Too many corpses, too few coffins: How Hong Kong’s Covid success story turned sour
Hong Kong has the world’s highest coronavirus death rate yet authorities are easing restrictions as the city known for its ‘zero-Covid’ strategy moves towards learning to live with the virus, reports William Yang
Corpses are piling up in hospital wards, crematoriums are struggling to cope, and coffins are in short supply: the Covid response success story that was Hong Kong is fast turning into a cautionary tale, with coronavirus deaths having rocketed to a global high.
Before 2022, the financial hub was held up as an example of how to contain the pandemic, with its “dynamic zero” Covid strategy – which aims to curb outbreaks as they occur with contact tracing, testing and isolation – keeping life relatively normal for most of its 7.5 million residents.
Then came the Omicron variant, which has caught the Chinese-controlled territory off guard and overwhelmed its health system and care homes, fuelling a dramatic surge in cases and deaths – especially among the elderly who refused to get vaccinated.
In the first two years of the pandemic, Hong Kong recorded just 213 Covid deaths. In the last two months alone, there have been more than 6,000 deaths.
Hong Kong’s coronavirus caseload last week surpassed one million, while its seven-day rolling average of new Covid deaths is 240, or 32 fatalities per one million residents – the highest in the world. Some health experts estimate that up to four million people could be infected, with many isolating at home without informing the authorities they have Covid.
The rapidly growing number of infections has overwhelmed hospitals across the city, while Hong Kong’s funeral industry warned of coffin shortage as “dead bodies continue to pile up”.
Experts highlighted several factors as the cause of the soaring caseload and death rate as the city struggles to contain its fifth and worst wave of the virus.
“Omicron’s potential to transmit rapidly combined with the low vaccination rates among the most vulnerable, lack of immunity from prior waves and a high population density came together to overwhelm Hong Kong’s health care system and lead to such high death rates,” said Vijaykrishna Dhanasekaran, a virologist at the University of Hong Kong (HKU).
The biggest problem is the authorities’ inability to vaccinate the elderly, he told The Independent.
While at least 82 per cent of the overall population has received at least two jabs, that drops to under 40 per cent for those aged 80 and over, according to data from Hong Kong’s Covid vaccination portal.
Elderly people in Hong Kong have often failed to keep up
With authorities imposing strict restrictions on social gatherings and hospitals struggling to provide basic care to everyone who may need it, some communities, especially the elderly, have become particularly vulnerable to coronavirus.
“Due to unfamiliarity with digital technologies and the lack of socialising since the pandemic, elderly people in Hong Kong have often failed to keep up with crucial information such as vaccination, mandatory examination, and how to deal with a Covid diagnosis,” said Stanley, a pastor in his fifties serving marginalised communities in Hong Kong.
The pastor – who did not give his full name due to security concerns – said older citizens who had to isolate for long periods were struggling with depression and often had to rely on help from charities to obtain essentials like food and medicine.
Ultimately, Stanley said he feared for the lives of elderly people who contract Covid because the health system was “overloaded” with hospital hotlines often busy and ambulances taking up to an hour to arrive.
When tens of thousands of cases emerged each day a few weeks ago, Hong Kong’s hospitals were overwhelmed by the number of patients. Covid sufferers have been seen lying on beds outside on the premises, while others have been treated in makeshift tents.
Stanley’s concern was echoed by Karen Grepin, an associate professor at HKU’s School of Public Health.
“When your healthcare system is like that, it’s impossible to provide high levels of care to all the people who need it – and that also greatly contributes to high levels of mortality,” she said.
Ms Grepin believed Hong Kong misjudged the scale of the initial Omicron outbreak in January, which caused the virus to keep spreading in the community until it spiralled out of control. The government could have pivoted towards a mitigation strategy at that point, which might have checked the rate of transmission and prevented hospitals from being stretched to the limit, she said.
Due to the chaotic situation across the city, Hong Kong was forced to abandon some core aspects of its zero-Covid strategy late last month. Patients with mild symptoms are no longer being sent to hospitals or isolation facilities, while authorities have begun to largely replace PCR tests with rapid antigen tests.
On Monday, Hong Kong’s chief executive Carrie Lam announced that several Covid restrictions would be eased from next month – a policy U-turn that comes following widespread criticism from residents, businesses, politicians and pro-Beijing media.
Ms Lam said the city will lift its Covid flight ban on nine countries – which include Australia, Canada, India, the UK and US – and shorten mandatory quarantine from 14 days to seven days from April if travellers test negative.
Schools will be able to resume in-person classes from 19 April and the government plans to gradually lift restrictions on social gatherings from 21 April. Furthermore, a plan to carry out mass coronavirus testing would be put on hold, Ms Lam said.
Many Hong Kong natives have been stuck abroad during the pandemic and unable to return home due to a shortage of mandatory quarantine hotels, and Ms Lam suggested in a media briefing that more space would be provided.
Nevertheless, Mr Dhanasekaran said he remained sceptical about the capacity of Hong Kong’s hotels when international flights start arriving next month, while Ms Grepin argued that the reduction of quarantine time and suspension of the universal testing programme plan was unlikely to make any difference to the current wave.
Both experts agreed that the series of plans introduced on Monday show signs that Hong Kong may be prepared to transition to learning to live with the virus.
“[This] signals a break from the strict application of the zero-Covid strategy in the short run in Hong Kong,” said Ms Grepin.
Mr Dhanasekaran said he believed Hong Kong was in a good position to move towards a “living with Covid” strategy due to the high infection rate and therefore immunity to the virus, but warned about a spike in cases as restrictions were relaxed.
“As social measures continue to be released, an exit wave should be expected and all measures should be made to mitigate overburdening the health system,” he said. “[Authorities can do so] by continuing to improve vaccination rates in the elderly.”
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