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Covid-19: Why the third wave of Hong Kong is a warning

Woman Wearing Surgical Mask After Coronavirus Outbreak (COVID-19), Hong Kong, China, July 17, 2020

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Infections reached a record high ̵

1; 149 cases – on Thursday

Until recently, Hong Kong was considered a poster child in the fight against the Kovid-19 pandemic.

Despite the division of the border with mainland China, where the first cases were recorded, Hong Kong reduced the number of infections and was able to avoid emergency blockade measures imposed in parts of China, Europe and the United States.

But now he was struck not even by a second, but by the third wave of infections. The government warned that its hospital system could collapse, and it was just a record number of new infections per day.

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

Exceptions to quarantine and loopholes

The first case of Kovid-19 in Hong Kong took place in late January, which caused widespread concern and panic, but the number of infections remained relatively low and the spread was fairly rapid.

It experienced what became known as the “second wave” in March, after foreign 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 returnees were required to pass Covid-19 testing and 14-day quarantine.

He even used electronic bracelets to keep track of new arrivals and make sure they stay home.

This, combined with the widespread use of masks and social exclusion measures, worked – Hong Kong passed weeks without cases of local transmission, and life seemed to return to normal.

So how did the “third wave” lead to more than 100 new cases in nine consecutive days?

  • Hong Kong is on the verge of a “large-scale” outbreak

“It’s very frustrating and frustrating that things were really under control in Hong Kong,” said Malik Peiris, a professor of virology at the University of Hong Kong.

He believes that there were two flaws in the system.

First, many returnees opted for 14-day quarantine at home – arrangements common in many countries, including the United Kingdom – rather than in quarantine camps.

“There is a weakness because other people at home are not under any form of restraint, and they will still come and go,” says Professor Paris.

However, he believes that a more serious problem arose from the government’s decision to exempt several groups of people from testing and quarantine when they entered Hong Kong.

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

He said exceptions were needed to ensure normal day-to-day operations in Hong Kong, or because their trips were necessary for the city’s economic development.

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

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

The government initially said the quarantine exceptions were not to blame, but later acknowledged that there was evidence that the exceptions were behind the latest outbreaks.

They have now tightened rules for air and sea crews – but this can be difficult to enforce. Earlier this week, there was an alarming situation when a foreign pilot was reportedly spotted at inspections pending the results of a Covid-19 test.

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

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

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

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

Like Hong Kong, the UK also exempts some travelers from border rules, including truck drivers, sailors and crew.

Social distancing measures were abolished

Exceptions to quarantine in Hong Kong have been in place for several months, but the third wave did not affect July.

Professor Peiris believes that this is due to the second most important factor – the measures of social exclusion were significantly canceled in June.

“As long as social exclusion measures existed, the system could cope – but once measures are eased,” import infections spread quickly, he says. “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 lunches

Dr Tsang recalls that by the end of June, the government had allowed public gatherings of up to 50 people, while celebrating Father’s Day and the anniversary of the transfer to Hong Kong.

“Many citizens were tired after months of social backwardness, so when the government said that everything seemed normal and relaxed, they began to meet with friends and family.

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

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

He believes that the introduction of social exclusion 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 adds, the problem will be the cessation of imported infections – especially after the abolition of social backwardness.

This is a challenge that other countries will also face when they succeed in containing the virus within their borders, because “when you get to a low level of transmission within your population, unregulated introduction from outside can lead to disaster.”

Did democratic protests spread the virus?

Much of the fight against the Hong Kong pandemic will affect other cities, but the area has also experienced another crisis – a political one – over the past year.

On July 1, thousands of people took part in a pro-democracy rally, despite the fact that the march was banned by the authorities, who said it violated the rules of social exclusion. Hundreds of thousands of people also voted for opposition primers in mid-July, despite a government warning that the primaries could violate a new security law.

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Thousands of people went to Hong Kong on the anniversary of his transfer, July 1

Since then, Chinese state media have accused both events of causing a third wave of infections, while one politician called it “completely irresponsible behavior.”

However, medical experts say there is no evidence that they caused the outbreak.

Prof. Cowling says scientists “can connect cases to detect transmission chains, and there are no clusters related to these events,” while Prof. Paris argues that events “may make things a little worse, but I don’t think it was the main determinant one way or another.”

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

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There have been similar debates around the world – especially in light of the anti-racist protests sparked by George Floyd’s death – as to whether demonstrations could lead to a spike in infections. risk than originally expected.

Can the outbreak affect the Hong Kong election?

It is widely believed that the Hong Kong government may postpone the September elections to the Hong Kong Parliament – the Legislative Council – citing a spike in infections.

Several local media outlets, citing anonymous sources, say the government intends to postpone the election for a year.

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

However, the move was welcomed by some, including former legislature President Jasper Tsang, who told local media: “The government will not be able to absolve itself of blame if polling stations become hotbeds of the virus.

“In addition, it is almost impossible for candidates to get votes, given the rules of social exclusion.”

Prof. Cowling says the government’s social exclusion measures have halted the pace of acceleration over the past week.

“I’m not sure we need to postpone the election – certainly not for a year. You can think of postponing it for two weeks or a month, because by then we would almost certainly have [local infection] numbers back to zero. “

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

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Singapore has taken additional security measures for its general election

Governments have taken very different approaches to this – at least 68 countries or territories have postponed elections thanks to 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 it received the highest turnout in recent years, said Eugene Tan, a law professor and political commentator at Singapore University of Management.

“There is never a good time for an election during a pandemic,” he said, but the vote went ahead with several security measures and “demonstrates that public health can be protected even when people go to exercise their democratic right to vote.” .

However, he believes that deciding whether to continue the election is a tough call for governments, especially if public confidence is low.

“If you postpone the election, you may be accused of waiting for a better time [for the government] – but if you are ahead, you may be accused of playing people’s lives quickly and freely. The worst thing would be to hold elections and then have a spike in the number of cases. “

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