The pandemic in Hong Kong: does the zero COVID-19 policy work?, by Elmer Huerta

Incredible as it may seem, these days the situation of the pandemic in Hong Kong It is very similar to what Peru had during the worst part of the first wave in 2020: very high number of cases and deaths, and collapse of the health system.

Reviewing what is happening there, a Special Administrative Region of the People’s Republic of China, will give us the opportunity to evaluate zero COVID-19 policies adopted by some countries, in addition to appreciating the enormous importance of vaccines in preventing serious disease and death from it pandemic.

in the last two weeks As of March, 312,000 cases of COVID-19 were registered (almost all by omicron), and the number of deaths is such that the authorities use refrigerated trucks to store the corpses, since the morgues have been overwhelmed. In the week of March 3, Hong Kong had the highest number of deaths per million inhabitants on the planet.

For reference, as of January 31, 2021, 213 deaths had been recorded in Taiwan. That number rose to 1,554 the first week of March. In other words, in just over 12 weeks, there have been six times more deaths than during the first two years of pandemic.

“When the omicron variant arrived in that region, it found a disproportionate number of defenseless people.”

What has happened for such a health calamity to occur? The first thing is to understand that Hong Kong, under the leadership of mainland China, adopted the zero COVID-19 policy: close borders, restrict the entry and exit of people, implement an aggressive infection surveillance system and close entire cities if a single case is found.

Unfortunately, that policy was not coupled with an aggressive vaccination program. In this regard, in the first week of March, only 48% of the population over 70 years of age had received two doses of vaccine and, at the beginning of the year, only 25% of the population over 80 years of age had received one dose of vaccine.

When the omicron variant arrived in that region, it found a disproportionate number of defenseless people. This variant, which usually causes mild illness in people with a strong defense system, found a highly susceptible population and caused severe illness and death. The vast majority of deaths are in older adults.

By contrast -and to demonstrate the value of vaccination-, countries like New Zealand and Singapore, which also opted for zero COVID-19 policy, have not had an excess of deaths despite presenting records in the number of cases per omicron. In these countries, the variant found a protected population.

The situation in Hong Kong once again puts on the table the zero COVID-19 policy of China, the most populous country on the planet that has raised this unique policy as the flag of the fight against the pandemic. About, of the 214 new cases registered in China on March 6 – one of the highest figures since the start of the pandemic – almost a third occurred in Guangdong, the province bordering Hong Kong.

As we had anticipated in a previous column, the statistics related to the pandemic in China are surprising. At the time of writing this article, the death toll in that country is 4,636citing that in the 2021there were less than 17,000 cases and only one death from COVID-19 in that country of 1.4 billion people. In more than two years of the pandemic, China registers only 112,940 cases.

From the beginning of the pandemicChina developed an app for smartphones that had to show a green code so that a person can circulate in society, having even quarantined cities with millions of inhabitants for finding a single case.

This vertical and severe control of the pandemic has meant that in a recent index of return to normality -published by “The Economist”– China, Vietnam and New Zealand are the only countries that have practically returned to normal life.

On the other hand, China is one of the few countries in the world that has almost exclusively used its own Sinopharm and CoronaVac vaccines to protect its population, thus managing to vaccinate the 85.5% of its populationand there are no data on the proportion of the population that has received a booster dose. The problem is that Chinese vaccines, while relatively effective in preventing severe illness and death, have proven much less effective in protecting against infections, especially omicron.

China then finds itself –thanks to its zero COVID-19 policy– in the particular situation of having billions of people without natural immunity, but immunized with not highly effective vaccines.

That apparent strength may be a huge weakness, as models developed by Chinese researchers project that, should an uncontrolled outbreak occur, hundreds of millions of infections would spread across the country, resulting in at least three million deaths. Given its patchy healthcare system and critically low number of ICU beds, the breakdown of defenses against COVID-19 it could spell disaster.

The big question is: how long will it last? Will it be possible to maintain this draconian system of control and geographic isolation during the coming months? What will happen when a new variant appears? Some say China is playing for time, closely watching the virulence of variants and relying on cellular memory immunity provided by vaccines.

China may be betting that the COVID-19 become a simple cold, and that when that time comes, they can allow their population to become infected. Unfortunately, there is no guarantee that such a plan will work.

SUBSCRIBE TO OUR NEWSLETTER