The repurposed AsiaWorld Expo center in Hong Kong echoes with the groans of elderly COVID-19 patients. Kept in 8 square meter cubicles, many go for weeks without fresh air, sunlight or a bath. Some breathe their last in the glare of the Congress Hall lights. An ambulance will be here in an hour on a good day to take their bodies away.
“It’s a nightmare,” said Lily, a 22-year-old nurse in the isolation ward. “Sometimes we call an ambulance because a patient needs to go to the hospital and we are told it will take a day or two to get there. It’s really shocking.”
The nurse, exhausted from caring for more than 150 patients with another colleague, declined to give her last name because staff were ordered not to speak to the press about conditions at the site, which have become exemplary for the runaways are COVID-19 crisis in Hong Kong.
In just a few weeks, the city of more than 7 million people has gone from being one of the safest places during the pandemic to having what is believed to be the city with the highest COVID-19 death toll in the world. As of February 18, Hong Kong had recorded a total of 259 COVID-related deaths since the pandemic began. A month later, the number had risen to nearly 4,600 — on par with the reported total in China, a country of 1.4 billion people.
With an alarmingly low vaccination rate among the elderly, about 90% of deaths in Hong Kong in the last wave were in patients over 60. Morgues and hospitals have run out of space to store corpses. The city is waiting for a new shipment of coffins to arrive by sea.
Concern is now spreading to mainland China, which is facing its worst outbreak since the disease was first reported Wuhan in early 2020. Fueled by the easily transmissible Omicron variant, the number of mainland cases has surged over the past week, prompting authorities to respond by sealing off neighborhoods in major cities like Shanghai, Shenzhen and the entire Jilin province, with repercussions had tens of millions of people.
“We are at a key stage,” said Jilin Communist Party leader Jing Junhai. according to state media.
Combined with Omicron-fueled outbreaks in South Korea and Vietnam, the pandemic is proving stubbornly resilient in parts of Asia at a time when the United States and Europe have decided – rightly or wrongly – to move away from the coronavirus, mask mandates suspend and allow large gatherings.
This social freedom comes after the loss of more than 2 million American and European lives. By comparison, the death toll in China, Hong Kong, South Korea and Vietnam is officially in the tens of thousands, not least due to strict adherence to policies such as zero tolerance for COVID.
The strategy, which relies on tightly controlled borders, mass testing, quarantine and isolation to eliminate all instances of the virus, has already been under pressure to sap economic growth and strain the nerves of millions of people desperate to travel, go to school and wanted to do business Vor.
Now it faces its biggest test: Omicron is expected to infect more than half of Hong Kong’s population in the coming weeks and threatens to spread to mainland China, where there is virtually no natural immunity and millions of unvaccinated seniors.
“In the earlier stages of the pandemic, the goal of keeping cases as close to zero as possible was reasonable,” said Keiji Fukuda, a leading epidemiologist and former director of Hong Kong’s top public health school at the University of Hong Kong. “But over time, COVID-19 has shown its ability to endure and evolve. … [It] shows no signs of disappearance. As the most likely scenario is that the world will live with COVID-19 indefinitely, the value of a zero-case policy diminishes.”
Hong Kong, a former British colony that still maintains some autonomy from China, has proven that zero tolerance can work when case numbers are low. But when Omicron increased the number of daily infections in the city by more than 800% from mid-February, many of the city’s shortcomings were exposed – nothing more devastating than the failure to vaccinate enough Hong Kong elderly.
Less than 45% of Hong Kong residents aged 70 and over were vaccinated when the outbreak began. For seniors in assisted living facilities, the rate was even lower—less than 20%. That’s well below Hong Kong’s overall immunization rate of 72%.
Overnight, the Asian financial hub was inundated with scenes of ailing elderly patients flooding the infirmaries. Space became so limited that many had to be wheeled outside and kept at the curb without shelter.
Experts say a number of factors have led to low vaccination rates among Hong Kong seniors. Political unrest that began in 2019 fueled mistrust of the government and weakened calls to heed public health advice. Other seniors have been influenced by misinformation online and in local media about threats vaccines are said to pose to the elderly and infirm. Many argued that when the city had so few cases, it wasn’t worth risking a shot. Additionally, studies have shown that China’s native vaccines from Sinovac and Sinopharm are less effective at preventing disease than their mRNA counterparts such as Pfizer-BioNTech and Moderna.
“This tragedy was completely foreseeable and completely preventable,” said Gabriel Leung, dean of medicine at the University of Hong Kong. “We have had early, sustained, uninterrupted and privileged access to vaccines. And yet we are probably the only population in the Global North with such poor care for our most vulnerable.”
Hong Kong Chief Executive Carrie Lam recently acknowledged that “not enough” had been done to vaccinate seniors.
Now the city is stepping up its efforts. The health department did not respond to a request for comment on conditions at the AsiaWorld expo center.
Lam’s government has been widely criticized for its handling of the crisis. A failure to clearly rule out a lockdown led to panic buying and supermarket shelves being emptied earlier this month. Forced isolation of COVID-19 patients resulted in parents being separated from their infants. And a plan to test all residents for the virus appears to have failed because the city’s labs are under capacity.
The missteps have heightened perceptions of Hong Kong’s demise as a global city. The outbreak has exacerbated the exodus of residents, which last year has reached levels not seen in more than half a century. Meanwhile, the city’s stock market fell to its lowest level in eight years this week.
“The government could have handled this much better,” said Bruno Ko, a fourth-year biomedical engineering student who recently recovered from COVID-19. “They allowed rumors to spread and created panic.”
Ko said he was likely infected by his parents, with whom he shares a 1,000-square-foot apartment. When his father called a hotline to find an isolation center, he couldn’t get through because the line was flooded. The family eventually gave up trying and recovered at home.
“Everyone is exhausted,” said Ko, his voice still raspy from his illness. “We go insane staying at home with no social life and no food. You can’t even have KFC deliver at night. You cannot go ahead with zero-COVID because that will take years.”
Officials in mainland China have begun to consider what more accommodating COVID-19 policies might look like. However, in briefings and interviews with Chinese state media, experts and epidemiologists said current preventive measures must be maintained to minimize serious illness among the unvaccinated and the drain on the country’s medical resources.
Zhang Wenhong, a well-known epidemiologist in Shanghai, said on China’s Twitter-like platform Weibo this week that the situation in Hong Kong has shown the importance of vaccination, especially among the elderly.
About 81% of China’s 264 million people over 60 have received at least one dose of vaccine, according to a report by the state-run Xinhua news agency in November, leaving about 50 million unvaccinated.
As a surge in confirmed cases sparks a nationwide scramble to contain outbreaks, many residents are more concerned about being caught up in the country’s COVID-prevention efforts than actual infection.
Cindy, a 26-year-old Shanghai resident who declined to give her last name, said the breadth and uncertainty of the recent COVID-19 restrictions have been frustrating. Although she lives less than a mile from an outbreak site, she is concerned about what will happen to her dog when she is away from home.
“What scares most of my friends around me is being locked up in the wrong place for 14 days,” she said. “The government is keen to have zero cases.”
Others say they can no longer tell the difference between a lockdown and the COVID controls that have permeated everyday life in China.
In Shenzhen, photographer Leo Lee doesn’t feel much like staying at home as he often works from home and orders groceries online for delivery. Two of his colleagues chose to live in the office in anticipation of the partial lockdown to gain access to the photo studios. When public transport was stopped, one took a taxi and the other rode a bike, he said.
“People here are optimistic and fully cooperating,” Lee said. “I don’t think it will take us long to reach zero cases.”
There are signs that China is seeking more flexibility in its recent COVID-19 control measures. Instead of shutting down the entire city of Shanghai, apartment complexes and communities have been locked down in shifts while residents undergo mass testing. China’s National Health Commission adjusted its policy to allow patients with mild symptoms to be isolated in central quarantine facilities instead of hospitals, and lowered the bar on patient discharges.
Zhang, sometimes referred to as China’s Dr. Anthony Fauci, despite the outburst at his public post, struck an upbeat tone. He said containing the virus will provide an opportunity to vaccinate more elderly residents and improve testing and treatment, and that doesn’t mean the strategy going forward will always be lockdowns and large-scale testing. Any long-term measures must be gentle and sustainable, he said.
“Is the most difficult time in two years of fighting the pandemic the long winter night or the spring cold snap?” wrote Zhang. “When we see clearly the road ahead and the spring that must come, what should we be afraid of?”
Pierson reported from Singapore and Yang from Taipei, Taiwan. Special correspondents Chi-Hui Lin in Taipei and Antonia Tang in Hong Kong contributed to this report.
https://www.latimes.com/world-nation/story/2022-03-17/hong-kong-china-asia-omicron-zero-covid Hong Kong runs out of coffins while Omicron takes a deadly toll