Catch a break: Higher vitamin K intake linked to lower bone fracture risk late in life

A long term study looking at the relationship between fracture-related hospitalisations and diet in almost 1400 older women has found vitamin K1 reduced risk of hospitalization significantly.

Peer-Reviewed Publication

EDITH COWAN UNIVERSITY

 

IMAGE: DR MARC SIM. view more 

CREDIT: EDITH COWAN UNIVERSITY.

Breaking bones can be life changing events — especially as we age, when hip fractures can become particularly damaging and result in disability, compromised independence and a higher mortality risk.

But research from Edith Cowan University’s Nutrition and Health Innovation Research Institute has revealed there may be something you can do to help reduce your risk of fractures later in life.

In collaboration with the University of Western Australia, the study looked at the relationship between fracture-related hospitalisations and vitamin K1 intake in almost 1400 older Australian women over a 14.5-year period from the Perth Longitudinal Study of Aging Women.

It found women who ate more than 100 micrograms of vitamin K1 consumption — equivalent to about 125g of dark leafy vegetables, or one-to-two serves of vegetables — were 31 per cent less likely to have any fracture compared to participants who consumed less than 60 micrograms per day, which is the current vitamin K adequate intake guideline in Australia for women.

There were even more positive results regarding hip fractures, with those who ate the most vitamin K1 cutting their risk of hospitalisation almost in half (49 per cent).

Study lead Dr Marc Sim said the results were further evidence of the benefits of vitamin K1, which has also been shown to enhance cardiovascular health.

“Our results are independent of many established factors for fracture rates, including body mass index, calcium intake, Vitamin D status and prevalent disease,” he said.

“Basic studies of vitamin K1 have identified a critical role in the carboxylation of the vitamin K1-dependant bone proteins such as osteocalcin, which is believed to improve bone toughness.

“A previous ECU trial indicates dietary vitamin K1 intakes of less than 100 micrograms per day may be too low for this carboxylation.

“Vitamin K1 may also promote bone health by inhibiting various bone resorbing agents.”

So, what should we eat — and how much?

Dr Sim said eating more than 100 micrograms of vitamin K1 daily was ideal — and, happily, it isn’t too difficult to do.

“Consuming this much daily vitamin K1 can easily be achieved by consuming between 75-150g, equivalent to one to two serves, of vegetables such as spinach, kale, broccoli and cabbage,” he said.

“It’s another reason to follow public health guidelines, which advocate higher vegetable intake including one to two serves of green leafy vegetables — which is in-line with our study’s recommendations.”

Vitamin K1-rich foods

Vegetables: Kale, spinach, broccoli, green beans

Fruits: Prunes, kiwi, avocado

‘Dietary Vitamin K1 intake is associated with lower long-term fracture-related hospitalization risk: the Perth longitudinal study of ageing women’ was published in Food & Function.

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JOURNAL

Food & Function

DOI

10.1039/D2FO02494B 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Dietary Vitamin K1 intake is associated with lower long-term fracture-related hospitalization risk: the Perth longitudinal study of ageing women

Monkeypox vaccine modelling study provides road map for vaccination

Peer-Reviewed Publication

CANADIAN MEDICAL ASSOCIATION JOURNAL

A modelling study to explore optimal allocation of vaccines against monkeypox virus (MPXV) provides a road map for public health to maximize the impact of a limited supply of vaccines. The article, published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.221232, confirms that prioritizing vaccines to larger networks with more initial infections and greater potential for spread is best.

"We hope that these insights can be applied by policy-makers across diverse and dynamic epidemic contexts across Canada and beyond to maximize infections averted early in an epidemic with limited vaccine supply," says Dr. Sharmistha Mishra, MAP Centre for Urban Health Solutions, Unity Health Toronto.

As of November 4, 2022, there were 1444 cases of MPXV in Canada, disproportionately among gay, bisexual and other men who have sex with men (GBMSM). A very limited supply of smallpox vaccines is available and is being prioritized to populations experiencing disproportionate risks.

Researchers modelled two hypothetical cities as interconnected networks with a combined GBMSM community size of 100 000. The team then varied the characteristics of the two cities across a range of plausible settings and simulated roll-out of 5000 vaccine doses shortly after the first detected case of MPXV.

They found that the strongest factors for optimal vaccine allocation between the cities were the relative reproduction number (epidemic potential) in each city, share of initial cases, and city (or network) size. If a larger city had greater epidemic potential and most of the initial cases, it was best to allocate the majority of vaccines to that city. The team varied the reproduction number with a single parameter, but they highlight how many factors could influence local epidemic potential, including the density and characteristics of the sexual network, access to prevention and care, and the underlying social and structural contexts that shape both sexual networks and access.

"Under our modelling assumptions, we found that vaccines could generally avert more infections when prioritized to a larger network, a network with more initial infections and a network with greater epidemic potential," writes Jesse Knight, lead author and PhD candidate at the University of Toronto and MAP Centre for Urban Health Solutions, Unity Health Toronto. "Our findings further highlight the importance of global vaccine equity in responding to outbreaks, and also in preventing them in the first place," he says.

The study emphasizes the interconnectedness of regions and that a population-level perspective is necessary.

"Strategic prioritization of a limited vaccine supply by network-level risk factors can maximize infections averted over short time horizons in the context of an emerging epidemic, such as the current global MPXV outbreak," conclude the authors.

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JOURNAL

Canadian Medical Association Journal

DOI

10.1503/cmaj.221232 

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Maximizing the impact of limited vaccine supply under different early epidemic conditions: a 2-city modelling analysis of monkeypox virus transmission among men who have sex with men

ARTICLE PUBLICATION DATE

28-Nov-2022

Virtual overdose monitoring may help reduce opioid deaths

Peer-Reviewed Publication

CANADIAN MEDICAL ASSOCIATION JOURNAL

Virtual overdose monitoring has the potential to reduce the risk of death from opioids and other substances by offering timely and anonymous access to emergency care. An article reviewing the latest evidence is published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.220579.

Isolation and solitary use of opioids and other substances are the main driver of overdose deaths, as people are unable to seek help. Virtual overdose monitoring using phone lines or smartphone apps can connect people anonymously with people who can develop personalized emergency response plans and supervise substance use. These services operate 24 hours a day and have no restrictions on the type of substances or how they are used.

"Virtual overdose monitoring services are novel public health interventions capable of providing timely and accessible harm reduction and overdose prevention services for people who use substances," writes Dr. Monty Ghosh, an internist and addiction specialist, Department of Medicine, University of Alberta, Edmonton, and the Cumming School of Medicine, University of Calgary, Calgary, Alberta, with coauthors. "Evidence, including pilot data from the National Overdose Response Service, suggests that virtual overdose monitoring services have promise as an adjunct to supervised consumption services in the continuum of care for people who use substances."

The authors call for more high-quality research to better understand potential benefits and risks of virtual overdose monitoring services.

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JOURNAL

Canadian Medical Association Journal

DOI

10.1503/cmaj.220579 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Virtual overdose monitoring services: a novel adjunctive harm reduction approach for addressing the overdose crisis

People with depression are less likely to have children

Peer-Reviewed Publication

UNIVERSITY OF HELSINKI

Women are at their greatest risk for depression during their childbearing years, and according to a recent study published in the prestigious American Journal of Obstetrics and Gynecology, depression is indeed associated with a lower likelihood of having children among men and women.

Drawing on the unique Finnish register data, this study with over 1,4 million participants examined the associations between diagnosed depression and the likelihood of having children, the number of children, and the age at first birth for all men and women born in Finland between 1960 and 1980.

“One of the main results was that depression was associated with a lower likelihood of having children and a lower number of children among men and women. Depression was also linked to a slightly lower age at first birth”, says principal investigator Kateryna Golovina from the Helsinki Collegium for Advanced Studies.

Men with even mild depression have a lower likelihood of having children

Men diagnosed with depression had 33% lower odds of having a child compared to men without depression; women diagnosed with depression had 15% lower odds of having a child than women without depression.

An important observation was that the severity of depression was associated with a likelihood of having children: for men, even mild depression was related to a lower likelihood of having children, whereas for women the link was found only for severe depression.

Socioeconomic differences in the association between depression and the likelihood of having children

The study further examined whether there were any educational differences in the association between depression and the likelihood of having children.

“Among men and women with secondary and higher education, depression was related to a lower likelihood of having children and having fewer children. As for the participants with basic education, no associations were observed for men, whereas for women depression was related to a higher likelihood of having children” says Kateryna Golovina.

Early prevention and on-time treatment of depression are crucial

The findings have clinical implications, suggesting that depression is one of the factors contributing to the likelihood of having children, which is why early prevention and on-time treatment of depression are crucial. For example, timely screening for depression can be implemented by increasing the availability of mental health professionals or it can be done by obstetrician-gynecologists and women’s health providers. For men, the severity of depression should be considered, given that already milder depression may have more negative health and behavioral effects for them compared to women. 

“Overall, our results give another motivation to provide accessible mental health services to young people and implement low-threshold interventions and therapies”, states Professor Marko Elovainio from the Faculty of Medicine.

The study was conducted in collaboration between the University of Helsinki and the Finnish Institute for Health and Welfare. Funding was provided by the Helsinki Collegium for Advanced Studies, University of Helsinki, and the Academy of Finland.

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JOURNAL

American Journal of Obstetrics and Gynecology

DOI

10.1016/j.ajog.2022.10.016 

ARTICLE TITLE

Association between depression and the likelihood of having children: a nationwide register study in Finland

Diamonds and X-rays open a new window into the Earth's inner core

Peer-Reviewed Publication

TOHOKU UNIVERSITY

 

IMAGE: THE COMPRESSIONAL VELOCITY OF PURE IRON AT HIGH PRESSURE AS DETERMINED IN THE PRESENT WORK (BLUE SYMBOLS) COMPARED TO THE HIGHEST PREVIOUS DETERMINATION USING THESE METHODS (OPEN SYMBOL) AND TO THE KNOWN RELATION OF THE INNER CORE DETERMINED FROM SEISMIC OBSERVATIONS (DASHED RED LINE WITH STARS). view more 

CREDIT: DAIJO IKUTA

A collaborative research group has succeeded, for the first time, in measuring the speed of sound of pure iron under pressures similar to the Earth's inner core boundary.

It may be surprising, but we do not have much information about the center of the planet that we live on. One can dig down a few kilometers, and volcanoes and plate tectonics can bring up material from depths of a few hundred km, but what lies beneath, down to the center of the Earth, some 6000 km beneath our feet, is not well understood.

It is generally accepted that the core some 3000 km below us is mostly iron: a sea of liquid iron, the outer core, around an inner core of solid iron. The best information we have is from tracking the progress of seismic waves from earthquakes, as they propagate through the planet. This tells us the density and the speed of sound. But those values do not exactly agree with what people expect for pure iron; there needs to be something else present in the core. What that material is, and how much of it there may be, are active areas of investigation as they have implications for understanding the present properties of the Earth and the evolution of the solar system.

Many research teams try to recreate the conditions of the center of the Earth in their laboratories. But this is difficult, requiring keeping materials under extreme pressure, millions of atmospheres, and extreme temperatures, similar to the surface of the sun, all while doing sensitive measurements.

The collaboration between Tohoku University, the RIKEN SPring-8 Center, Ehime University and the Japan Synchrotron Radiation Research Institute succeeded, for the first time, in measuring the speed of sound of pure iron under pressures similar to the Earth's inner core boundary, 330 GPa (the pressure if one supported 33,000 metric tons on a 1mm×1mm area).

After years of work, the researchers were able to effectively combine diamond anvil cell technology - something used to generate high pressures but which requires considerable skill to achieve pressures comparable to the Earth's core - with an X-ray scattering technique known as inelastic X-ray scattering. This technique allows scientists to observe the atomic motions in materials using X-rays and is the only method for accurately measuring the sound velocity of metals under static compression in a diamond anvil cell. This was done at RIKEN's world-leading facility for inelastic X-ray scattering, the Quantum NanoDynamics Beamline at SPring-8 in Hyogo Prefecture.

The researchers showed that the sound velocity of the inner core determined from seismological studies is 4±2% slower in compressional velocity and 36±17% slower in shear velocity than that of metallic iron.

Combining the new result with previous work suggests the Earth's core may be enriched in silicon and sulfur consistent with the existing outer core model with oxygen, as the growth of the inner core may have created a secular enrichment of oxygen in the outer core.

Details of the group's research were published in the journal Nature Communications on November 25, 2022.

Comparison of density‒velocity relations of iron at inner core conditions with Preliminary reference Earth model (PREM). The vp difference (A) and the vs difference (B) in the inner core.

CREDIT

Daijo Ikuta

BL43LXU, the RIKEN Quantum NanoDynamics Beamline at the RIKEN SPring-8 Center.

CREDIT

Alfred Q. R. Baron

The diamond anvil cell used in this experiment. (A) Symmetric Diamond Anvil Cell, (B) Schematic diagram of a diamond anvil. The orange circle is the area corresponding to (C, D) (C) Image of the top of the (stepped beveled) diamond anvil designed for IXS measurement at ultrahigh pressure, (D) Cross-section of the diamond anvil corresponding to (C).

CREDIT

Daijo Ikuta

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DOI

10.1038/s41467-022-34789-2 

ARTICLE TITLE

Sound velocity of hexagonal close-packed iron to the Earth's inner core pressure

Understanding polar species’ behavior to reduce risk of extinction: HKU Scientists discovered the southward migration of Arctic Ocean species during the last glacial period for the first time

Peer-Reviewed Publication

THE UNIVERSITY OF HONG KONG

 

IMAGE: AN IMAGE OF ARCTIC OSTRACODS PRODUCED BY SCANNING ELECTRON MICROSCOPE (SEM). view more 

CREDIT: DR HE WANG

In order to survive, a species must find the most favourable habitat to pass on its genes. Therefore, learning how species migrated with climate change is very important for protecting species from environmental threats.

In light of this, a research team led by Dr He WANG and Dr Moriaki YASUHARA from the School of Biological Sciences (SBS) and the Swire Institute of Marine Science (SWIMS) of The University of Hong Kong (HKU) studied the impact of East Asian winter monsoon (EAWM) along with their collaborators (note), identified two southward migration events of polar species Arctic ostracods in the Last Glacial Period and determined the ages of these two events for the first time. The results would help better understand Asian monsoon dynamics and their impacts on the marine ecosystem and polar species, thereby reducing the risk of species extinction. The study has recently been published on Geophysical Research Letters.

EAWM is a determining factor of wintertime weather and climate in East Asia, affecting crop and livestock productivity and socioeconomic activities over large areas of East Asian countries. The impacts of climatic conditions on marine ecosystems and the distribution of marine species are major concerns due to ongoing anthropogenic climate change; however, the impacts of EAWM variability on marine biota remain poorly known, which hinders the understanding of future climate change and its impact on polar species or cold water species.

The Yellow Sea is a great location to study the evolution of the EAWM, as it is sensitive to climate change, and its environment is strongly influenced by the EAWM. It also has been regarded as an ideal location to track changes in cold-adapted marine species (polar species), as it is located at the southern end of the distribution of Arctic circumpolar species. Furthermore, the abundance of fossil records in the area provides direct evidence of past climate impacts. Therefore, the research team selected eight spots from the Yellow Sea and the Sea of Japan to reconstruct the temporal and spatial changes of Arctic ostracods in the northwestern Pacific Ocean, which helps to better understand the biogeographic distribution of Arctic ostracods and their responses to climate change.

By using microfossil proxies in sediment cores from the northwestern Pacific Ocean to better understand the relationship between EAWM dynamics and marine biota, the research team identified two southward migration events of Arctic ostracods in the Last Glacial Period and determined the ages of these two events for the first time: 120 to 100 and 30 to 15 thousand years ago — intervals that are consistent with the periods of strengthened East Asian winter monsoon (EAWM) during the Last Glacial Period. Therefore, the team suggests that the stronger EAWM during these periods enhanced the formation of Yellow Sea Bottom Cold Water and/or lowered the winter temperatures of the Yellow Sea, allowing cold water species Arctic ostracods to inhabit more southern regions of the Yellow Sea.

Dr He Wang, the lead author of the study and the former Postdoctoral Fellow at SBS explains: ‘In order to understand the above topics, one of the challenges is that we need to find a good proxy. Fortunately, we find many well-preserved ostracod specimens from a new core in the Yellow Sea, including both Arctic species and Subtropical and temperate species. Ostracods have fully calcified, bivalved carapaces, and thus have been the most common fossil arthropods, which provide an excellent fossil record for detailed paleoecological reconstructions.’

"Understanding polar species’ behaviour is important because they are sensitive to climatic warming and cooling. Numerous evidence shows that species respond to ongoing human-induced warming by changing their latitudinal distribution. So, polar species distributions are getting narrower to poleward with warming compared to the wider ice-age distribution we showed in this study. These narrower habitats may result in a higher extinction risk of polar species in the near future," said Dr Moriaki Yasuhara.

The results help better understand Asian monsoon dynamics and their impact on marine ecosystems in the past, present, and future on this rapidly changing planet. Learning how these cold-adapted species (polar species) migrated with climate change is very important for protecting polar species from threats by the ongoing human-induced climate change.

The research paper can be accessed from:
https://agupubs.onlinelibrary.wiley.com/doi/10.1029/2022GL100818

Note: Other contributors of HKU and collaborators: Dr Penghui ZHANG from Hohai University; Dr Huai-Hsuan M. HUANG from National Museum of Natural History, Smithsonian Institution; Dr Yuanyuan HONG and Miss Skye Yunshu TIAN from HKU SBS and SWIMS;Professor Jian LIU, Professor Jianwen CHEN and Professor Jie LIANG from China Geological Survey; Professor Yong Il. Lee from Seoul National University.

Image download and caption: https://www.scifac.hku.hk/press

For media enquiries, please contact Ms Casey To, External Relations Officer (tel: 3917 4948; email: caseyto@hku.hk / Ms Cindy Chan, Assistant Director of Communications of HKU, Faculty of Science (tel: 3917 5286; email: cindycst@hku.hk).

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JOURNAL

Geophysical Research Letters

DOI

10.1029/2022GL100818 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Cells

ARTICLE TITLE

Southward migration of Arctic Ocean species during the Last Glacial Period

Global assessment by HKU Marine Scientists found that Oyster reef restoration rapidly increases marine biodiversity but increased restoration effort is needed to eliminate historical damage

Peer-Reviewed Publication

THE UNIVERSITY OF HONG KONG

 

IMAGE: MEMBERS OF THE RESEARCH TEAM DOING BIODIVERSITY SURVEYS OF OYSTER HABITAT AND THE SURROUNDING AREAS IN PAK NAI, HONG KONG. view more 

CREDIT: MR KHAN CHEUNG

Global assessments of historical oyster reef distribution have estimated that over 85% of oyster reefs have been lost to overfishing and coastal development. In recent decades, enormous effort has been put into developing and implementing different methods for restoring oyster reefs globally. However, the overall effectiveness of these efforts has remained uncertain because of a lack of assessment of how long it takes for restored oyster reefs to begin to support marine biodiversity and provide ecosystem services to the same level of undamaged reefs.

Dr Bayden RUSSELL and Dr Ashley HEMRAJ from the Swire Institute of Marine Science (SWIMS), and the School of Biological Sciences, The University of Hong Kong (HKU), along with their international collaborators (see remark), utilised an assessment method (recovery debt) to examine the effectiveness global oyster reef restoration to date. They screened over 70 journal articles which compared restored oyster reefs to surviving natural oyster reefs in an attempt to benchmark what constitutes successful recovery of oyster reefs and identify the most successful methods of oyster reef restoration. The research has recently been published in Science Advances.

Their findings revealed that oyster reef restoration initiates a rapid increase in biodiversity and abundance of reef-associated species within two years; however, the recovery rate then decreases substantially, leaving a global shortfall in recovery of 35% below a pre-disturbed state.  Following this initial ‘boost’ in recovery, the shortfall in species diversity, ecosystem functions and services will likely be gradually overcome by the development of ecosystem complexity. Therefore, while these young, restored reefs rapidly enhance biodiversity, they will require long-term protection to mature into complex ecosystems and recoup historical losses of biodiversity and ecosystem services.

‘The rapid increase of oysters and fauna on restored oyster reefs is very promising and shows great return for the financial investment and effort put towards restoration. However, it is also clear that newly restored oyster reefs require time to develop into self-sustaining ecosystems, equivalent to remnant oyster reefs. By reducing disturbances to these restored reefs, in particular activities like harvesting or development which damage the reef, we can help them recover faster.’ said Dr Ashley Hemraj, the lead author of the study.

Importantly, the research also demonstrated that some of the most simple and cheap restoration techniques – the use of limestone rock as the base for restoring reefs – can be as effective as more costly techniques.

‘The exciting thing about this research is that it consolidates the outcomes of global efforts in oyster reef restoration and provides some direction for maximising success,’ said the group leader Dr Bayden Russell. ‘We were pleasantly surprised by how rapidly biodiversity increases in the early years after restoration, including recreational and commercially fished species, which provides good motivation and justification for rapidly expanding restoration in regions of the world where restoration programmes are still in the early stages of development.’ Dr Bayden Russell added.

With the recognition that restoration of coastal marine ecosystems is a key component of protecting biodiversity and maintaining the services they provide to humans, this research offers timely direction for achieving these goals with oyster reef restoration.

About the journal paper:
Oyster reef restoration fails to recoup global historic ecosystem losses despite substantial biodiversity gain. Science Advances 8, eabp8747. 

The journal can be accessed from here: https://www.science.org/doi/10.1126/sciadv.abp8747

Remark: Collaborators: Dr Boze HANCOCK: The Nature Conservancy; Dr Melanie BISHOP: Macquarie University; Dr Jay MINUTI: The City University of Hong Kong (Former Postdoctoral Researcher at HKU); Dr Philine zu ERMGASSEN: University of Edinburgh; and Dr Ruth THURSTAN: University of Exeter.

Theoretical diagram of general recovery debt for ecosystems not requiring structural restoration (red dashed line) and recovery debt specific to restored oyster habitats (dark blue lines) where structural restoration is necessary. The yellow line indicates the expected rate of recovery, which slows but stays positive over time. Figure modified from the published paper.

CREDIT

The University of Hong Kong

CAPTION

Dr Bayden Russell documenting the species diversity of a restored oyster reef in Hong Kong.

CREDIT

Miko LUI, The Nature Conservancy HK.

CAPTION

Measuring the growth of oysters on restored reefs is key to understanding restoration success. Photo from Hong Kong.

CREDIT

Dr D. Ashley Hemraj

Images download and captions: https://www.scifac.hku.hk/press

For media enquiries, please contact Ms Casey To, External Relations Officer (Tel: 3917-4948; email: caseyto@hku.hk) and Ms Cindy Chan, Assistant Communications Director of Faculty of Science (Tel: 3917-5286; email: cindycst@hku.hk).

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JOURNAL

Science Advances

DOI

10.1126/sciadv.abp8747 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Oyster reef restoration fails to recoup global historic ecosystem losses despite substantial biodiversity gain

HKUMed researchers found a reduction in hospitalisations and a concurrent increase in deaths during the COVID-19 pandemic in 2020 in Hong Kong: implications for healthcare planning during public health emergencies

Peer-Reviewed Publication

THE UNIVERSITY OF HONG KONG

HKUMed researchers at the WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine at The University of Hong Kong (HKUMed) found a significant reduction in public hospital admissions and an increase in mortality, particularly from cardiovascular diseases, during the first year of the COVID-19 pandemic in Hong Kong in 2020. The findings, which may reflect avoidable deaths caused by changes in healthcare seeking during the early pandemic, are now published in The Lancet Regional Health - Western Pacific. [link to the publication]

In addition to the respiratory morbidity and mortality caused by SARS-CoV-2 infection, there exists a broad range of direct (e.g. SARS-CoV-2 infection of the heart or brain) and indirect (e.g. increase in cancer mortality due to reduced cancer screening or delayed treatment) public health impacts of the COVID-19 pandemic and related policy responses. To describe these impacts across many medical outcomes, the research team used comprehensive long-term hospitalisation and mortality data collected from the Hospital Authority and the Census and Statistics Department of the Government of the Hong Kong Special Administration Region (HKSAR), to quantify the health impacts of the COVID-19 pandemic.

They found an absolute reduction of 359,790 hospitalisations in public hospitals largely from respiratory and cardiovascular diseases, and 1,873 additional deaths particularly from cardiovascular diseases in 2020, above what would have been expected in the absence of the pandemic. Children under 5 years of age and older adults aged over 65 years were most affected. Reductions in the number of deaths occurring inside public hospitals were accompanied by increases in deaths occurring outside of public hospitals, which may suggest a reluctance to seek care even when gravely ill.

The results of this study suggested important, indirect impacts of the COVID-19 pandemic on public health in Hong Kong, likely resulting from worry about SARS-CoV-2 exposure in hospitals or other barriers reducing timely access to medical services. These impacts may outweigh even the direct consequences of SARS-CoV-2 infection in some jurisdictions and high-risk population groups. With the possible emergence of more virulent or transmissible strains of SARS-CoV-2 or other epidemics, medical institutions and policymakers should prepare adequate resources, including risk communication, to ensure maintained access to healthcare for non-infected patients during public health emergencies.

About the research team
The researchers from the School of Public Health, HKUMed are: Mr Hualei Xin, PhD candidate; Dr Peng Wu, Assistant Professor; Dr Jessica Wong Yuen-ting, Research Officer; Mr Justin Cheung Kai-him, Research Assistant; Dr Eric Lau Ho-yin, Scientific Officer; Dr Joshua Nealon, Research Assistant Professor; Professor Gabriel Leung, Honorary Clinical Professor; Professor Benjamin Cowling, Chair Professor of Epidemiology, Head of Division of Epidemiology and Biostatistics, and Co-Director of the WHO Collaborating Centre for Infectious Disease Epidemiology and Control.

This project was supported by the Health and Medical Research Fund (grant no. CID-HKU2), the Collaborative Research Scheme (project no. C7123-20G) of the Research Grants Council, and AIR@InnoHK administered by Innovation and Technology Commission of the Hong Kong SAR Government.

About the WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, HKUMed
The School of Public Health, LKS Faculty of Medicine of The University of Hong Kong (HKUSPH) has a long and distinguished history in public health education and high impact research. With world leading research in infectious diseases as well as on non-communicable diseases of both local and global importance, the School has made significant contributions through its research and advocacy to improve the health of populations and individuals, both locally and globally. The School is a leading research and teaching hub in public health on influenza and other emerging viruses, control of non-communicable and infectious diseases, tobacco control, air pollution, psycho-oncology, behavioural sciences, exercise science, life-course epidemiology, population mental health, and health economics, health services planning and management. Work done by HKUSPH researchers has informed international (e.g. the US Food and Drug Administration, Health Canada, the World Health Organization), national and local public health policies.

The School of Public Health hosts the WHO Collaborating Centre (WHO CC) for Infectious Disease Epidemiology and Control. With a view to protecting the public's health in Hong Kong and across the region, the WHO CC aims to coordinating research on the control and prevention of infectious diseases and providing local and regional education and training in infectious disease epidemiology and control. Members of the WHO CC are involved in the response to COVID-19 and conducted a range of scientific research projects. The team has created a website to share the latest scientific findings and the implications for evidence-based public health policies on the ongoing COVID-19 outbreak [link to website: https://covid19.sph.hku.hk/].

Media enquiries
Please contact LKS Faculty of Medicine of The University of Hong Kong by email (medmedia@hku.hk).

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JOURNAL

The Lancet Regional Health - Western Pacific

DOI

10.1016/j.lanwpc.2022.100645 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Hospitalizations and mortality during the first year of the COVID-19 pandemic in Hong Kong, China: An observational study