These times of COVID-19 are deeply undefined. Uncertainty can be distressing, but uncertainty can be managed.

 

In this issue, we share with you some insights you can refer to.

 

We talk to the Chief Medical Officer of AXA Hong Kong and Macau, Dr. Alexander Chiu, about the Coronavirus vaccine rollout, and share the stories of how two families are managing their vastly different risk needs.

 

In this issue:

The COVID-19 vaccine facts you need to know with Dr. Alexander Chiu* - Part I

The COVID-19 vaccine facts you need to know with Dr. Alexander Chiu* - Part II

Case study: In-country medical and competitive pricing

Case study: Protecting three generations and beyond


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Woman waiting in a long line for a flight wearing a N95 face mask during a global pandemic

The COVID-19 vaccine facts you need to know with Dr. Alexander Chiu* - Part I


Vaccination against COVID-19 takes us all closer to a post pandemic future. As vaccines begin rolling out across the world, PCS by Mercer speak to Dr. Alexander Chiu – the Chief Medical Officer of AXA Hong Kong and Macau shares some COVID-19 vaccine facts in the following two-part series.  

 

Parts I and II are edited excerpts from our conversation.** 

Why is COVID-19 vaccination so important?

 

By vaccinating, you are proactively managing a major health risk. The Coronavirus is a highly contagious virus. Without vaccination, you are at serious risk of catching it and potentially developing a life-threatening disease. With vaccination, you can significantly lower that risk. 

 

Aside from your personal health, vaccination also helps protect your loved ones and society in general. In addition, when you travel to other countries, being fully vaccinated might prevent the need to quarantine for a period of time. 

 

We are fighting a pandemic, so even after you are fully vaccinated (i.e. Received both the vaccine shots needed for the vaccines that are available in HK and Macau), it’s very important to continue pandemic hygiene practices. Social distancing, mask-wearing, and handwashing need to continue until at least 70% of the population – the expected threshold for herd immunity – have been vaccinated. 

 

What are the known complications associated with the available COVID-19 vaccines? 

 

There are risks associated with all medications. The known complications, irrespective of vaccine type, are extremely low – much lower than your risk of catching COVID-19 without vaccination. The known complications are in the range of two to three cases per million and include anaphylaxis, facial palsy and Guillain-Barré syndrome. 

 

Is there anyone who should not be vaccinated? 

 

There are three categories of people who absolutely need to consult their personal physician with regards to vaccine suitability:

 

  1. People who have previously experienced severe side-effects, including anaphylaxis – from drugs, vaccines, or vaccine components
  2. Pregnant or lactating women. Scientists and physicians are still analyzing vaccine suitability for women in this category
  3. People who have poorly controlled chronic illnesses such as diabetes, heart disease and hypertension

 

What are your key tips for the vaccination days? 

 

  1. Wear loose, short sleeves! The injection site is very high on your arm, above the point to which some long-sleeve tops and shirts can be rolled. You don’t want to have to take your top off to enable access to the injection site, especially when some vaccination centers only have curtained partitions and not private rooms
  2. Don’t get vaccinated on an empty or too-full stomach. Anyone can faint if their blood sugar is too low and if you do faint, medical resources must then be deployed to investigate whether the fainting is linked to the vaccination, or just to low blood sugar

 

If anaphylaxis does occur (there is a very low risk of 2-3 cases per million injections), a full stomach might lead to vomiting, which in turn might affect the resuscitation process

 

How do I fit vaccination around travel plans? 

 

Maximum protection from COVID-19 is achieved 14 days after the second vaccination, so any travel plans should ideally be scheduled after that. In your planning, it’s important to note: 

1. You should also be up to date on any recommended travel vaccines for your destination

2. Check your destination’s restrictions, such as mandatory quarantine periods, before travel

3. It’s important to continue pandemic hygiene practices – not everyone you meet will have been vaccinated, so stay safe

 

Read Part II for facts about the vaccine rollout in Hong Kong and Macau. 

 

* Dr. Alexander Chiu is the Chief Medical Officer at AXA Hong Kong and Macau. He is a member of the Royal College of Physicians in the UK and has a medical degree from the Chinese University of Hong Kong. 

 

Dr. Chiu practiced as an intensive care physician for 17 years before embarking on a career in health administration. During SARS, Dr. Chiu worked in the intensive care unit of Queen Mary Hospital, looking after SARS patients. 

 

** PCS by Mercer spoke to Dr. Chiu on 23rd March 2021 and this edit excerpt reflects his views and available data on that date. This article is general in nature and not intended as advice; it might not be appropriate to you.


The COVID-19 vaccine facts you need to know with Dr. Alexander Chiu* - Part II


In Part I, Dr. Chiu talked about the fundamentals of the Coronavirus vaccine. Here, he addresses the specifics of the vaccine rollout in Hong Kong and Macau.

 

Parts I and II are edited excerpts from our conversation with Dr. Chiu.** 

 

Which vaccines are currently available in Hong Kong and Macau?

 

At present, both jurisdictions have access to Comirnaty (Fosun/Pfizer/BioNtech) and CoronaVac (Sinovac). Both vaccines require a two-shot protocol to be maximally effective: 

 

  • Coronavac = 28 days between the two shots
  • Comirnaty = 21 days between the two shots

 

The vaccines differ in that they use different technologies. Comirnaty is a messenger-RNA vaccine and CoronaVac is an inactivated-virus vaccine, much like influenza vaccines. 

 

How much does vaccination cost? 

 

The vaccines are Government-provided and free-of-charge.

 

Can I choose which vaccine I have? 

 

We are very fortunate to have access to two types of vaccines in Hong King and Macau. As one of the measures to reduce potential confusion, only one type of vaccine is available at any given location. You are therefore able to choose either vaccine by going to the location where your preferred vaccine is available.1


Individual vaccine effectiveness in reducing the risk of infection: 

 

Comirnaty Vaccine = 95% effective

CoronaVac Vaccine = 62.3% effective


Is one better than the other?

 

It’s not appropriate to directly compare vaccine efficacy as individual vaccine effectiveness was assessed by different measures in research. That said, both vaccines have proven to be highly effective in reducing the likelihood of severe disease if you are infected with COVID-19. 

 

Can I have both vaccines? 

 

The booking system has inbuilt checks that prevent any one person from having more than one vaccine. 

 

Where can I get vaccinated? 

 

CoronaVac can be received at Community Vaccination Centres (CVC), private clinics, as well as government clinics. 

 

Cominarty can only be received at CVCs due to its stringent storage temperature requirements. The vaccine needs to be stored in ultra-cold freezers at -70°C. To ensure cold chain integrity, only designated vaccination centers are being used for the Cominarty vaccine. 

 

 

* Dr. Alexander Chiu is the Chief Medical Officer at AXA Hong Kong and Macau. He is a member of the Royal College of Physicians in the UK and has a medical degree from the Chinese University of Hong Kong. 

 

Dr. Chiu practiced as an intensive care physician for 17 years before embarking on a career in health administration. During SARS, Dr. Chiu worked in the intensive care unit of Queen Mary Hospital, looking after SARS patients. 

 

** PCS by Mercer spoke to Dr. Chiu on 23rd March 2021 and this edit excerpt reflects his views and available data on that date. This article is general in nature and not intended as advice; it might not be appropriate to you.


1 For a list of the vaccination location: https://www.covidvaccine.gov.hk/en/programme

 

 

Case study: In-country medical and competitive pricing

 

 Background

 

PCS by Mercer Client, male, has three children as well as three grandchildren. One of his children is a business owner and wants her personal (family-derived) wealth to be separated from her business assets. The family was seeking a solution that helps legacy planning while safeguarding their family wealth through generational transfer.

 

Complications: 

 

  • Client’s liver function is less than ideal and all test results were out of range
  • Due to COVID-19 lockdowns, our Client was unable to travel offshore for his medical
  • Received competitive offers from other Life Insurance providers/ brokers
  • Client was premium price sensitive and resistant to pre-existing condition loading. If loading for his liver function was applied the premium, he was very unlikely to proceed

 

 Solution

 

  • PCS by Mercer set-up in-country medical and liver function retesting at an exclusive private facility
  • The Client set up a trust with the patriarch as the insured, and all children and grandchildren as beneficiaries 
  • Life Insurance policy with US$15 million coverage
  • US$6 million premium. This market competitive result was achieved through extensive negotiations with the insurance company. PCS by Mercer fought for and won a premium with no loading for the client. Ordinarily, insurance companies would postpone policies with this type of pre-existing health condition for at least six months. 

 

Key takeaways

 

  1. The Life Insurance policy can ensure the Client’s family wealth is preserved 
  2. The trust ring-fences private wealth from business assets
  3. PCS by Mercer solutions are Client-specific. We work to find the right solution for each of our Clients
  4. The Client is able to attend the medical examination, in-country, with the scope meeting the requirements of the insurance company
  5. PCS by Mercer solutions are market competitive

 

 

Caroline Chung

Senior Vice President

Private Client Services by Mercer Limited 

E: Caroline.Chung@mercerpcs.com


Case study: Protecting three generations and beyond

We show you how to simultaneously protect the long-term prosperity of an entire family now, and into the uncertain future.

 

 Background

 

From humble beginnings, a small trading company founded by PCS by Mercer Clients (patriarch and matriarch) more than thirty years ago has since grown into a network of businesses valued at more than US$200 million. The Clients have three married children who graduated from American colleges. Not only are the children and their spouses involved in the family business, but all six of them play crucial roles. There are nine grandchildren in the third generation, aged one to twelve.

 

The entire family shares the belief that life must be enjoyed to the fullest, and that their hard work should be rewarded from time to time. They have an enviable lifestyle, living harmoniously together in a large compound, each nucleus family enjoying their own separate, purpose-built house. They make a point of enjoying meals together on weekends, and prior to the COVID-19 pandemic, the family regularly took overseas trips together to exotic destinations. 

 

The Clients believe in managing risk through careful planning. They want to ensure: 

 

  • Their hard-earned wealth is protected for the grandchildren and even the following generations
  • There are enough individual family savings in the second generation to safeguard the grandchildren’s future
  • Retirement funding for themselves

 

 Solution

 

In consultation with PCS by Mercer the Clients set up: 

  • A trust with the patriarch as the settlor, and all nine grandchildren as trust beneficiaries
  • A Life Insurance plan for each of the three children and their spouses (each plan with US$15 million coverage)
  • Individual Savings Plans for the matriarch and patriarch respectively, providing steady income during their retirement years. Each plan can provide a yearly income of about US$100,000 per year when they turn 75 (US$400,000 yearly premium, over 5 years)
  • The Savings Plans can be transferred to the second generation in the future, thus also providing their children with yearly retirement income

 

Key takeaways

 

  1. The six Life Insurance policies can ensure their family wealth is preserved and protected against inflation (through low-risk investments)
  2. A total of US$90 million life coverage from a combined premium of US$20 million, financed by their private bank
  3. At each triggering event, the trust will be injected with fresh funds. A lasting legacy of wealth is thus created for future generations
  4. A Savings Plan is an effective tool in generating regular cash income during retirement years
  5. Savings Plans can be transferred to the next generation

 


 

Pornlert Pravichphibul 

Senior Vice President

Private Client Services by Mercer Pte. Ltd.

E: pornlert.pravichphibul@mercerpcs.com