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The coronavirus might not be the worst of it
The Washington PostDemocracy Dies in Darkness

For two years, Hong Kong held off the pandemic. Then, everything fell apart.

Dozens of covid-19 patients in Hong Kong were being treated in makeshift open air spaces outside medical centers with several hospitals operating over capacity. (Video: Reuters)
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HONG KONG — Cocooned in mylar and fleece hospital blankets, the nearly two dozen elderly patients lay in hospital beds outside the Caritas Medical Center on Wednesday morning as health-care workers in full protective gear buzzed around them, cleaning and sanitizing.

They were among the roughly 100 waiting at Caritas as hospitals have been crippled by a tenfold explosion of coronavirus infections over the past week. Inside, however, it wasn’t much better. One patient who tested positive was isolated in a women’s bathroom with an air purifier, because no other rooms were available, according to a nurse.

Before this week, Hong Kong had avoided scenes like these since the first case of the novel coronavirus was detected more than two years ago. The city’s success in dealing with the pandemic — the highest daily toll of local infections recorded before 2022 was below 200 in a population of 7.5 million — was the envy of the world, as patients overwhelmed hospitals in other major cities around the world.

But poor planning; lagging vaccinations, particularly among the elderly; and a failure of Hong Kong’s “zero-covid” policy has left the city vulnerable. While the rest of the world is starting to open up, Hong Kong is being swamped by an avalanche of new cases, with more than 4,000 recorded Wednesday. That number is expected almost to double by the end of the week.

Hong Kong’s ‘zero-covid’ policy buckles under the onslaught of omicron — but authorities won’t let it go

For the first time since the onset of the pandemic, hospitals are beyond capacity, with wait times of up to eight hours at emergency rooms. At one hospital designated to treat covid-19 patients, a security guard at the outdoor triage area said people have been waiting up to five days to get coronavirus test results before they are sorted into isolation facilities.

Low morale is rife among health-care workers, who face tremendous pressure, a mounting workload and an increasing risk of getting covid-19. At least 290 of them have been infected with the virus in the past three days.

“It’s like we are playing Russian roulette and seeing who among us medical staffers test positive,” said David Chan, a front-line nurse at Caritas Medical Center and the chairman of the Hospital Authority Employees Alliance, a labor union. Some workers, he added, are too busy to eat or use the restroom while they monitor as many as 100 patients at a time.

Coronavirus infections and deaths continue to rise, mirroring the exponential spread of the more-transmissible omicron variant seen in other parts of the world. On Wednesday, Hong Kong recorded 4,285 new infections, and 7,000 preliminary cases. Experts say this number underestimates the severity, as positive results from rapid antigen tests are not officially recognized, and other people probably are skipping tests.

At least nine have died of the coronavirus in the past 24 hours, the latest victims include a 3-year-old girl and a 100-year-old woman.

Hong Kong follows what it describes as a “dynamic zero covid” policy, which broadly aims at getting local infections down to zero. This is in contrast to a strategy of living with the virus with a vaccinated population, a policy that increasingly is being followed elsewhere.

This zero-covid approach is promoted by Beijing, which exerts strong control over Hong Kong’s local officials, and the policy mirrors the one being implemented in the rest of China. Reopening the border to the mainland to end a closure that has now lasted two years is the stated goal of Hong Kong’s government. Plans to establish a quarantine-free “travel bubble” with Singapore were dropped after that city-state shifted to a strategy of living with the coronavirus, and flights into Hong Kong are banned from several countries, including the United States and Britain.

Hong Kong’s strategy met its limit when the more-transmissible omicron and delta variants began to spread more widely in the community, despite strict social distancing rules and draconian measures to limit international travel.

The situation in Hong Kong is evolving into an embarrassment for Beijing, which prides itself on controlling and managing coronavirus outbreaks and is in the midst of hosting the Winter Olympics.

Pro-Beijing media, which echoes the state’s views, have warned that losing the fight against the coronavirus could “threaten the safety of the nation.” The same outlets reported on Wednesday that Chinese leader Xi Jinping urged Hong Kong’s government to stabilize the local pandemic situation, saying authorities there had the “main responsibility” for handling the outbreak and should prioritize controlling it “before anything else.”

In response to Xi’s comments, Hong Kong Chief Executive Carrie Lam said she would follow his instructions and “mobilize all available manpower and resources and adopt all necessary measures” to control the spread of the coronavirus. Over the weekend, Hong Kong officials traveled to the mainland and agreed to cooperate on various aspects of the pandemic, including enhancing testing capabilities and constructing isolation and treatment facilities.

The problem for Hong Kong, however, is that it doesn’t have the resources and capacity to eradicate the coronavirus through heavy-handed lockdowns and population control the way other Chinese cities have.

Speaking this week, Lam said there were “no plans” for a citywide lockdown, as seen in Xian, Wuhan and other places in China. Acknowledging that the capacity of Hong Kong’s hospitals is limited, the government announced Sunday that priority admission will be given to children, older people and those in serious condition, halting the unwieldy practice of hospitalizing all coronavirus-positive cases.

Authorities are planning to build a mega hospital, similar to hastily built facilities that cropped up across the mainland when the pandemic hit in 2020, but so far, they have just shortlisted three potential sites.

Experts inside and outside the territory say that Hong Kong’s approach will not work; on one hand, it is not restrictive enough to prevent the spread of the coronavirus, and on the other, it is not forward-looking enough to shift to mitigation and focus on vaccinations to end the pandemic.

Ooi Eng Eong, an infectious-disease expert at the Duke-NUS Medical School in Singapore, said that keeping with zero covid indefinitely is “not possible” and only makes sense if it is a measure to buy time to get the vaccines distributed.

Hong Kong’s elderly also have a serious vaccination problem — only about half of those between 70 and 79 and about a quarter of those over 80 have been fully vaccinated. The official focus on zero covid had many thinking they wouldn’t need the vaccines.

Instead of focusing on vaccinations, city authorities kept ties to the outside world at an absolute minimum, neglected to boost hospital capacity and focused on scapegoating, including an ill-advised culling of the hamsters widely kept as pets because they might be a source of infection.

David Owens, a founding partner of OT&P Healthcare, which is among the biggest private health-care providers in Hong Kong, wrote in a recent blog post that the “reluctance to consider scenarios other than a return to zero Covid is the antithesis of prudence.”

“Vaccinations work, and they are the only long-term solution,” he wrote, urging the government to acknowledge that zero covid is a “temporary state.”

Read more:

Hong Kong is clinging to ‘zero covid’ and extreme quarantine. Talent is leaving in droves.

Hong Kong hamster massacre: Residents resist ‘zero covid’ city’s pet project

Hong Kong had a year to vaccinate its elderly. As omicron spreads, low uptake has left them vulnerable.