Until recently, Hong Kong was considered a poster child when handling the Covid-19 pandemic.
Despite sharing borders with mainland China, where the first cases were reported, Hong Kong kept its infected numbers down and managed to avoid the extreme blocking measures in place in parts of China, Europe and the United States.
But now he was hit by neither the second nor the third wave of infections. The government has warned that its hospital system may face collapse, and has just recorded a record high number of new infections per day.
What has gone wrong and what are the lessons for countries that are juggling both a pandemic and a blockage economic pain?
Quarantine and “gap” exceptions
Hong Kong had its first Covid-19 cases in late January, leading to widespread concern and panic, but the number of infections remained relatively low and the spread was controlled relatively quickly.
It experienced what became known as its “second wave” in March after foreign students and residents began returning to the territory, leading to an increase in imported infections.
As a result, Hong Kong imposed strict border controls that barred all non-residents from entering its borders from abroad, and anyone who returned had to undergo a Covid-19 test and a 14-day quarantine.
He even used electronic bracelets to track new arrivals and made sure they stayed home.
This, combined with the widespread use of masks and segregation measures, worked – Hong Kong went without a locally transmitted case for weeks, and life seems to be heading back to normal.
So how did the “third wave” come, leading to more than 100 new cases in nine days in a row?
- Hong Kong on the brink of a large outbreak
“It’s quite disappointing and frustrating because Hong Kong really had things under control,” said Malik Peiris, a scientific virology institute at the University of Hong Kong.
He believes there were two shortcomings in the system.
First, many returnees opted for quarantine for 14 days at home – an arrangement that is common in many countries, including the United Kingdom – and not in quarantine camps.
“There is a weakness because other people in the household are not restricted in any way and are still coming and going,” says Prof Peiris.
However, he believes that the more serious problem came from the government’s decision to exempt several groups of people from testing and quarantine when they entered Hong Kong.
Hong Kong has released about 200,000 people from quarantine, including sailors, aircraft crews and executives of listed companies.
She said exceptions were needed to ensure the continuation of normal day-to-day operations in Hong Kong or because their travel was essential for the city’s economic development.
As an international city and trading port, Hong Kong has a large number of air connections and many ships there change crews. The territory also depends on imports of food and basic goods from mainland China and elsewhere.
Joseph Tsang, an infectious disease specialist and physician, describes the exceptions as a significant “gap” that increases the risk of infection, especially from sailors and aircraft crews who have also visited tourist sites and used public transport.
The government initially stated that quarantine exemptions were not to blame, but later admitted that there was evidence that these exemptions were behind the final focus.
They have now tightened the rules for air and sea crews – but enforcing the rules can be challenging. Earlier this week, an alarm occurred when a foreign pilot was reportedly spotted waiting for the results of the Covid-19 test.
And balancing public health, practical problems and the economy can be difficult – the union representing FedEx pilots has asked the company to stop flights to Hong Kong because it talks about stricter Covid-19 measures, including mandatory hospital stays for pilots who test positive. “Unacceptable conditions for pilots”.
Benjamin Cowling, a professor of epidemiology at the University of Hong Kong, argues that Hong Kong’s experience with quarantine problems may occur in other countries.
“You also have a 14-day quarantine at home in the UK, so you would have the same potential leak problem.”
Meanwhile, New Zealand and Australia have a mandatory policy of quarantining hotels, which is a “good concept – although there is the question of who pays for it,” he added.
The United Kingdom, like Hong Kong, exempts certain passengers from border rules, including lorry drivers, seafarers and aircraft crews.
Social distance measures have been repealed
Hong Kong’s quarantine exemptions have been around for months, but the third wave did not hit until July.
Prof. Peiris is convinced that this is due to the second decisive factor – measures to distance themselves in the social field were significantly repealed in June.
“If measures are put in place to distance themselves from society, the system can be settled – but once the measures are relaxed,” import infections are spreading rapidly. “It’s a lesson for everyone.”
Dr Tsang recalls that in late June, the government allowed public gatherings for up to 50 people while Father’s Day celebrations and the anniversary of the handover of Hong Kong were held.
“Many citizens were tired after months of social distancing, so when the government said things seemed out of order and restrictions were relaxed, they began to meet with friends and family.
“I think it’s very unfortunate – many factors come together at the same time.”
Prof. However, Peiris emphasizes that the Hong Kong was “extremely compliant” with social distance and hygiene measures in the first and second waves— “in fact, they were even one step ahead of government instructions and wore masks before being obliged.” ”
He believes that the reintroduction of distancing measures into society is already having an effect and hopes that Hong Kong will return to almost zero local infections within four to six weeks.
At this point, he adds that it will be a challenge to stop imported infections – especially after the abolition of measures to distance themselves from society.
It is a challenge that other countries will face if they manage to keep the virus within their borders, because “if you reach a low level of transmission within your population, unregulated external deployment can lead to disaster.”
Did pro-democracy protests spread the virus?
Many of the pandemic struggles in Hong Kong will apply to other cities, but there has also been another crisis in the territory over the last year – a political one.
On 1 July, thousands of people took part in a pro-democracy demonstration, despite the ban being banned by authorities who said they were violating the guidelines on social separation. In mid-July, hundreds of thousands of opposition primaries voted, despite a government warning that the primaries could violate the new security law.
Since then, Chinese state media have accused both events of triggering a third wave of infections, while one politician called it “absolutely irresponsible behavior.”
However, health experts say there is no evidence that they cause an increase in infections.
Prof Cowling says scientists “can combine cases to identify transmission chains and no clusters are attributed to these events,” while Prof Peiris argues that these events “can make things a little worse, but I don’t think it was one or the other major determining factor ’.
Meanwhile, Dr. Tsang claims that research has shown that “the coronavirus strain in the third wave is different from the strains in the previous waves” – specifically, it has the type of mutation observed in aircraft crews and sailors from the Philippines and Kazakhstan, so he believes the strain was imported.
Similar discussions have taken place around the world – especially in light of the anti-racist protests sparked by the death of Georg Floyd – on whether demonstrations could lead to a sharp rise in infections. Some experts suggest that external events in which participants wear masks and take action may be at lower risk than originally expected.
Could the outbreak affect the elections in Hong Kong?
There is widespread speculation that the Hong Kong government could postpone the September elections to the Hong Kong Parliament – the Legislative Council – citing an increase in infections.
Several local media reports, quoting anonymous sources, say the government should postpone the election for a year.
Opposition politicians have accused the government of using the pandemic as an excuse to postpone the election, especially since the opposition had a strong performance in local elections late last year.
- Hong Kong bans elections for democracy elections
- Why people are afraid of the new Hong Kong law
However, some welcomed the move, including former Legislative Chairman Jasper Tsang, who told local media: “The government will not be able to get rid of the blame if polling stations turn into whirlpools to spread the virus.
“It is also almost impossible for candidates to get votes according to social distance rules.”
Prof. Cowling says that measures to distance society, which the government has reintroduced, prevented cases from accelerating last week.
“I am not sure that it is necessary to postpone the elections – certainly not for a year. You could consider postponing their extension by two weeks or a month, because by then we should almost certainly have [local infection] numbers back to zero. ‘ “
He added that there were many ways to increase election security, including increasing the number of polling stations and staff to reduce waiting times, providing well-ventilated polling stations and testing all polling station staff two days before the election.
Governments have taken very different approaches – at least 68 countries or territories have postponed elections due to Covid-19, while the International Institute for Democracy and Electoral Assistance estimates that the elections took place in 49 places as planned.
Singapore held a general election earlier this month – and its highest turnout has been in recent years, says Eugene Tan, a law professor and political commentator at Singapore University of Management.
“This is never the right time for elections during a pandemic,” he says, but the vote was taken with a number of security measures in place and “showing that it is possible to protect public health even when people continue to exercise the democratic right to vote. ”
However, he believes that deciding whether to pursue elections is a harsh judgment required by governments, especially when public confidence is low.
“If you postpone the election, you may be accused of waiting for a more favorable time [for the government] – but if you continue, you can be accused of playing fast and free with people’s lives. The worst thing would be to have elections and then in many cases to increase sharply. ‘ “