Coronavirus: What can be learned from the third wave of Covid-19 in Hong Kong?

Hong Kong was once considered a role model in handling the Covid-19 pandemic. However, the 'third wave' of Covid-19 cases hit the region.

Despite sharing a border with mainland China, where the first cases of Covid-19 were reported, the number of coronavirus infections in Hong Kong is low and the region has been able to circumvent the extreme regional quarantine policies introduced in parts of China, Europe and the US.

But now, not just the second wave, Hong Kong is facing the third wave of Covid-19 transmission.

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The government has warned the hospital system could collapse. Hong Kong also recently recorded the number of new infections a day.

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What's wrong, and what lessons can countries facing a pandemic and an economic downturn due to lockdowns?
Quarantine exceptions and 'loopholes'
Hong Kong recorded its first Covid-19 case in late January, which caused widespread concern and panic buying. But the number of infections remains relatively low and the spread of the virus can be brought under control fairly quickly.

Hong Kong experienced what became known as a "second wave" in March, after students and residents from abroad began returning to the region, leading to a spike in imported infections.

As a result, Hong Kong enforces strict border controls, barring all foreign nationals from entering its borders, and all people returning from abroad are required to undergo a Covid-19 test and a 14-day quarantine.

In fact, new arrivals are asked to wear an electronic bracelet to ensure they stay at home.

That policy, coupled with the massive use of masks and the imposition of social distancing restrictions, worked. For weeks, there were no local cases of transmission in Hong Kong, and life appeared to be returning to normal.
So how did the "third wave" - ​​with more than 100 new cases for nine consecutive days - occur?

"It's quite disappointing and frustrating because Hong Kong really controls a lot of things," said Malik Peiris, Chair of Virology at the University of Hong Kong.

He believes there are two weaknesses in the system being implemented.

First, many people returning from overseas choose to be quarantined for 14 days at home - a common arrangement in many countries including the UK - instead of in quarantine camps.

"There are weaknesses in the system because other people at home are not restricted in their movements, and will still enter and leave the house," said Prof Peiris.

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However, he believes a more serious problem arises when the government excludes some groups of people from testing and quarantine when they enter Hong Kong.

Hong Kong has exempted some 200,000 people, including seafarers, aircrews and executives of companies listed on the stock exchange, from quarantine.

Exceptions were made to ensure normal day-to-day operations continued in Hong Kong, and because their travel was deemed necessary for the city's economic development.

As an international city and trading port, Hong Kong has many air routes, and many aircraft change crew there.

The region also depends on imports from mainland China and from other regions for food and essential goods.
Joseph Tsang, an infectious disease specialist and doctor, described the exclusion as a significant "loophole" that increases the risk of infection, particularly from sailors and flight crews who also visit tourist attractions and use public transport.

The government initially said quarantine exemptions were not to blame, but later admitted there was evidence the policy was causing the latest wave of infections.

They have now tightened the rules for air and sea crews - but they may be difficult to enforce.

There were warnings earlier this week after a foreign pilot was reported to have seen the streets awaiting the results of a Covid-19 test.

Balancing public health, practical and economic concerns can be difficult.

The union representing pilots at FedEx has asked the company to stop flights to Hong Kong due to stricter Covid-19 prevention measures, including mandatory hospitalization requirements for pilots who test positive,