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Covid-19: Why Hong Kong’s “third wave” is a warning

A woman wears a surgical mask after the coronavirus epidemic (COVID-19) in Hong Kong, China, on July 17, 2020.Copyright

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Infections reached record highs ̵

1; 149 cases – on Thursday

Until recently, Hong Kong was considered a poster child in the aftermath of the Covid-19 pandemic.

Despite sharing a border with mainland China, where the first cases were reported, Hong Kong maintained the number of infections and managed to avoid the extreme blocking measures imposed in some parts of China, Europe and the United States.

But now it is affected not even for a second, but a third wave of infections. The government has warned that its hospital system could collide and simply have a record number of new infections a day.

What went wrong and what are the lessons for countries juggling both the pandemic and the economic pain caused by the blockade?

Exemption from quarantine and “doors”

Hong Kong had the first cases of Covid-19 in late January, which led to widespread concern and panic buying, but the number of infections remained relatively low and the spread was controlled fairly quickly.

He experienced what became known as the “second wave” in March after overseas students and residents began returning to the area, leading to a surge in imported infections.

As a result, Hong Kong imposed strict border controls, banning all non-residents from entering its borders from abroad, and all those who returned had to pass a Covid-19 test and a 14-day quarantine.

He even uses electronic bracelets to track new arrivals and make sure they stay home.

This, combined with the widespread use of masks and social distancing measures, worked – Hong Kong passed for weeks without a case transmitted locally, and life seemed to be returning to normal.

So how did the “third wave” come about – this led to more than 100 new cases in nine consecutive days?

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“It’s pretty frustrating and frustrating because Hong Kong really had a lot of things under control,” said Malik Peiris, chairman of virology at the University of Hong Kong.

He believes that there are two shortcomings in the system.

First, many returnees opted for quarantine for 14 days at home – an agreement common in many countries, including the UK – instead of in quarantine camps.

“There is a weakness there because other people in the home are not under any form of restraint and will still come and go,” said Professor Peiris.

However, he believes that the more serious problem comes from the government’s decision to release several groups of people from testing and quarantine when they enter Hong Kong.

Hong Kong had quarantined about 200,000 people, including sailors, crew and CEOs of listed companies.

He said the exceptions were needed to ensure the normal daily functioning of Hong Kong, or because their travel was necessary for the city’s economic development.

As an international urban and commercial port, Hong Kong has a large number of air connections and many ships change crews there. The territory also depends on imports from mainland China and elsewhere for food and basic necessities.

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Joseph Tsang, an infectious disease specialist and doctor, described the exceptions as a significant loophole that increases the risk of infection, especially from sailors and air crews who also visit tourist destinations and use public transportation.

The government initially said the quarantine exemptions were not to blame, but later admitted there was evidence that the exemptions were behind the latest outbreak.

They have already tightened rules for air and sea crews – but this can be difficult to enforce. Earlier this week, there was an alarm when a foreign pilot was spotted sightseeing while awaiting the results of Covid-19 tests.

And balancing public health, practical issues and the economy can be difficult – a union representing FedEx pilots has asked the company to suspend flights to Hong Kong as it says tougher Covid-19 measures, including mandatory hospital stays for pilots who test positively create “unacceptable conditions for pilots”.

Benjamin Cowling, a professor of epidemiology at the University of Hong Kong, says Hong Kong’s experience with quarantine problems could happen in other countries.

“In the UK, you also have a 14-day quarantine at home, so you would have the same potential leakage problem.”

New Zealand and Australia, meanwhile, have a mandatory hotel quarantine policy, which is “a good concept … although there is a problem with who pays for it,” he added.

Like Hong Kong, the United Kingdom also exempts some passengers from border rules, including truck drivers, sailors and crew.

Social distancing measures were repealed

The quarantine release in Hong Kong has been in place for months, but the third wave did not hit until July.

Prof. Peiris believes that this is due to a second decisive factor – the measures for social distancing were significantly repealed in June.

“As long as there were measures for social distancing, the system could cope – but once the measures were eased,” the imported infections spread quickly, he said. “It’s a lesson for everyone.”


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The government has now banned the gathering of more than two people – and briefly banned all dinner services

Dr Tsang recalled that by the end of June, the government had allowed public gatherings of up to 50 people, while there were Father’s Day celebrations and the anniversary of the surrender to Hong Kong.

“Many citizens were tired after months of social distancing, so when the government said things looked good and calm restrictions, they started meeting friends and family.

“I think it’s very unfortunate – many factors combine at once.”

However, Professor Peiris emphasizes that Hong Kongers were “extremely respectful” of social distancing and hygiene measures during the first and second waves – “in fact, they were even one step ahead of government instructions, wearing face masks before they became mandatory.”

He believes that the introduction of social distancing measures is already having an effect and hopes that Hong Kong will return to zero local infections within four to six weeks.

At this point, he added, the challenge will be to stop imported infections – especially after the removal of social distancing measures.

The challenge is that other countries will also face it once they manage to keep the virus within their borders, because “when you reach low levels of transmission within your population, unauthorized introduction from outside can lead to disaster.”

Pro-democracy protests spread the virus?

Many of the struggles for the Hong Kong pandemic will apply to other cities, but the territory has also experienced another crisis – a political one – in the last year.

On July 1, thousands of people took part in a democracy protest, although the march was banned by authorities, who said it violated social distancing guidelines. Hundreds of thousands also voted in opposition primaries in mid-July, despite a government warning that the primaries could violate a new security law.


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Thousands marched in Hong Kong on the anniversary of its July 1 broadcast

Since then, Chinese state media have blamed both events for causing the third wave of infections, while one politician called it “absolutely irresponsible behavior.”

However, health experts say there is no evidence that they are causing chic infections.

Prof. Cowling says scientists “are able to link cases to identify transmission chains and there are no clusters attributed to these events,” while Professor Peiris says the events “may have made things a little worse, but I don’t think so.” that it was a major factor in one way or another “.

Dr. Tsang, meanwhile, says research has shown that “the third-wave coronavirus strain is different from previous waves” – in particular, it has a type of mutation seen in air crews and sailors from the Philippines and Kazakhstan. that he believes the strain was imported.

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There are similar discussions around the world – especially in light of the anti-racism protests sparked by George Floyd’s death – about whether demonstrations could lead to a jump in infections, with some experts suggesting outdoor events where participants wear masks and take precautions. may be lower risk than originally expected.

Could the epidemic affect Hong Kong elections?

There is widespread speculation that the Hong Kong government may postpone the September parliamentary elections in Hong Kong – the Legislative Council – citing a jump in infections.

Several local media reports, citing anonymous sources, say the government is ready to postpone the election for another year.

Opposition politicians have accused the government of using the pandemic as an excuse to delay the election, especially after the opposition performed strongly in local elections late last year.

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However, the move was welcomed by some, including former Legislative Council Chairman Jasper Tsang, who told local media: “The government will not be able to absolve itself of guilt if polling stations become beds for the virus to spread.

“Furthermore, it is almost impossible for candidates to collect votes in compliance with the rules of social distancing.”

Professor Cowling says social distancing measures reintroduced by the government have already stopped the number of cases from accelerating in the past week.

“I’m not sure we need to postpone the elections – certainly not by a year. You might consider postponing them by two weeks or a month, because by then we would almost certainly have [local infection] numbers back to zero. “

He added that there are many ways to make elections safer, including increasing the number of polling stations and staff to reduce waiting times by ensuring that polling stations are well ventilated and testing all polling station employees. days before the election.


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Singapore has adopted additional security measures for its general elections

Governments have taken very different approaches to this – at least 68 countries or territories have postponed elections because of Covid-19, while 49 seats have held elections as planned, according to the International Institute for Democracy and Electoral Assistance.

Singapore held its general election earlier this month – and had the highest turnout in recent years, said Eugene Tan, a law professor and political commentator at Singapore University of Management.

“It is never a good time for an election during a pandemic,” he said, but the vote continued with several security measures and “shows that it is possible to protect public health even when people continue to exercise their democratic right to vote.” ”

However, he believes that deciding whether to proceed with the election is a difficult call for government decisions, especially if public confidence is low.

“If you postpone the election, you could be accused of waiting for a better time [for the government] – but if you move on, you can be accused of fast and free games with people’s lives. The worst thing would be to have an election and then a jump in the number of cases. “

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