In April 2003, the Chinese health minister and the mayor of Beijing were both dismissed for their mishandling of the deadly SARS outbreak. The mysterious infection is believed to have first been identified in late 2002 in southern China. But the failure of government officials to report the outbreak, and then to track its spread, was blamed for its transmission to Hong Kong, and later worldwide.
That coronavirus eventually claimed nearly 800 lives, mainly in Asia.
Two senior health officials in Hong Kong later resigned to take responsibility for their own clumsy response to the SARS crisis. Local politicians also called for the resignation of the city’s director of health, Margaret Chan – although Beijing had a very different appraisal of her performance. She later joined the World Health Organisation in 2003, rising to the position of director-general three years later, thanks to the Chinese government’s backing.
Two decades on, another coronavirus has wreaked a far, far more catastrophic impact since first being reported in China, although the authorities there have tried to keep it in check with a ‘zero tolerance’ approach (see WiC569).
Hong Kong followed a similar strategy for nearly two years, before finally succumbing to the fuller impact of the pandemic after a disastrous few weeks this year when the ‘Fifth Wave’ arrived (the highly contagious Omicron variant). Moreover, the former British colony is being blamed this time for a spillover of infections back into the mainland.
As the city struggles to cope with elevated levels of infection and death, the question is whether its experience of the pandemic is going to force the Chinese government into a rethink of its own Covid-19 approach, perhaps by moving towards a ‘live with it’ strategy more akin to that adopted across the rest of the world.
A tale of two cities, again…
Regular WiC readers should be familiar with the term ‘Shenzhen speed’, which is often deployed to describe the dazzling pace at which the southern Chinese city transformed first from paddyfields to an urban metropolis and more recently into a global tech hub.
Hong Kong’s momentum in recent years has been pedestrian by comparison, as underlined by the symbolism of the large swathes of undeveloped land along its border with Shenzhen (see WiC556).
The Shenzhen government wasted no time in underscoring its effectiveness again on Monday when it announced a return to normal life in the city as its latest Covid-19 resurgence subsided.
The decision was taken after many of the city’s 17 million residents were locked down in their homes for a week while three rounds of Covid tests were carried out citywide.
On the same day Hong Kong also announced its own easing of various quarantine and social distancing measures, some of which had been imposed for more than a year.
But these changes were not because the city had been successful at containing Covid. Far from it: the coronavirus has been spreading frenetically across the territory for the last two months. Around a million people from the 7.8 million population have registered positive for Covid at government testing centres (however, the actual figure for infections is substantially higher: according to modelling from the University of Hong Kong, at least 4.4 million of the city’s residents have probably had it). More than 6,500 have died.
This compares with about 140,000 confirmed cases and 4,600 deaths in mainland China since the virus was first reported in Wuhan in November 2020.
Local authorities in Shenzhen had been forced to impose a partial lockdown in the city after spotting an uptick in imported cases, with many blaming Hong Kong for failing to contain its own outbreak and then allowing cases of infection to spill across the border.
The situation also meant that comparisons have been made between how the two cities have adapted to managing the crisis. In its simplest form the argument is that Shenzhen had illustrated once again how a ‘zero tolerance’ approach was effective in stamping out the chain of transmission. But the Hong Kong government is taking a very different approach, having relaxed many quarantine measures as the caseload became too big to contain (even now newly confirmed cases still exceed 10,000 per day).
Many local commentators have questioned if the city’s authorities had finally come to terms with the new reality i.e. switching to a more pragmatic ‘live with it’ approach and ditching the ‘zero Covid’ mantra as unworkable.
How has Hong Kong coped with Covid for the last two years?
For many months the city did well relative to other major urban areas in the developed world. About 12,500 local infections were reported by the end of 2021. With just 213 deaths, the fatality rate was among the lowest in the world.
To a certain extent the government’s initial containment measures (which have included bans on dining out, the closure of gyms and public parks, and lengthy quarantines for people arriving from other countries) worked for long periods. Much of that success, however, can also be credited to the local population which was highly disciplined (after the 2003 experience of SARS) in wearing masks and keeping to social distancing rules for more than two years.
That success had led to optimism that the city could soon return to something that resembled normality. Although international flights were reduced to bare minimum levels (flagship airline Cathay Pacific was carrying only 797 passengers a day in January), there were plans to reopen border crossings into China by the start of 2022, reportedly on the basis that Hong Kong suffered no new local infections for a prolonged period.
However, the government started to lose control of the situation when the Omicron variant began to spread. New cases of infection started to pile up from a daily rate of several dozen in February to an exponential peak of more than 80,000 earlier this month.
In fact, Hong Kong’s initial success in containing Covid-19 seems to have been a factor in the higher fatality rates experienced in recent weeks. Many residents saw less need to get vaccinated, for instance, because they had been shielded from the more dangerous levels of infection seen in other countries. Critics of the government counter that the lower incidence of Covid also made the authorities complacent and that they failed to ensure that the elderly population was protected against the virus with a more successful vaccination campaign.
The numbers of daily new infections had dropped back to about 10,000 a day by mid-March but medical experts have warned that this decline is mostly due to a change in counting methods, after the surge in cases meant the government had to rely on ailing Hongkongers to self-test at home (it’s widely accepted by local health experts that vast numbers of people have chosen not to register with the authorities if they tested positive – hence why the University of Hong Kong model estimates infection levels could be over four times higher than the official statistics).
How have the mainland Chinese reacted to events in Hong Kong?
On February 16 – with the Winter Olympics entering their final week in Beijing – Chinese President Xi Jinping had weighed in on the worsening situation with a rare directive to Hong Kong officials. With his message published by two local Hong Kong newspapers Xi instructed the city’s bureaucrats that their “overriding mission” was to control the outbreak – although even prior to this health experts in China had already upped the pressure on the Hong Kong government to do more to combat Covid. Tian Feilong, a law professor at Beihang University in Beijing, accused the city’s officials of being half-hearted in carrying out the ‘zero Covid’ policy. Decisionmakers, he rebuked, were keener on reconnecting with Western economies then working to reopen the Hong Kong-China border.
For critics like Tian, Xi’s personal intervention was another reminder that ‘living with Covid’ wasn’t on the policy agenda for Hong Kong’s decisionmakers. Instead, they should stick to harsher Covid containment controls – including building a host of giant camps for isolating residents who tested positive – so as to stay in line with the ‘zero-tolerance’ methods used in the rest of China.
Soon after Xi released his statement Carrie Lam, the city’s chief executive, announced that the government was planning to conduct three sets of mandatory citywide Covid tests within the next month. Hints that there could also be some form of fuller lockdown containment strategy triggered panic-buying in supermarkets that rapidly emptied shelves. Lam announced that elections for her own chief executive role would be postponed to early May from March 27, as her administration needed to concentrate on fighting Covid-19.
At this juncture, epidemiologists and other medical professionals began to arrive from the mainland, including Liang Wannian, head of the National Health Commission’s Covid-19 task force, who had long staunchly advocated the ‘zero Covid’ strategy. They were reported to have conducted at least nine rounds of discussions with Lam’s administration. The Hong Kong public looked on nervously as Chinese construction firms arrived to help build the afore-mentioned quarantine camps – estimated to contain around 50,000 beds. When photos of these new facilities began to circulate in newspapers and online it alarmed the local population (contributing to an exodus of residents going overseas that would exceed 100,000 departures in February and March).
All of this instilled the impression that Beijing had taken a more direct role. International media outlets started to talk about the threat to the city’s relative autonomy. “The notion of ‘one country, two systems’ increasingly looks like a future of responsibility to the mainland but little choice, even when different choices might serve the city’s interests,” the Wall Street Journal remarked.
But Hong Kong then changed direction…
On Monday Lam announced that Hong Kong would shelve plans to carry out compulsory citywide testing, a key tool in the Chinese ‘zero Covid’ playbook. This was a reversal (albeit a sensible one – given over half the population had likely already had Covid) but was still a considerable volte face less than a month after telling the public the tests would be necessary.
Lam said she had sensed a shift in the public mood: “I have a very strong feeling that people’s tolerance is fading. I have a very good feel that some of our financial institutions are losing patience about this sort of isolated status of Hong Kong.”
As a result Lam said the city would also start to phase out restrictions on international travel arrivals and loosen some of its social distancing measures, starting next month.
The impact of the changes will take time to materialise, not least in international travel, where airlines are waiting to see if they will be released from a separate regulation that bans them from flying for two-weeks if they bring four or more infected people into Hong Kong (Lam’s administration says it is looking at changing this rule, which is dissuading the airlines from reinstating more of their schedules after April 1, when the block on direct flights from countries like the UK and Australia is going to be lifted).
On a local radio show Joseph Tsang, co-chairman of the Medical Association’s advisory committee on communicable diseases, argued the government should scrap the route suspension mechanism, given that the threat from imported cases was less serious than the large and existing transmission chains in Hong Kong already.
But news of even the modified policies came as a surprise to many, with journalists immediately asking Lam if the easing of Covid controls meant that Hong Kong was adopting a similar approach to other countries and moving away from the tactics deployed in mainland China.
“Right now, I would advise that you need not draw any conclusion of what we are heading towards in the announcement that we have made today,” she replied.
The decision to hold back on mass testing was reached after consultations with experts including those from the mainland, Lam added, with their agreement that it was no longer appropriate for Hong Kong to “devote finite resources” to mass testing when thousands of new cases were already being reported on a daily basis.
Lam also cited Hong Kong’s role as a financial and aviation hub as a factor in the new approach, with the implication that the city’s battered economy risked even more damage if the previous policy mix went on unchanged.
But she insisted that the government’s overall decisionmaking would always take into account the city’s connectivity with the outside world as well as the mainland.
That statement speaks volumes about the awkward position the Hong Kong government finds itself in. On one side there is intense pressure on Hong Kong to drive down Covid cases to the point at which it can reopen its border with the mainland (the city will celebrate its 25th anniversary of returning to Chinese rule on July 1, when Xi is expected to pay a visit). On the other side, there is the clamour to reopen Hong Kong to the wider world, with local businesses and much of the city’s population losing faith with such draconian Covid-19 controls.
Property tycoon Allan Zeman, for one, said many senior people from the business community (himself included) had written to Lam recently about the situation and the need to rethink the strategy. “I told her frankly that people in the financial industry are leaving for cities like Singapore, and the economy is in a mess,” Zeman told the South China Morning Post
What could Hong Kong’s change of heart mean for Covid policy in mainland China?
Liang Wannian told a press conference on Tuesday that Hong Kong’s decision to hold back on universal testing didn’t mean that the city’s government had chosen the approach of ‘living with the virus’ instead.
The epidemiologist reiterated that China needs to stick to the ‘zero Covid’ approach in responding to a worsening situation at home.
Indeed, Chinese health officials are battling to control the worst local outbreaks in two years, with the National Health Commission reporting more than 40,000 infections (including asymptomatic ones) nationally this month. More than half of them were concentrated in northeastern Jilin province, where the authorities have struggled to contain new case numbers. A number of districts in Shenyang, a city of nine million people in Liaoning province, were locked down on Wednesday after reporting more than 4,000 cases a day this week. Even in Shanghai, local authorities have reported a fifth consecutive daily record of locally transmitted cases.
This resurgence in Covid cases is a headache, although events in Shenzhen suggest that some of the policy responses are being reappraised. With the blessing of the central government the city relaxed lockdowns early to help some industries and avoid supply chain crunches, the Financial Times commented. President Xi himself played a role in this, telling a Party gathering last week that containment strategies should be conducted at “a minimal cost” using more targeted measures that soften the economic impact of any disruption.
In a similar vein, the National Health Commission pragmatically revised its guidelines for China’s nucleic acid testing process on Tuesday. Local governments will no longer be required to conduct citywide testing but can instead narrow the monitoring to mass-test specific districts, for instance.
Hints like these seem to highlight that Beijing is looking for ways to ease its ‘zero-Covid’ stance. They also raise questions about how Hong Kong’s ongoing experience might help policymakers to formulate a new approach.
Jaime Sze, a businessman based in Hong Kong and a political advisor of Beijing, has gone so far as to advocate that Hong Kong serve as “a laboratory” for China to experiment with ‘living with Covid’.
Yet China’s central government will still be wary of a wider loosening of its Covid policy, the Financial Times cautions, because of fears of “Hong Kong’s failures but on a huge scale”. Most of the deaths in Hong Kong have come from unvaccinated people aged 60 or older. Data from the National Health Commission suggests there are 50 million people in the same age bracket in mainland China and that 20% of them are not fully vaccinated. Should Omicron be allowed to spread through communities unchecked – mirroring what’s happened in Hong Kong this month, when transmissions have breached the point at which containment is still a viable strategy – very large numbers of deaths among the unvaccinated elderly are likely.
In the meantime, government officials in China risk further career scrutiny for how they respond to new cases of the virus in their home jurisdictions. At least 74 civil servants have been sacked or reprimanded for failures to respond to recent outbreaks, the South China Morning Post reported this week, including the mayor of Jilin, the capital city of Jilin province.
In comparison, no one in Hong Kong has yet to bear any responsibility for the handling of the Covid crisis, the economic fallout and the exodus of 100,000 or more of the city’s residents overseas (some perhaps never to return).
Perhaps the elections for the next chief executive – delayed until early May – will offer insights on how Beijing is going to evaluate that situation and whether any of Hong Kong’s senior officials end up being given more of the blame…
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