Now is time to consider easing pandemic quarantine measures

I am cautiously optimistic about the mood music now emanating from John Lee Ka-chiu and the new chief executive’s office for the Hong Kong Special Administrative Region concerning the city’s way forward with COVID-19. The music is not yet sweet but it is more upbeat, reflecting I think a new pragmatism and realism while remaining true to the nation’s overall strategy. 

It’s clear we need to scientifically pursue new ways to overcome this pandemic, and we do not necessarily need to carry on as we have been doing unless we are prepared to accept the tremendous ongoing, untold damage the current policies will continue to have on our international reputation, opportunities, livelihoods, overall wealth and very future. Hence, it’s so encouraging to hear positive moves may be in the pipeline to reduce hotel quarantines further and to explore opening up Hong Kong more to the rest of the world, especially to the Chinese mainland, perhaps as early as August. Clearly this is a reassuring manifestation of “one country, two systems” at work where our unique situation and local conditions may allow some minor but dynamic divergence from an overall zero-COVID paradigm.

It has always, it seems to me, been a numbers game, but perhaps now not in the inflexible way most people have been imagining from the beginning.

The number of infections, the number of imported cases, the number of airline companies banned — already more this month than the whole of June — the high numbers of expats leaving — these are all numbers that we have been bombarded with by the media daily until we are numb by their repetition. We are obsessed with them. They come across as unremittingly negative and tell of a mindset caught up in COVID-19 infection numbers as if this is the be-all and end-all of our entire response.

Less attention is paid, it seems, to the really key numbers — the numbers of those who have died and the numbers of the seriously ill in hospitals. These now tell an interesting story and must surely drive policy everywhere. For example, if COVID-19 evolves to a totally benign form, then a zero-COVID approach becomes manifestly redundant, even burdensome. We are not there yet, of course, but in the end, we may end up with an endemic COVID-19 world in which the virus is on a par with the flu and the common cold in their lethality and cannot be fully cured yet remain an everyday nuisance. It’s always mutating, may still be fatal (especially like the flu), but is manageable, treatable and for the great majority of us just another flulike infection we may all get from time to time but recover from it with commonplace medications, including Chinese home remedies and simple rest. We may not even read much about it in the media before long.

Right from the start, I have been an avid follower of the Worldometer website that provides daily updates from the best available sources on each country’s COVID-19 history, daily cases, total cases, recovered, total deaths, daily deaths, deaths per million, etc, etc. A veritable gold mine of global statistical data. About three weeks ago, I did a snapshot of the HKSAR for a week — about 6,000 cases and three deaths. I did another snapshot for the period June 28 to July 3 — 12,420 reported cases and six deaths, or about 0.05 percent of reported infections. It’s clear many cases are totally asymptomatic and many do not report their positive tests. So this mortality percentage is actually likely a lot lower. This compares with death rates in the approximately 1 percent level at the very start of the pandemic.

For comparison, the total number of age-adjusted death rates in the USA for influenza and pneumonia were about 15 per 100,000 or about 0.015 percent, about a third that for COVID-19 in Hong Kong now!

So, what has changed? Well, several things — the wide availability of a series of effective vaccines, the evolution of the virus to not only be more transmissible but also less deadly, it seems and also the emergence of herd or near-herd immunity in many countries. This is combined effectively together with very high levels of vaccinations and multiple booster shots. This has now, happily, reached our most elderly and vulnerable in society. At one stage, there were more than 3 million global cases per day in the massive omicron wave in January 2022 with an accompanying 12,000 or so daily deaths (about a 0.3 percent mortality). This is from examining the cumulative global charts for COVID-19. There is now a significant uptick once more in the daily cases globally — and this is also seen in Hong Kong, but interestingly this is not reflected in the death tally, which is now lower than it has been since the very start of the pandemic way back in February 2020, which now seems like a lifetime ago. This reflects both the high levels of immunization and immunity but also sadly the reality that of the 6.3 million recorded COVID-19 deaths globally (likely a significant underestimate given the patchy and unreliable reporting from many countries), so many have been among our already very ill and elderly. Hence, some of that vulnerable, unvaccinated cohort has passed on. Even among the current victims of COVID-19 within the HKSAR, I read recently that 70 percent (of what is now a very low death rate) still arises from among the unvaccinated. Clearly, vaccination of essentially everyone remains the key protector of public health.

So where to now? At what point does pragmatism and realism concerning not the numbers of infections but the numbers who are actually ill begin to matter more and drive some modest policy rethink? I think we are already at this point. It does not mean we throw out the zero-COVID imperative, but it can be more aspirational than something ever likely to be achieved in practice. We must remain vigilant and continue to enforce various policies on social distancing and strong vaccination and booster programs in place, etc, and also monitor very carefully for the emergence of new strains that may again require very robust action. However, the numbers game has fundamentally changed. Our policies would be more effective and beneficial if they reflected this actual dynamic truth. COVID-19 is here to stay — it is increasingly endemic, continuously evolving and insidious. We will be living with boosters and new tweaked vaccines indefinitely, so we need to get back to as much normality as we can for the sake of our overall physical and mental well-being, to overcome the disruptive education of a whole generation of children, and to restore our people’s confidence, social vitality and the economic prosperity of our brilliant city.

I am currently in Europe, my first trip overseas in more than two years, and it is disturbing to be walking around the streets of Paris, Strasbourg and Manchester with 95-plus percent of people not wearing masks. I am conditioned to wear one now and feel odd and almost naked without one. But it is clear the rest of the world has moved on. China and by extension the HKSAR are global outliers, but their approach has overall been a tremendous success if counted in terms of relative numbers of hospitalizations and deaths. This has provided much-needed breathing space to develop vaccines and push the vaccination program. In Europe and most of the world, there is more openness and fluidity to travel, and the lack of overt restrictions to movement and interaction across this world affords significant advantages to all our competitors, and we need to take note and respond where we can.

So, do we allow Hong Kong to wither on the vines of unharvested potential and opportunity, or do we move forward like the rest of the world in our own way? I believe we can now afford to cautiously, prudently and carefully reduce quarantine impositions, and relax flight restrictions, negotiate the lifting of restrictions on cross-border travel between Hong Kong and the mainland, and at least try to enact pragmatic zero-COVID policies that reflect the reality of the more-positive new numbers before us.

The author is a professor in the Faculty of Science at the University of Hong Kong and the director of its Laboratory for Space Research.

The views do not necessarily reflect those of China Daily.