September 9, 2022
HONG KONG – Over the past few days, Hong Kong’s COVID-19 caseload has risen back to around 10,000 cases per day. Statisticians and health experts now predict that the number of new cases will continue to rise over the next few weeks.
The newest, highly transmissible subvariants of the well-publicized omicron variant — BA.4 and BA.5 — currently account for over 50 percent of new cases.
When omicron BA.5 first came onto the scene, it accounted for only 10 percent of total cases.
With a reproduction number — also known as an “R-naught” (R0) — of 1.5, it means that a single infection can cause 1.5 additional infections. And it is likely that this subvariant will mutate and comprise an increased R-naught of 2 to 3.
And making matters worse, it appears that both the BA.4 and BA.5 subvariants are immune to the typical antibody responses found in people who have been vaccinated or have recovered from COVID-19.
Therefore, it is no surprise that hospitalization cases are also on the rise, as well as other serious medical conditions resulting from contracting one of the subvariants.
The Hong Kong Special Administrative Region government has asked the city’s 13 private hospitals to spare some of their beds. They have also said that nonurgent treatments such as for cancer be postponed. Sadly, the reality is that even when treatments are not urgent, their importance to the patients and their families cannot be disregarded. For example, macular degeneration cases have a “golden window” of a few weeks for effective outcomes. Otherwise, it will result in irreversible blindness.
Throughout the pandemic, Hong Kong has been compared to Singapore, highlighting the latter’s comparably relaxed COVID-19 measures. Singapore no longer requires wearing masks in public spaces. Additionally, international visitors do not need to be vaccinated or undergo quarantine.
While it is convenient to compare us to Singapore, the two cities are poles apart. For one thing, our systems of government and population densities are different; Hong Kong is far more densely populated.
The doctor-to-patient ratios are also different. In Singapore, there are 2.5 doctors for every 1,000 people, versus 1.9 doctors for every 1,000 people in Hong Kong.
More importantly, Singapore’s vaccination rates are also considerably higher. While children under 5 are not vaccinated, over 75 percent of children aged 5 to 11 have been vaccinated. For other age groups up to the age of 80, the vaccination rate is over 90 percent.
In Hong Kong, the overall vaccination rate of those with three vaccinations is 73 percent. For those over 70 years old, it’s 67 percent; for those aged 80 and above, only 48 percent.
From August this year, the SAR government allowed children from 6 months to 3 years old to be vaccinated. At present, only 13 percent of this age group have received one jab or more.
So, as far as herd immunity is concerned, Singapore is in a stronger position to return to “business as usual”. If Hong Kong returned in the same way to normality, infections would soar to 200,000 — maybe even 300,000 — per day. It’s also more than likely that hospitalizations would increase and overwhelm the medical infrastructure.
People who travel to visit close family members across the boundary should be given a high priority. Speaking as a healthcare professional, it is inhumane for families to remain separated as they have been for the past two and a half years. Young people who study on the mainland should come next, followed by those who have businesses in the mainland
There is also the question of “long COVID”. In Hong Kong, it is estimated that cases of long COVID are in some 3 percent of recovered patients.
Further to this, if we are to accept the estimate that about 4 million Hong Kong residents have been infected, it would mean that 120,000 people are or will be long-COVID sufferers. Our battered healthcare system would certainly collapse if we were to allow Hong Kong to return to the same level of normality as Singapore has, without Singapore’s high vaccination rates.
The current infection rate in Hong Kong is 1,273 people per million. On the mainland, it’s 4 per million. In the West, it’s 3,000 to 4,000 per million. And there are good reasons for these huge differences.
There is a common belief that these BA variants are less fatal. But you don’t need to be an expert to know that this is not true; the death rates resulting from contracting the BA variants are higher than previous strains.
Insofar as easing the curbs on cross-boundary travel is concerned, instead of relaxing our preventative measures, I believe a “reverse quarantine” would be a solution to address the shortage of quarantine facilities on the Chinese mainland. Travelers wanting to cross into the mainland would quarantine at designated facilities in Hong Kong, and then bused to examination points on the mainland, hence tackling one of the bottlenecks.
Of course, it goes without saying that the quarantine facilities close to the boundary would need to be renovated, as they are currently not ideal.
A revised daily quota will also need to be considered. The maximum number of Hong Kong residents allowed to enter quarantine in Shenzhen per day was reduced from 2,000 to 1,800 on Thursday, and will drop further to 1,500 on Sunday and 1,000 on Monday. This is far less than the 400,000 Hong Kong residents who crossed the boundary daily in pre-pandemic times. There is also the question of allocating to travelers who apply to travel for different purposes within this quota.
In my humble opinion, people who travel to visit close family members across the boundary should be given a high priority. Speaking as a healthcare professional, it is inhumane for families to remain separated as they have been for the past two and a half years.
Young people who study on the mainland should come next, followed by those who have businesses in the mainland.
So, the government should prioritize families first, then students, followed by businesspeople.
Transportation would be another vital consideration that the government would need to oversee. Current ticket prices bought through scalpers for the cross-boundary express bus, known as the Golden Coach, are as high as HK$10,000 ($1,274).
I also believe we should scrap the “3+4” rule for incoming international travelers. In lieu, I would suggest making inbound travelers quarantine either at home or at a hotel for seven days, but with freedom of movement subject to strict daily PCR tests.
The government could set up PCR counters at designated hotels and establish testing centers in popular districts. As for people quarantining at home, they can take designated transport to these testing centers.
For example, businesspeople who need to attend face-to-face meetings can test first thing in the morning and go about their day since the latest PCR tests can provide results within as little as 30 minutes. Upon receiving their negative test result, those under quarantine would have to travel “point to point” and download an app that could trace their movements, should authorities need to conduct contact-tracing.