SINGAPORE — The repurposed AsiaWorld Expo center in Hong Kong echoes with the moans of elderly COVID-19 patients. Kept in 8-square-foot cubicles, many go weeks without fresh air, sunlight or a bath. Some take their last breaths under the harsh glow of the convention hall lights. On a good day, an ambulance will arrive in an hour to carry their bodies away.
“It’s a nightmare,” said Lily, a 22-year-old nurse at the isolation facility. “Sometimes we call for an ambulance because a patient needs to go to a hospital and we’re told it will take one to two days to arrive. It’s really shocking.”
The nurse, exhausted by having to care for more than 150 patients with one other co-worker, declined to give her last name because staffers were ordered not to speak to the press about the conditions at the site, which have come to exemplify the runaway COVID-19 crisis in Hong Kong.
In just a matter of weeks, the city of more than 7 million has transformed from one of the safest places to be during the global pandemic to having what’s believed to be the highest rate of COVID-19 deaths in the world. On Feb. 18, Hong Kong had a total of 259 COVID-19 deaths since the pandemic began. A month later, the number had soared to nearly 4,600 — on par with the total in China, a country of 1.4 billion people.
With an alarmingly low vaccination rate among its seniors, about 90% of Hong Kong’s deaths in the latest wave have been of patients 60 or older. Morgues and hospitals have run out of room to store bodies. The city is awaiting a fresh batch of coffins arriving by sea.
Concerns are now spilling into mainland China, which is facing its worst outbreak since the disease was first reported in Wuhan in early 2020. Fueled by the easily transmissible omicron variant, the number of cases on the mainland has surged in the last week, with authorities reacting by locking down neighborhoods in major cities such as Shanghai, Shenzhen and the entire province of Jilin, affecting tens of millions of people.
“We are at a key stage,” said Jing Junhai, Jilin’s Communist Party chief, 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 on from the virus, lifting mask mandates and allowing large gatherings.
That 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 officially numbers in the tens of thousands, in no small part because of strict adherence to policies such as zero tolerance for COVID.
The strategy, which relies on tightly-controlled borders, mass testing, quarantining and isolation to eliminate all instances of the virus, was already under strain for weakening economic growth and fraying the nerves of millions of people desperate to travel, attend school and do business like before.
Now it faces its biggest test with omicron predicted to infect more than half of Hong Kong’s population in the coming weeks, while threatening to spread across mainland China where there’s virtually no natural immunity and millions of unvaccinated seniors.
“In the earlier phases of the pandemic, the goal of keeping cases as close to zero as possible was reasonable,” said Keiji Fukuda, a leading epidemiologist and the former director of Hong Kong’s top public health school at the University of Hong Kong. “But over time, COVID-19 showed its ability to persist and evolve…[It] shows no signs of disappearing. Since the most likely scenario is that the world will be living 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, proved zero tolerance could work when caseloads were low. But when omicron lifted the number of daily infections in the city by more than 800% starting in mid-February, it exposed many of the city’s shortcomings — none more devastating than the failure to inoculate enough of Hong Kong’s elderly.
Less than 45% of Hong Kong residents ages 70 and up were vaccinated when the outbreak started. The rate was even lower for seniors in assisted-living homes at under 20%. That’s well below Hong Kong’s total vaccination rate of 72%.
Overnight, the Asian financial center was inundated with scenes of sickly older patients flooding hospital wards. Space became so limited that many had to be wheeled outdoors and kept on the side of roads without shelter.
Experts say a number of factors have led to low rates of vaccination among Hong Kong’s seniors. Political unrest starting in 2019 bred distrust of the government, weakening their calls to heed public health advice. Other seniors were influenced by misinformation online and in local media about threats vaccines allegedly posed to the elderly and frail. Many reasoned it wasn’t worth risking a jab when the city had so few cases. Moreover, studies have shown China’s domestic vaccines made by Sinovac and Sinopharm are less effective at preventing disease than their mRNA counterparts.
