Hong Kong Zero Covid: An analysis

EDITORIALS HONG KONG ZERO COVID: By: Colin Chau An Analysis Photography by: Tallie Lin Layout by: Jocelyn Ho

As residents of Hong Kong, we have all experienced the effects of Hong Kong’s Zero Covid policy, whether that be positive or negative. Until 2022, the HKSAR government mostly prevented the spread of Covid-19 in our city. Of course, this all ended in January 2022, which begs the question: In Hong Kong, has Zero Covid been an overall positive or negative?

As a health policy, the most obvious way to analyze Zero Covid is through the lens of healthcare, its intended beneficiary. The initial benefits of Zero Covid were undeniably high - in both China and Hong Kong, cases and deaths were minimized. In the first and second waves, the government held cases under 5000, a remarkably low number, especially given Hong Kong’s extreme density, which could potentially have allowed for easy transmission amongst the population. Through the responsible hygiene habits of the populace (such as mask-wearing) as well as strict government social distancing policies (ie. dining bans, 2 persons to a table etc.), Hong Kong was able to prevent the mass spread of Covid-19. This same idea was mirrored in China - their Zero-Covid policy prevented hundreds of thousands of deaths, especially from their large elderly population. This was contrasted on the world scale by the events occuring in the US and Europe, where cases were exploding into the tens of thousands a day, ultimately resulting in thousands of deaths in hospitals and where conservatives and liberals alike were unwilling to comply with social distancing and mask wearing orders. Seeing this from Hong Kong was truly a sight - at the time, I thought that the sheer stupidity of not locking down was ridiculous. It can clearly be seen that tens of thousands of Hong Kong lives were saved by this policy, especially taking into the account the large elderly population of Hong Kong. This Zero Covid policy was ultimately able to defeat Covid in Hong Kong for 4 waves, a feat only achieved elsewhere by China and Taiwan.

In the spring of 2021, the vaccines were rolled out. In Hong Kong, two jabs were made available to the public: the Chinesemade CoronaVac (Sinovac) and the German Comirnaty (Pfizer-Biontech). Both of these vaccines proved effective in the early stages, being able to reduce deaths significantly, and had a high chance of preventing infections too. People in Western countries vaccinated in droves after seeing the horrors of Covid. Of course, there were massive exceptions to this in the US, but overall the rate of vaccination grew quickly: 50% of the eligible US population was vaccinated by the end of the summer, drastically reducing the number of deaths. Yet, in Hong Kong, the situation was completely different. By the end of August 2021, only 36% of the city was fully vaccinated, a very low figure compared to other Asian countries. For example, Singapore was 64% fully vaccinated at this time. Likely, all the safety provided by Zero Covid resulted in people not getting vaccinated; they reasoned that there was no need to get vaccinated when there was no risk of infection. Many others were scared off the vaccines by their possible side effects which were hyped up by media such as HK01. Hence, Zero Covid was a ticking time bomb; if a deadlier or more infectious variant were to spread in Hong Kong, it would be a disaster due to the low vaccination rate.

It was only a matter of time before the disaster hit, in the form of Omicron. Omicron, though less likely to lead to severe illness,was an extremely infectious variant, and it rapidly made its way into Hong Kong through infected air crew and transmission at a designated

quarantine hotel. However, the government still tried its old policy of contact tracing - which was impossible. Too many had caught the virus and come in contact with others. Soon, the number of cases per day broke records, and an entire public housing estate in Kwai Chung was locked down. Unfortunately, we had yet to see the worst. The government again tried to use their old playbook, banning dining after 6pm and reducing diners to 2 per table. Omicron was simply too infectious however; experts estimate that each case of Omicron results in 7 other cases and thus the policy was ineffective. Ultimately, Omicron ravaged Hong Kong, killing thousands, particularly those in residential care homes: a tragedy that could have been avoided by vaccinating the elderly. The government continued its policy of sending infected persons to Penny’s Bay or other isolation facilities, which resulted in massive public distrust, and, while the exact numbers cannot be confirmed, many infected persons chose not to report themselves and stayed home, probably resulting in more cases. The Zero Covid strategy was woefully ineffective against the power of Omicron. Arguably, the most severe side effects of the Zero Covid policy are its social and economic repercussions. At the beginning, these issues were fairly miniscule compared to the potential death and suffering at the hands of a novel virus.

However, the latest wave brought businesses in Hong Kong to their knees. Countless gyms and restaurants have been forced to shut their doors, due to their businesses being completely unprofitable under the social distancing guidelines. Hong Kong’s once proud status as a financial hub has dissipated, thanks to the travel restrictions put in place. The social costs are also immeasurable; the mental issues arising from online learning are clear, and are even worse for the poor and the young. Zero Covid has brought too much economic and social harm to our city to be sustainable in the long term. The final straw seems to be the confusing nature of Zero Covid and the “Dynamic Zero Covid” policy. Much of the Covid policy was based on unsupported science and overzealous advisors. For example, a 21 day quarantine was enacted in December 2020, when Covid cases were ramping up again worldwide. The issue here is that Covid simply does not have an incubation period of 21 days. The average incubation period of most Covid variants lies between 3 days and 7 days, and 21 days is 3 times the realistic maximum. While a 7 day quarantine might have allowed for extra infections, a 10-14 day quarantine would have sufficed to detect all Covid cases. It is unclear why this was then put in place, whether this was for political reasons, but it was a clearly unscientific policy. Most frustrating of all were the extra infections that resulted from this. Due to the ventilation systems in quarantine hotels, Covid particles were able to travel from one room to another. This led to Covid-negative individuals being infected in the hotel, and subjected to isolation for another 21 days in the hospital. Of course, this risk would not have been eliminated with a shorter quarantine, but at least the risk would have been reduced and the opportunities for infection would have been lessened. This is, of course, not even considering the mental health impacts of 21 day quarantine. Another example of the unscientific nature of Zero Covid were the dining bans after 6 pm,which many argued did not make sense as Covid-19 can spread just as easily during the day. In the long term, there are certain provisions that the government could enact, so that Hong Kong does not completely lose its relevance. Of course, it would be imprudent for the government to immediately relax all restrictions. One idea would be to gradually open up Hong Kong, and resume international travel during the summer, with the caveat that all travelers must quarantine at either a hotel or their home for 7 days. This would likely be sufficient to catch imported cases, and would not create a massive health threat for Hong Kong. Ultimately, if new policies are not enacted, it is unclear how Hong Kong can face subsequent waves in ways that will not continue to impact society, education and the economy, not to mention people’s health and well-being.