HKCT Review 2020: Coronavirus outbreak

HKCT Review 2020: Coronavirus outbreak (w/ David Hui's remarks)

Do you still remember the scenes where elderly queuing outside pharmacies in cold mornings just to get masks? 22 January marked the first case in Hong Kong - a 39yo infected male entered Hong Kong from Wuhan (https://www.info.gov.hk/gia/general/202001/22/P2020012200982.htm). Hong Kong has since entered an era of fear and lack of confidence after people in different camps have lost trust in the government. 

David Hui, a CUHK microbiologist and government adviser, said Hong Kong did very well in the first and second wave, as people were worried and drastically reduced dining out. The government and companies allow work from home, but things turned sour since the third wave when aircrew and sailors were not tested at all. As at 31 Dec, 144 people succumbed to the decade's public health archenemy. Most lives taken were the elderly.

FIRST WAVE

On 26 January, 3 days after the first case of coronavirus infection was recorded in Hong Kong, the government decided to turn Fai Ming Estate in Fan Ling into a quarantine facility without consulting the neighbourhood. CE Carrie Lam pledged on 28 January "not to use public rental housing flats to take up residents in the coming year as a quarantine facility" but on 8 February she backpedalled. So neighbouring residents blocked the entrance to the estate, preventing government vehicles from entering, and Molotov cocktails were thrown to the estate concourse. A dozen citizens in neighbouring residential estates were later arrested (https://www.facebook.com/hkcolumn/posts/2559881620895888), and the government's arrangement was withdrawn eventually - Chun Yeung Estate in Fo Tan was used instead. On the following 2 days, 3 bombs were discovered in various locations, which was believed to be a warning demanding the government to shut down Hong Kong's borders to contain the epidemic (https://www.facebook.com/hkcolumn/posts/2561273080756742). Suspected explosives were discovered again on 2 February on a train arriving at Lo Wu Station (https://www.facebook.com/hkcolumn/posts/2565378910346159). Nobody was injured in any of the suspected bombings. On 7 March, 17 people were arrested, among them 6 were charged, among others, with conspiring to cause an explosion of a nature likely to endanger life or to cause serious injury to property. It was learnt that police had refused to let the defendants meet their lawyers, and forced them to provide their mobile phones' passwords and buildings' access codes, and 2 of the defendants had suffered such injuries during their arrest that they could not attend the hearing (https://www.facebook.com/hkcolumn/posts/2596633890553994).

On 1 February, a similar protest broke out in Mei Foo against the government's plan to use the Heritage Lodge in Jao Tsung-I Academy as a quarantine centre, which was dispersed and then continued on following days with residents calling for a general strike and border shutdown. A number of arrests were made on those days (https://www.facebook.com/hkcolumn/posts/2565400593677324). Also on 1 February, the Hospital Authority Employees Alliance (HAEA) passed a motion with a landslide majority to stage a strike against the government's handling of the coronavirus epidemic, marking probably the first strike ever by medics in Hong Kong. More than 9,000 employees pledged to participate in a 5-day strike plan which started on 3 February (https://www.facebook.com/hkcolumn/posts/2564548970429153). The HAEA also demanded CE Carrie Lam's presence in negotiations as well as a full border shutdown.

The government then announced the closure of some border crossings with mainland China, leaving 3 border control points open, stressing that mainland tourists would not be banned from entering Hong Kong and the enhanced measures were not related to the HAEA's strike plan (https://www.facebook.com/hkcolumn/posts/2566045026946214). Over 7,000 hospital workers took part in the strike, which was close to 10% of all HA staff (https://www.facebook.com/hkcolumn/posts/2566848136865903). On 5 February, with medics exerting pressure, CE Carrie Lam announced 14-day mandatory quarantine for anyone arriving in Hong Kong from China (https://www.facebook.com/hkcolumn/posts/2567645330119517). The strike ended on its 5th day on 7 February, as the majority of the workers voted to end the strike and resume working (https://www.facebook.com/hkcolumn/posts/2569249709959079). Throughout the 5-day strike, the government had never taken part in any negotiations despite repeated meeting requests by the HAEA. Worse still, hospital workers who had gone on strike later received letters from the HA on 26 February warning them of a possible salary cut for the period of the strike, which was referred to as "absence from duty"/AWOL (https://www.facebook.com/hkcolumn/posts/2587512371466146). The HA also requested lists of absent medics at public hospitals allegedly for statistical purposes, although it claimed those who had joined the strike would not be terminated (https://www.facebook.com/hkcolumn/posts/2585672738316776). [At last, Hospital Authority decides to deduct the paid salary of "AWOL staff" from 3-7 February. (https://www.facebook.com/hkcolumn/posts/2816942718523109)]

During the HAEA's strike, isolated protests broke out on 4 February at multiple locations, including Tseung Kwan O, Sha Tin and Tin Shui Wai, demanding the government to close all borders. Police deployed large amounts of tear gas, rubber bullets and pepper spray, and arrested several protesters (https://www.facebook.com/hkcolumn/posts/2566950246855692). Then, on 9 February, hundreds of residents protested against the government's plans to turn existing facilities into quarantine centres in Sai Kung, Tai Po and Fo Tan respectively (https://www.facebook.com/hkcolumn/posts/2571028919781158). In Sai Kung, a large group of riot police was deployed and subdued the protesters violently (https://www.facebook.com/hkcolumn/posts/2570763183141065). A similar protest with clashes with the police took place in Wong Tai Sin on 12 February, as protesters demonstrated against a government plan to designate a public clinic in the district for possible COVID-19 patients and later blocked a road. Police arrested a few protesters and a district councillor, and barred reporters from filming their action (https://www.facebook.com/hkcolumn/posts/2573546579529392). More of such protests with hundreds of demonstrators sprung up in various districts, including Tin Shui Wai, Tai Po, Aberdeen, and Kennedy Town on 15 February as the government planned to set up multiple designated clinics to deal with COVID-19 patients. Fuelled by resentment against police resulting from months of political events, the demonstrators clashed with the police, but were subdued by riot police using pepper spray and dozens were brought away (https://www.facebook.com/hkcolumn/posts/2575819085968808).

Diamond Princess, a cruise ship parked in Japan, was found seriously plagued as many passengers were infected. With the help of the Chinese embassy in Japan, Hong Kong government arranged about 208 passengers back in 3 batches by chartered flights in late February (https://www.info.gov.hk/gia/general/202002/23/P2020022300055.htm). Those who decide to return were quarantined in Chun Yeung Estate for 2 weeks, and those who decide to treat in Japan were in hospitals there.

Since the first case in the city was identified on 23 January, the first wave of coronavirus outbreak lasted until mid-March with 149 counts of cases. 

SECOND WAVE

On 16 March, Hong Kong began to see what Dr Chuang Shuk-kwan described on that day's press conference as the second wave of coronavirus outbreak, as almost all the newly recorded cases were people who are believed to have been infected while they were outside the city. During that time, a lot of students returned from overseas amid the outbreak in Europe, the UK and the US. Hong Kong saw 26 consecutive days with double-digit confirmed cases, among which 103 cases were associated with the bar cluster.

In April, daily confirmed cases went down to single-digit and eventually zero. More and more activities resumed to normal. On 1 May, Dr Chuang Shuk-kwan described the situation as "slightly under control, but the risk is still there". In June, many social distancing measures were relaxed, including the gathering ban. Restaurants immediately received more bookings for Father's Day. It was also during the same period (8 June) when the government decided to grant quarantine exemption to sailors; as of 24 Jul, at least 10,000 sailors had entered Hong Kong without quarantine.

In May and September, the government arranged to distribute CuMask+ by postmen and at post offices (https://www.info.gov.hk/gia/general/202009/11/P2020091100764.htm). There were also rounds of wage subsidies under Employment Support Scheme disbursed (https://www.info.gov.hk/gia/general/202006/12/P2020061200902.htm).

THIRD WAVE

In mid-July, Hong Kong began to see a sharp increase in daily confirmed cases. On hindsight, government advisers believed sailors and pilots exempted from quarantine orders were the cause of the third wave in Hong Kong. The number of confirmed cases exceeded 100 for 12 consecutive cases with various clusters in the city. 12 elderly homes were affected unfortunately, with a total of over 200 staff members and residents infected. With 77 associated cases in a single location, Kwai Tsing Container Terminals was the largest cluster during the third wave. Over 4,000 infections and 100 deaths were recorded during the third wave. Tsz Wan Shan became one of the most impacted areas in Hong Kong. Some other clusters, such as "Celebrating handover" banquet in Mong Kok, were to blame too.

On 1 September, the Universal Community Testing Programme (UCTP) was launched to provide free tests to all Hong Kong citizens for 2 weeks (https://www.info.gov.hk/gia/general/202008/28/P2020082800837.htm). Prior to the launch, Mainland nucleic acid test support teams arrived in August to assist in the preparatory work to ramp up testing capability; there were widely supported by the pro-Beijing camp but the responses of pro-democracy councillors were lukewarm. There were rumours claiming the Government will transport the DNA data of the public to the Mainland during virus testing, which the government described as "absolutely unfounded" (https://www.facebook.com/hkcolumn/posts/2714332915450757). Carrie Lam stressed that she doesn't want to see any negative stance on the UCTP ahead of the implementation (https://www.facebook.com/hkcolumn/photos/a.1489251731292221/2733716920179023/). The UCTP, which cost $530 million to carry out tests for over 1.78 million participants, found 32 positive patients and has a 0.002% positive test rate. However, the positive rates of mild symptoms patients at GOPCs and private GPs are 0.5% and 0.8%, which are higher than 0.002% a lot. HKU microbiologist Yuen Kwok-yung once commented, "the focus and direction were wrong, and the key should be virus tests for people with mild symptoms" (https://www.facebook.com/hkcolumn/posts/2774258196124895).

On 15 September, Hong Kong recorded the first zero confirmed daily case since the third wave started in July, and the social distancing measures were relaxed subsequently (https://www.facebook.com/hkcolumn/photos/a.1446445815572813/2752074215009960).

David Hui and Yuen Kwok-yung said the taxi driver infected on 5 July may have carried people exempted from quarantine, who brought the virus to the community. HKU and PolyU research team found out in genetic sequencing that the virus strain in the patients in this wave is similar to that in Kazakhstan and the Philippines. However, the government insists that exempted persons are not the loophole in the battle against COVID-19.

David Hui said in early June, Transport and Housing Bureau and Commercial and Economic Development Bureau decided to let sailors in without quarantine - this was totally off the table from the expert committee. Those sailors may be here for 2-3 days, but exactly they can spread the virus into the community in these 2-3 days.

This wave also marked the highest single-day case growth record - 149 cases on 30 July.

FOURTH WAVE

In October and November, the number of daily confirmed cases seemed to be under control, but the local transmission chains were never completely cut off. Clusters associated with bars and staycation clusters were identified. 

On 11 November, the government announced the establishment of a travel bubble between Hong Kong and Singapore, which would be operated on a dedicated flight basis and will depart on 22 November. After observing a series of preventive measures, passengers from both sides would be exempted from the quarantine arrangement upon arrival, and their travel purpose and itinerary would not be restricted. However, in view of the growth of confirmed cases in Hong Kong, the arrangement was put on hold before it commenced (https://www.facebook.com/hkcolumn/posts/2812087335675314). As we write at the end of this year, the measure remains on the backburner.

In late November, a dance club cluster was the epicentre of the outbreak. On 20 November, 9 cases were related to Starlight Dance Club in Wan Chai. Eventually, over 720 cases were linked to this cluster. Other big clusters included construction sites of LOHAS Park/Kai Tak and Fong Shu Chuen Day Activity Centre/homes for the disabled. Some housing estates were found to have clusters of cases with unknown sources, causing fears that the coronavirus may have been transmitted via the building's waste pipes. Residents living in particular blocks of Kwai Shing West Estate, Richland Gardens, Shek Lei (II) Estate, Choi Wan Estate, etc. are required to go through mandatory testing and follow stay home orders.

David Hui said the source should be in mid-September, where some Nepali with HKID card were visited by others during quarantine when they are not supposed to. Visitors brought the virus to the community after infection. The virus made their way into China Secret and other bars. When there is a dance club cluster, the virus has permeated into different housing estates, Hui said.

In achieving zero infections, Hui also supported real-name phone registration, which is imposed in China, to track people's whereabouts. Harsher measures are required, such as lockdowns or curfews, but that must lead to many criticisms, such as affecting businesses. In the future, Hui hopes more people to vaccinate. When over 70% people are vaccinated, there will be herd immunity. He expects at least by the end of 2021 or the start of 2022 that there will be enough people with antibody. Therefore in 2021, wearing a mask is still needed, said Hui.