the subway and went home.

Hong Kong had only two confirmed cases of the coronavirus on Jan. 23, 2020. The next month, there were 75. Currently, there are 1,040 confirmed cases. The numbers have slowly increased, but there is still speculation over missed cases during the beginning of the outbreak. Martin was in Hong Kong over the winter break when he fell violently ill and was bed-ridden for two weeks. 

“I had a high fever that wouldn’t go down, but I didn’t go to the hospital. I ended up with pneumonia, so that’s when I went to get tested,” he said.

The doctors tested him for 21 types of viruses, but he tested negative for all of them. At that time, there had yet to be a viable COVID-19 test. However, two weeks later, after he had recovered with fever-reducers and rest, the doctor called him back. 

“They said I probably had the coronavirus,” Martin said.

He wasn’t surprised, but already having it once didn’t sway him from taking the necessary safety precautions of catching it again. After all, he didn’t — and still doesn’t — want to be the 1,041th case.


Alana Tse is a Staff Writer. She can be reached at alanat3@uci.edu.