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Is the pandemic under control? Yes. Over? No.
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Opinion Hong Kong’s ‘zero covid’ days are over. But where’s the exit plan?

People undergo coronavirus testing at a facility in Hong Kong on Feb. 17. (Louise Delmotte/Bloomberg)

As I watched the Super Bowl on a big screen in Hong Kong this month, Los Angeles seemed like an entirely separate post-pandemic world. More than 70,000 fans packed together in a stadium, screaming and often maskless. And I was watching the game at a table for two, the maximum number allowed to sit together under Hong Kong’s stringent coronavirus restrictions.

Eating and drinking are permitted, but even a short walk to the bathrooms required donning a face covering. Restaurants must close at 6 p.m. except for takeout. Bars, nightclubs, salons, gyms and swimming pools have all been shut.

Though much of the United States is edging into post-pandemic normalcy — albeit against the advice of many health experts — Hong Kong is in the grips of a brutal fifth wave and resorting to extreme measures more common in 2020 than 2022.

Flights are banned from nine countries, including the United States, Britain, Canada and Australia. Nonresidents from nearly 140 countries are barred. There is no airmail service to the United States. The daily covid-19 case count recently passed 6,000, with 15 deaths in a recent 24-hour period, and epidemiologists predict cases will likely reach tens of thousands per day. Anyone testing positive is sent into isolation facilities, straining available spaces.

In scenes reminiscent of New York City in early 2020, patients have been left outdoors on gurneys or sitting in plastic chairs in the cold February air, waiting for a hospital bed. The city is short of manpower, coronavirus testing kits, quarantine spaces and supplies, and city leaders have been forced to appeal to Beijing for help.

For two years, Hong Kong was a model for how to keep the coronavirus at bay, through aggressive contact tracing, on-and-off closures of public spaces and strict social distancing rules. It also boasted one of the world’s harshest quarantine regimes, requiring most incoming travelers to spend 21 days in a hotel room at their own expense. It became increasingly isolated and was ridiculed for some of its more drastic steps, such as ordering a mass cull of pet hamsters. But the measures largely worked.

So why is Hong Kong entering a crisis just as other countries are opening up?

The ostensible reason, offered by local officials and health experts, is that the share of elderly people vaccinated remains pitifully low, less than 40 percent of those over 80.

But that’s just part of the story. More important have been failures of policy, planning and public messaging.

The policy failure has been the government’s insistence on sticking with its “zero covid” approach, trying to stamp out every case and cut every transmission chain. Local leaders had no real choice, because the policy was imposed by mainland China. Hong Kong desperately wants to fully reopen the border to the mainland, and adhering to “zero covid” is the price.

But Hong Kong is different from the mainland. It’s a dense urban metropolis, an international hub that needs people flying in and out. And its residents are less accustomed to being controlled, more jealous of safeguarding their privacy rights and more likely to flout rules imposed by a distrusted, disliked local government.

This defiance has led to an underground economy of people trying to make ends meet. Gym trainers take their mats and equipment to parks to continue lessons. Hair stylists, masseuses and yoga teachers are making home visits. New outdoor watering holes skirt the closure of bars by offering alcoholic drinks with limited take-out food items that no one seems to order. Hong Kong’s tough policies always contained multiple exceptions and exemptions, and locals are now taking advantage of loopholes.

There was also an abysmal failure of planning. Having kept the caseload and death count to a minimum, officials appear to have been lulled into complacency. They had two years to purchase the millions of test kits now needed, build trust in vaccines and make contingency plans for a surge that would leave hospitals swamped. When this current wave became a tsunami, officials were still meeting and discussing where to build a new makeshift hospital and quarantine center.

Finally, there have been glaring issues with messaging. The government expended much effort touting the benefits of the new national security law and promoting its “patriots only” election. But not enough was done to prepare the population for an inevitable outbreak. Because the government spent years treating covid-19 as a largely overseas concern, many elderly residents saw little reason to get vaccinated.

Can this latest outbreak be contained? And is the “zero covid” policy sustainable with omicron running rampant?

“Maybe. If you close off the borders and severely restrict internal activities within Hong Kong long enough, it is theoretically possible to stop transmission,” said Keiji Fukuda, until recently the director of the School of Public Health of the University of Hong Kong and a veteran of the World Health Organization and the U.S. Centers for Disease Control and Prevention. But, he said, that would require broad public cooperation and exact a heavy economic toll.

“The real question is not whether the virus can be put back in the bottle,” he said, “but what is the end game for this policy?”

In other words, “zero covid” in Hong Kong is over. All that’s missing is the exit plan.