What Will the Future for Hong Kong in COVID-19 Look Like?

Much has arisen in the debate of when Hong Kong may transition from becoming one of the world’s remaining zero-COVID countries in the world, to an acceptance of cases and deaths.

One voice educating the public and authorities on a transition to a “new normal” for a Hong Kong recovering from sky-high infections and world-high deaths is Gabriel Leung, Dean of the Faculty of Medicine at the University of Hong Kong.

On March 22, Leung, among a team of epidemiological experts, conducted a press conference to inform the public about the current pandemic situation and a probable future for the Hong Kong government under a new face with COVID-19 in its borders.

In a slide presentation, Leung outlined the two viable options for “forward planning.” Option one sets out a plan of maintaining Hong Kong’s “dynamic zero-COVID" plan to clear out infections, whilst option two plans for a transition towards endemicity in the city.

Option One – Maintain “Dynamic Zero-COVID"

• Plan for the Community Universal Testing (CUT) when the daily number of infections reach below 1,000
• Build public capacity to quarantine five to 10 close contacts and 25 to 100 close contacts of contacts
• “Long shedders” and their contacts given that about 4.4 million people have been infected

• Challenge to reach and sustain zero cases with repeated CUTs and increased arrivals in the city

Option Two – Transition Towards Endemicity

• Introduce public health and social measures to be introduced dynamically to counter rising case numbers
• Account for surge capacity of public hospitals
• Manage tolerance levels for the public of “major morbidity and deaths”

• CUTs, community testing notices, and restriction-testing declarations could be cut, with major resources reallocated

Leung commented in the press conference that option two – a return to a “new normal” – is the necessary ultimate step, “if option one is selected as the immediate step.”

He suggested that the “safest” strategy, with considerations of scientific reasons and public health, is “a controlled transition towards endemicity sooner rather than later,” under the basis that COVID-19 will circulate worldwide for the near future.

With hybrid immunity in the public from natural infection or recovery, and passive immunity through vaccination, a majority of the Hong Kong public can be seen to have the “best protection against (re-)infection by a new strain, hospitalisation, and death.

Sixty percent of the Hong Kong population have already been estimated to be immune to Omicron. For the remaining 40%, Leung suggests it “would probably be safer to be exposed to an Omicron infection than an unknown emerging variant of concern that might be more transmissible, more severe, and more immune escape.”

It remains to be seen what measures health authorities and the government will take in the near future to counter an inevitable rise in cases. However, the compelling voice of one of Hong Kong’s leading medical experts may raise logic in the debate.