“Le hasard ne favorise que les esprits préparés” (“Chance favours but the prepared mind”), so said Louis Pasteur, doyen of the germ theory of disease and eponymous founder of Institut Pasteur, an important Asian outpost of which resides at 6 Sassoon Road.
This well-rehearsed aphorism has demonstrated its applicability in our case at HKUMed since the very beginning of the present pandemic, before it was declared a “public health emergency of international concern” or indeed even before it was officially named “coronavirus disease 2019” or COVID-19.
COVID-19
Our Department of Microbiology and the HKU-Shenzhen Hospital provided the world’s first evidence to establish person-to-person spread in The Lancet; the School of Public Health was the first to alert the world the likely national spread and global pandemic potential of the initial Wuhan case cluster in The Lancet, and working with China CDC presented the first set of epidemiological analyses showing how quickly the disease could spread and how to set quarantine and isolation rules in the New England Journal of Medicine. All these took place during the month of January, within a mere three to four weeks when the world initially learned of a handful of suspicious pneumonia cases in Wuhan on New Year’s Eve.
Altogether, HKUMed has published 2 reports in Science, 4 reports in Nature and 9 reports in Nature series journals, 2 reports in the New England Journal of Medicine, 4 reports in The Lancet and 13 reports in Lancet family journals alone, in addition to literally hundreds more in top-tier specialty journals to inform pandemic control worldwide so far. We were prepared for this extraordinary public health event not seen since the great influenza pandemic of 1918. And we have delivered, in spades.
Aside from the firsts that I mentioned, we have produced tests to diagnose COVID-19 that are used in more than 70 countries and territories; published timely evidence on the effectiveness of face masks that received global coverage in social and mainstream media; developed a hamster model that is critical for testing therapeutics and vaccine candidates; and innovated on treatment and vaccine options, among a wealth of other research on the disease. Many governments, institutions and media outlets from around the world have also sought our expert input, particularly the World Health Organization and the Hong Kong government, thus re-affirming HKUMed’s world-class stature.
In addition to innovating at direct care by the bedside in both our flagship teaching hospital Queen Mary and the community treatment facility at Asia World Expo, HKUMed also recruited more than 200 students who were joined by as many staff and alumni, totalling over 400 individuals, to operate the Universal Community Testing Programme sites in Kennedy Town and Wong Chuk Hang over a period of 11 days in September.
Other KE items concerning COVID-19 include a series of infection control infographics for the general public, a realtime dashboard, a popularly subscribed MOOC; all of which can be found at the one-stop online resource centre – med.hku.hk/covid-19.
Looking forward, HKUMed is privileged to have become the only Asia-based founding member of The Trinity Challenge (TTC), coordinated by Trinity College of the University of Cambridge (thetrinitychallenge.org). TTC’s vision is to safeguard the lives and livelihoods of one billion more people by using data and analytics to better predict and prevent outbreaks, epidemics and pandemics, and to improve the health, economic and social response and recovery to health emergencies and endemic diseases. It provides the brightest minds a platform to partner with leaders from businesses, the social sector and academia to collaborate and contribute insights as global public goods.
All these and more have been captured in HKUMed’s first supplement on COVID-19 available at med.hku.hk/go/covid19booklet.
Research and Innovation
Our research achievements were of course not limited to COVID-19. On research funding, we continue to excel and have still improved by considerable margins. HKUMed’s total research funding awarded exceeded $2 billion in the past year.
Foremost, we have won the largest number of InnoHK hubs in HKU and for any faculty across the entire tertiary sector across Hong Kong, totalling $1,628 million for the following five centres:
All five hubs have already executed Master Agreements and set up HKU wholly-owned operation companies. Renovation and outfitting works, as well as procurement of major equipment, have just commenced with the first tranche of funding transfer. Collectively these projects involve 47 HKUMed professoriate and 32 overseas collaborators. They plan to hire an additional 122 junior professoriate and postdocs, 21 senior scientific/technical staff and 68 research support personnel.
In addition to the above one-off exercise, HKUMed secured in excess of $500 million research funding from the Research Grants Council (RGC), Health and Medical Research Fund (HMRF), Innovation and Technology Fund (ITF), and mainland/overseas funding agencies in the past academic year.
More specifically, accounting for one-third of RGC General Research Fund/Early Career Scheme projects awarded to HKU overall, HKUMed gained 12 more projects this year, bringing the total to 78 successful applications. This has widened our lead over our nearest competitor to 28 projects, demonstrating broad-based competitive advantage across a wide range of research fields. We continue to dominate HMRF funding, our largest single source of sustained research grant support, again winning more grant award in dollar terms than all other institutions combined SAR-wide.
Our researchers have filed and been granted 69 and 9 new patents respectively.
Another major achievement in terms of enhancing support to our research community concerns the transformation of the erstwhile Laboratory Animal Unit into the Centre for Comparative Medicine Research (CCMR), effective July 2020. This goes much deeper than a simple name change but a genuine recognition of its leadership in supporting and advancing animal welfare, veterinary care, ethics and cutting-edge scientific innovation. The unit has long been the only AAALAC (Association for Assessment and Accreditation of Laboratory Animal Care) International accredited animal facility in Hong Kong and the Greater Bay Area.
The re-designation of CCMR better reflects the support it actually provides to animal users in furthering HKUMed’s cutting-edge research in the emerging field of comparative medicine for the study of health, illness and treatments of human and animal diseases, and particularly at the interface between the zoonotic and epidemiologic.
Coinciding with this organisational transformation, a major expansion project was recently completed in October this year. The $101m project has converted the Dexter Man Building into a new animal experiment and holding facility in order to cope with our ever expanding biomedical animal research needs.
At the other end of the experimental spectrum in health research, HKUMed’s Clinical Trials Centre (CTC) has initiated a series of new training courses to support investigator-initiated clinical studies (IISs). This type of studies is where bench science translates into clinical practice at the bedside. HKUMed has therefore tasked CTC and the Biostatistics and Clinical Research Methodology Unit (BCRMU) to establish an “IIS Facilitation Scheme”, through which a range of support services will be offered to clinical investigators. Training courses are the first of several components in this newly launched Scheme.
Teaching and Learning
COVID-19 has upended teaching and learning although HKUMed’s ongoing curricular modernisation efforts have prepared us better than most in weathering the disruption.
I am pleased to report that there has been a high level of student satisfaction with e-learning videos, online quizzes and generally the stepped-up interactivity of the MBBS preclinical curriculum that has been undergoing “modernisation”. This has now become most useful as we have necessarily relied on virtual delivery since the beginning of the pandemic. All didactic undergraduate teaching sessions, whether delivered face-to-face or virtually, are now professionally edited and made available online. To facilitate teachers’ preparation of digital materials, we have offered training and technical support through the Multimedia Learning Resource Centre.
The flagship MBBS Enrichment Year has been substantially affected by COVID-19. For M23, those who were overseas undertaking intercalated studies, research attachments or humanitarian service had to return in March. Given the University-wide moratorium on all outbound exchange during the current semester, Dr George Tipoe and his team successfully assisted M24 students in identifying local alternatives. Hopefully students will be able to resume overseas and mainland study programmes in the coming semester, COVID-19 willing of course.
For the clinical years, the prolonged ward closure to student teaching imposed by the Hospital Authority has required quick innovation in maintaining uninterrupted teaching delivery. Colleagues in various disciplines have pioneered new and different forms of “from bedside to webside” learning, including clerking patients via Zoom, of course with all the appropriate cybersecurity and patient confidentiality assurances in place. Simulation laboratories, especially in nursing, have become another popular learning mode.
I am proud to relate that despite the COVID-19 challenge of physical distancing, HKUMed undertook all summative examinations – written and clinical – successfully this past summer, and without a single instance of cross-infection. It was a herculean effort masterminded by Dr Victor Lee (Assistant Dean for Assessment) and ably supported by Dr Samson Wong and Ms Julie Lau. We carried out more than 1,000 PCR tests and put in place a series of infection control measures to ensure the health and safety of all candidates, patients, proctors and examiners. We did not compromise on standards while keeping everyone safe.
This past year of social unrest and pandemic-related “lockdowns” have dealt a severe blow to student wellbeing and tested everyone’s resilience to the absolute limit. The Teaching and Learning Deanery has done a great deal of soul searching and brainstorming, particularly around the evolving nature of student wellness as perceived and felt. To further enhance our student wellness effort, we have strengthened the supporting team by appointing Dr Kendrick Shih (Ophthalmology) as HKUMed’s first Director of Student Affairs, Ms Rainbow Wong as administrative lead with an expanded and refreshed team of clinical psychologists and social workers, in partnership with the student body at large.
HKUMed did rather well on admissions, again. All 3 of the local DSE top scorers with 7 subjects of 5** grades who chose a medical programme are now members of the Class of 2026. They have been joined by 7 IB perfect scorers and 5 GCE A-level 5A* achievers. Of note, we have over-admitted by about 10% this year due to the cancellation of IB and GCEAL examinations globally. The consequent controversies over “inferred” or “synthetic” vs. “predicted” grades for both have compelled the authorities to regrade many candidates’ submissions, leading to upward revision in many cases. Thus, in order to honour our non-JUPAS conditional offers that had been made earlier, we ended up with a slight unanticipated surplus.
Our BPharm, BBiomedSc and BASc (Global Health and Development) programmes continue to be the most desired and selective in their respective fields amongst local programmes.
We welcomed all incoming freshmen in HKUMed’s first ever online orientation and white coat ceremony, to which very good feedback has been received from the student community. Congregation was also moved online, with all of the University’s 10 faculties celebrating in a joint ceremony that formally conferred degrees on all HKU graduands, including 1,200 from HKUMed. Of course, such an arrangement cannot replicate the elated feeling of walking across the stage with justified pride to receive one’s diploma, so we plan to organise an appropriate event to celebrate your graduation when the situation allows.
Clinical Service
Preparatory works for Phase 1 of the Grantham Hospital redevelopment including our Research Block are well underway with demolition and foundation works scheduled to commence during this final quarter of 2020, the super structure construction in 2022, and we are heading for on-time completion in 2025. Once completed it will provide world-class infrastructure for our Centre for PanorOmic Sciences to enhance the translational aspects of precision medicine, taking a multi-omics approach to understanding and treating cancer at the HKU-Jockey Club Centre for Clinical Innovation and Discovery at the redeveloped Grantham Hospital as Hong Kong’s first dedicated academic cancer centre.
Incubating under the auspices of HKU Health System, the Emergency Medicine Unit that staffs the Gleneagles Hong Kong Accident and Emergency Department as well as provides academic input to our other teaching hospital partners, has gone from strength to strength. With Professor Timothy Rainer having recently taken up duty as its first Professor and Head, the Unit will work hard over the next several years to attain departmental status that will hopefully be commensurate with its achievements in teaching and research in due time.
Government introduced the Private Healthcare Facilities Ordinance (Cap. 633) in July 2019 to further protect patient safety and rights through the introduction of this new regulatory regime. Hospital licences issued under this new Ordinance will take effect on January 1, 2021, and we have been working with our affiliated private hospital partners to ensure the goals and requirements are met. In parallel, HKU Health System has been continuing to enhance clinical governance within our own service units, establishing uniform guidance and accountability requirements, embedding the quality and safety principles of this new Ordinance in our everyday practice and providing effective oversight.
Over in Shenzhen where colleagues have been extraordinarily resilient and dedicated due to major inconveniences arising from COVID-19 border measures, the HKU-Shenzhen Hospital has been garnering many accolades, including the Shenzhen Mayor's Quality Award (Gold Award in Social Category) and being named Shenzhen's Top 10 Medical and Health Institutions in Reform and Innovation. For our part in controlling the pandemic, we have undertaken most of the PCT testing responsibilities for cross-border travellers such as the truck-drivers who have kept Hong Kong well stocked and supplied. For Hong Kong residents with chronic conditions who reside in Shenzhen who cannot conveniently return for their Hospital Authority appointments, we will begin looking after them by commission of the Hong Kong government. Having been designated as a National Training Base for Resident-Trainees, we are building collaborations with Shenzhen University to provide formal postgraduate training curricula in multiple specialties, as part of two “national goal” projects:- (1) structured specialist training for medical doctors in the Mainland and (2) attaining international (ISQua) accreditation for the National Class 3A Hospital Accreditation System.
The Li Ka Shing Foundation “Love Can Help” Medical Assistance Pilot Programme was launched in January last year. It is designed to help those who have exhausted other existing assistance schemes such as the Samaritan Fund, Community Care Fund, or otherwise fall outside the scope of the Hospital Authority formulary. The Programme has so far supported 207 patients at HK$17.7 million.
Human Capital
Following the “Human Capital Masterplan” prepared by Executive Associate Dean Professor Vivian Lin last year, we have recently soft launched the “140 for 140” global recruitment drive. In part to refresh our talent pool arising from normal attrition that has been exacerbated by local and international tensions, and in part to aggressively expand as a result of increased intake of UGC manpower-planned clinical programmes as well as preparing for deeper engagement in the Greater Bay Area, the “140 for 140” campaign aims to recruit 140 new faculty members in addition to more than 100 replacement professoriate staff by HKUMed’s 140th anniversary in 2027.
This is being built on an excellent track record of recruiting the best minds in their respective fields. Since last October to date, 53 new professoriate colleagues have been recruited to HKUMed (41 academic track, 12 practice track; amongst whom 8 at the full professor rank).
At the most senior levels, we are also looking to revitalise our disciplinary leadership cast. Specifically we will have reporting to duty new Heads in Emergency Medicine and Ophthalmology in the coming academic year; whereas headship searches for Chinese Medicine, Diagnostic Radiology, Family Medicine and Obstetrics and Gynaecology are making good progress. In the coming academic year, we will be conducting search exercises for six more headships or directorships. This forms a critical part of HKUMed’s renewal and succession planning.
On in-house nurturing of talent, our Early Academic Career Development Mentorship Scheme has just been launched with an encouraging response where some 20 senior professoriate faculty members have enrolled to become mentors. In the coming year, we plan to put together a comprehensive orientation programme for new recruits as well as inaugurate an internal research fellowship scheme that mirrors the corresponding Croucher and RGC programmes. For junior would-be clinician-scientists, HKUMed recently launched a new Clinical Research Fellowship Scheme in January 2020 that aims at engaging young Hospital Authority doctors (with fewer than five years’ experience after completion of specialist training) to undergo research immersion, with a view to broadening outreach to our public sector junior colleagues and bringing science closer and quicker to everyday patient care. Competition was fierce amongst six clinical departments who nominated candidates. The first awardee from the Department of Pathology, selected in May 2020, will commit at least half his time working on identifying novel genomic markers to improve breast cancer prognosis over the coming academic year.
This summer we bade farewell to our long-serving Faculty Secretary, Ms Jeannie Tsang, who has taken on new responsibilities as Registrar for the University. From 1996 until 2008, she had shepherded the research, teaching and learning, and faculty development portfolios. She became Faculty Secretary when Professor Sum Lee took on the deanship. Since 2013 I had benefitted enormously from her encyclopaedic knowledge of the Faculty, her common sense and wisdom, as well as equanimity and fair-mindedness. At the Registry, she follows in the footsteps of her immediate predecessor, Mr Henry Wai, now retired, who had also once been HKUMed’s Faculty Secretary. Her successor is Ms Wing Ho, who takes the helm in the Faculty Office having previously served as School Secretary in Public Health. Jeannie is the second senior administrator who has recently gone on to bigger and better things from our ranks. Ms Maggie Cheuk, whom I have worked closely with since she joined HKUMed as an Executive Officer some two decades back, became Faculty Secretary at Social Sciences last year, returning to her home faculty of her undergraduate and postgraduate student days. HKUMed is indeed the “Shaolin Temple” of HKU.
Infrastructure and Capital Projects
Ongoing construction of the new three-storey Annex on Tang Court, extensions of the first, fifth and sixth floors of the William MW Mong Block, a new lift tower and staircase at Fan Pui Garden and a new façade for the Laboratory Block facing the new Annex will be completed by the end of the first quarter of 2021. Thereafter, remodeling works for the vacated space on the 3rd to 6th floors of the William MW Mong Block will proceed that will have been repurposed for undergraduate and postgraduate teaching and learning.
The superstructure accommodating the Schools of Nursing and Chinese Medicine at 3 Sassoon Road is being constructed and slated for completion by the third quarter of 2022.
During this year’s Legislative Council session, funding support for short-term measures to cope with increased and increasing student numbers, including omni-telepresence and VR/AR1 works and additional anatomy laboratories, was approved. Medium-term measures for a new academic complex and student residences are making steady progress, anticipating completion during the 2026-7 academic year.
Lastly, the anachronistic UGC “Kaiser Formula” which discounts space eligibility for clinical professoriate, comprising more than half of HKUMed’s human resources strength, by 90% awaits review and resolution. This Gordian knot requires the wisdom and courage of a modern day Alexander the Great to untie.
Knowledge Exchange and Faculty Advancement (KEFA)
In September this year, the Li Ka Shing Foundation made a donation of HK$100 million in support of the establishment of the Li Ka Shing Cryogenic Electron Microscope (Cryo-EM) Facility and the Li Ka Shing Career Seeding Fund. The former will allow the most sophisticated structural biology work to be carried out at HKUMed whereas the latter is a $50,000 gift from Mr Li to each of our MBBS graduates in M20 through M23. Indeed he penned a personal note accompanying the gift to encourage our graduates, as follows:
“Kindness is the art of medicine,
an antidote to every patient
fighting the battle to recovery.
I hope you will practise it often.”
In addition, during the past year, we have raised HK$256.6 million from 1,173 donors, accounting for 21.4% of the total amount raised by the entire University. We have also received cumulative matched government funding of HK$130 million in the 8th Matching Grant Scheme, and HK$55 million in the Research Matching Grant Scheme so far.
The newly renovated entrance lobby at the William MW Mong Block was dedicated and named the Cheung Chin Lan Hong Atrium. The Atrium leads into the Cheung Kung Hai Conference Centre housing our four main lecture theatres. The generous family of Mr and Mrs Cheung have honoured their parents by these eponymous landmarks at the heart of HKUMed for which we remain indebted and grateful.
Two new professorships, namely the Bingei and L & T Charitable Foundation Professorship in Dementia Research and the Jiaohua Su Professorship in Paediatric Oncology and Transplant, were endowed. HKU honorary graduate Professor Lord Ara Darzi of Imperial College has been appointed the inaugural Leong Che-Hung Distinguished Visiting Professor of Leadership from 2020 to 2023.
Our scholarships also received some major new injections. S.K. Yee Medical Foundation donated HK$30 million to establish the S.K. Yee Medical Foundation Professor Sir David Todd Enrichment Scholarships, in memory of Sir David’s legacy. Aspiration Foundation pledged HK$10 million in support of the establishment of the Aspiration Foundation Scholarships and Grant Scheme. Sun Chieh Yeh Heart Foundation, through Professor CP Lau and other trustees, gave HK$7 million in support of the Sun Chieh Yeh Heart Foundation Student Enrichment Scholarship and Best Paper Award & Travelling Prize.
In terms of local, national and global outreach, we have successfully consolidated gains from our institutional identity renewal exercise from last year. Specifically we are now proactively engaged on social media platforms including Facebook/
Finally but certainly not least, I should like to take this opportunity to thank President Barbara Lam and her Executive Committee for their selfless dedication to the work of the Medical Alumni Association (HKUMAA) during the past four years. They have been a source of unwavering loyalty and support, for which the alma mater very much remains in their debt. We also welcome the incoming President Dr Matthew Tsui, who is also Deputy Hospital Chief Executive of Queen Mary Hospital.
Lessons of COVID-19 and the Limitations of Science and Medicine
For all of HKUMed’s scientific successes of which I immodestly boasted at the beginning of my report, there are of course lacunae and important lessons to reflect on.
Foremost, COVID-19 has exposed one of the gravest chasms of health-related inequity. Socioeconomic gradients of risk exposure, infection and death have been unjustly steep. The attack rate in Singapore’s migrant worker dormitories is 400 times that of the local general community. “Black Lives Matter” in the US has been exacerbated by unevenly distributed COVID-19 burdens imposed on poor African-American communities and in prisons that remain disproportionately populated by people of colour. Black, Asian and Minority Ethnic or BAME groups are unfairly overrepresented amongst British COVID-19 sufferers. Worse still, the magnitude of adverse risk for India’s migrant workers, overlaid on the age-old caste system, has remained unmeasured; they suffer the indignity of literally not being counted. What of Hong Kong?
In The COVID-19 Catastrophe, Richard Horton, who edits The Lancet, reminded us of the late German sociologist Ulrich Beck’s damning criticism of the scientific establishment’s “over-specialised division of labour, (their) concentration on methodology and theory, (their) externally determined abstinence from practice” having rendered us “entirely incapable of reacting adequately to civilisational risks”. “Techno-scientific rationality” can only take us so far.
Beyond the narrow confines of medicine and health, COVID-19 will almost certainly usher in a new way of relating to each other and living together. Slavoj Žižek, the supercharged Slovenian philosopher, speculated about a new form of “communism” emerging, mostly in the communitarian sense of the term, in his new work Pandemic: COVID-19 Shakes the World. Remarkably this form of state-led collectivism has taken hold in the heartlands of neoliberal democracies, the US and Europe, and has by and large been popularly accepted, even demanded. Governments the world over have invoked the ongoing disaster to commandeer hotels for quarantine, nationalise stockpiles of personal protective equipment and guarantee minimum survival of the unemployed by minting new currency – in essence by abandoning market mechanisms. Between sovereign governments, there have been pleas for cooperation to produce and share anti-pandemic resources, from face masks and ventilators to drugs and vaccines. These phenomena represent what Žižek has called “communism”. He believes that only this new form of governance will save the world from the barbarism of unmitigated capitalism as we have known it.
The French philosopher Michel Foucault would likely have shuddered at imagining where Žižek’s proposed “communist” shield against global barbarism brought on by COVID-19 might lead. From as early as the 1970s, Foucault had worried about the growing drift towards a “disciplinary society”. In particular, his nightmare had centred around Jeremy Bentham’s “panopticon” as an expression of how utilitarianism could be tightly weaved into everyday life. In fact, Bentham saw his panopticon as being applicable to, amongst other settings, lazarettos which are places of quarantine for those afflicted with the plague. Apropos COVID-19, Bentham’s utilitarian ideal meets Foucault’s worst fear in what have become common surveillance practices for pandemic control: QR health codes informed by social media footprints, “immunity passports” by routine pervasive testing, location-enabled bracelets to enforce quarantine, contact tracing apps, and so on.
Bernard-Henri Lévy entitled the opening chapter of his new book, The Virus in the Age of Madness, “Come Back Michel Foucault – We Need You!”. He deplored the “sealing of an incestuous union of the political and medical powers” that had been made plain by this pandemic, questioning the deification of medical technocrats and exhorting the public to think clearly about the appropriate loci of authority and power in a free society. With that, we medics have been put in our place!
Au contraire, many of us believe that a pandemic is precisely when doctors should rise to the challenge of providing science-based, sapiential leadership for sound policy making. To this end, I remember well Rudolf Virchow’s proclamation: “Medicine is a social science and politics is nothing else but medicine on a large scale” or Sun Yat-sen’s “Medical affairs and hygiene are truly the roots of the affairs of men”. As far back as almost three millennia ago 《國語·晉語》 〈醫和視平公疾〉already recorded that 「上醫醫國,其次疾人,固醫官也。」
Before the awesome altar of medical science, and more broadly of service for humanity, we must remain ever humble. COVID-19 has once again reminded us that there are more and larger questions, some of which I have tried to survey, that penetrate deep beyond the technical – always.
Class of 2020, I hope you now realise how much more there is yet to keep learning. Stay curious and keep hungry for knowledge. I label myself a student to this day. Above all, hold fast to your professional moral compass, not despite but because of tough conditions ahead.
Godspeed, good luck and all very best wishes!
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