Hong Kong’s COVID-19 Dilemma

Cases soar across the city . . .

As cases decline throughout much of the world and countries begin to re-open borders, Hong Kong faces a starkly different reality. The ‘zero-COVID’ strategy it has used to control the pandemic thus far is now in question as the city struggles to deal with a wave of new infections and deaths. Hong Kong recorded more than 55,00 new cases on Tuesday and now has the highest mortality ratein the developed world. Mirroring the early days of the pandemic in Canada and many other countries, the fatalities are heavily concentrated amongst the elderly; more than 600 long-term care homes are experiencing outbreaks.

Vaccine challenges exacerbate fifth wave . . .

This fifth wave is mainly being driven by the unvaccinated—they account for 91 per cent of the deaths since December. The tight control that Hong Kong has previously maintained over new infections has minimized any sense that the virus poses a high risk of transmission; thus, many have chosen to remain unvaccinated. Vaccine hesitancy has been particularly high amongst the most vulnerable elderly population due to fears of side effects. Misinformation has also played a part in the struggle to convince people to get vaccinated. Although massive vaccination drives since the Omicron outbreak began have raised the overall vaccination rate to 77 per cent, only one-third of those over 80 have received both doses.

Zero-COVID in name only . . .

The path forward is not clear. Hong Kong continues to pursue the 'zero-COVID' strategy endorsed by Beijing in the hopes of reopening unrestricted travel with the mainland. However, the high transmissibility of the Omicron variant is rendering this strategy increasingly futile—at least in Hong Kong. The overwhelming new case numbers have already forced the abandonment of some of the core strategies underlying the 'zero-COVID' approach. For example, individuals that tested positive for COVID were previously hospitalised regardless of severity; now, they are told to isolate at home unless requiring medical attention. Contact tracing capacity has also been overwhelmed. The government’s recent announcement to test all of Hong Kong's 7.4 million residents later in March means that some version of a lockdown is becoming increasingly likely. In recent days, Beijing has signalled that it is considering shifting to its own version of a ‘live with COVID’ strategy. Presumably, once Beijing proceeds in such a direction, Hong Kong will follow suit, but it will come too late to prevent the chaos now engulfing the city.

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