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People with existing non-communicable diseases (NCDs) are particularly vulnerable to health risks brought upon by emergencies and disasters, yet limited research has been conducted on disease management and the implications of Health-EDRM policies that address health vulnerabilities of people with NCDs during the COVID-19 pandemic. This paper reports the baseline findings of an anonymous, random, population-based, 6-month cohort study that aimed to examine the experiences of people with NCDs and their relevant self-care patterns during the COVID-19 pandemic. A total of 765 telephone interviews were completed from 22nd March to 1st April 2020 in Hong Kong, China. The dataset was representative of the population, with 18.4% of subjects reporting at least one NCD. Results showed that low household income and residence in government-subsidized housing were significant predictors for the subjects who experienced difficulty in managing during first 2 months of the pandemic (11% of the NCD patients). Of those on long-term NCD medication, 10% reported having less than one week's supply of medication. Targeted services for vulnerable groups during a pandemic should be explored to support NCD self-care.

BACKGROUND: The Hong Kong government has launched the Elderly Health Care Voucher (EHCV) scheme to facilitate primary care in the private sector for older adults. This study aimed to examine whether voucher use was associated with a shift of healthcare burden from the public to the private sector, vaccine uptake and continuity of care. METHODS: This cross-sectional survey recruited older adults with ≥3 chronic diseases through convenience sampling from seven general outpatient clinics, seven geriatric day hospitals, and five specialist outpatient clinics of the public healthcare sector in Hong Kong. We used multiple logistic regression to address the study objective. RESULTS: A total of 1032 patients participated in the survey. We included 714 participants aged 70 or above in the analysis. EHCV use was associated with higher utilization of private primary care services, including general practitioner and family doctor (Adjusted Odds Ratio (AOR) 2.67, 95% Confidence Interval (95%CI) 1.51–4.72) and Chinese medicine clinic (AOR 3.53, 95%CI 1.47–8.49). There were no significant associations of EHCV use with public general outpatient clinic attendance, Accident & Emergency attendance, and hospitalization. Furthermore, EHCV users were more likely to receive pneumococcal vaccination (AOR 2.17, 95%CI 1.22–3.85) and were less likely to visit the same doctors for chronic disease management (AOR 0.10, 95%CI 0.01–0.73). CONCLUSIONS: While the EHCV may promote private primary care utilization and preventive care, older patients continue to rely on public services and the EHCV may worsen continuity of care. Policy-makers should designate voucher usage for chronic disease management and continuity of care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-020-01851-x.

Recent Ebola virus (EBOV) outbreaks in West Africa and the Democratic Republic of the Congo have highlighted the urgent need for approval of medical countermeasures for treatment and prevention of EBOV disease (EVD). Until recently, when successes were achieved in characterizing the efficacy of multiple experimental EVD therapeutics in humans, the only feasible way to obtain data regarding potential clinical benefits of candidate therapeutics was by conducting well-controlled animal studies. Nonclinical studies are likely to continue to be important tools for screening and development of new candidates with improved pharmacological properties. Here, we describe a natural history study to characterize the time course and order of progression of the disease manifestations of EVD in rhesus monkeys. In 12 rhesus monkeys exposed by the intramuscular route to 1000 plaque-forming units of EBOV, multiple endpoints were monitored for 28 days following exposure. The disease progressed rapidly with mortality events occurring 7–10 days after exposure. Key disease manifestations observed consistently across the infected animals included, but were not limited to, viremia, fever, systemic inflammation, coagulopathy, lymphocytolysis, renal tubular necrosis with mineralization, and hepatocellular degeneration and necrosis.