Quarantine exemptions blamed for surge in Hong Kong cases

A convoluted system of quarantine exemptions, including allowing executives of listed companies to freely enter Hong Kong, has been blamed for a third wave of coronavirus cases sweeping the Asian financial hub.

The surge in cases, which doctors said was the city’s worst outbreak since the beginning of the pandemic, has also been attributed to the relaxation of social distancing restrictions and low testing rates.

After initially winning praise for controlling the virus without a lockdown, the number of cases in Hong Kong has soared by about 40 per cent since July 5 to nearly 2,000 cases as of Tuesday.

The territory has until now avoided the worst effects of the virus through the swift adoption of face masks, working from home and border controls under which most non-resident foreign nationals are not allowed to enter the city.

But virologists said pressure from the business community to prevent the city’s economy from shutting down led the government to grant exceptions to quarantine for certain groups and the relaxation of social distancing measures. The result, the virologists said, was a new outbreak that is “out of control”.

Malik Peiris, a virologist with Hong Kong University who played a central role in discovering SARS, said: “There were a number of exemptions that definitely contributed to introductions [of the virus]”.

David Hui, a respiratory disease expert from the Chinese University of Hong Kong, told a radio programme that carriers who were exempted from quarantine, including cabin crew and sailors, were responsible for the city’s third wave, which began two weeks ago.

Many other governments have imposed stricter measures on travel and social distancing, including for pilots and sailors. 

“All those loopholes [in] our previous quarantine or border control [are] why there [are] imported cases in the community again,” said Arisina Ma, chairperson of the Hong Kong Public Doctors Association.

The government said that exemptions were essential to “maintain the necessary operation of society and the economy”. It insisted that there were no confirmed cases among exempt travellers arriving from the mainland, Macau and Taiwan.

Most travellers to Hong Kong have had to quarantine at home or in hotels for two weeks. But the exemptions first granted to flight crews, seamen and truck drivers have been expanded to include 33 different groups. Among them are executives of large listed companies who can apply for an exemption when travelling between the mainland and Hong Kong.

Prof Peiris said a decision by American and United Airlines to cancel flights to Hong Kong over the subsequent introduction of mandatory testing of arriving crew neatly illustrated the dilemma for local authorities.

“[For] places like Hong Kong which are travel hubs . . . and economic hubs, the challenge is really much greater,” Prof Peiris said.

Hong Kong’s government wanted to maintain the city’s position as the region’s financial hub while weathering its first recession since 2009 as well as anti-government demonstrations.

“It’s very difficult to find the right balance . . . you have to sacrifice GDP growth [to] get on top of the situation,” said Kevin Lai, an economist at Daiwa Capital Markets. He warned he expected the latest outbreak to lead to greater unemployment.

Despite the surge in cases, restaurants have been allowed to remain open for dine-in meals until 6pm, while businesses have only been encouraged, rather than ordered, to make staff work from home. Ms Ma said the guidelines were not nearly strict enough to contain the outbreak.

After weeks of just a handful a local cases, Yuen Kwok-yung, a senior microbiologist from Hong Kong University, told a radio programme that local residents had lost their “fear” of the epidemic, a crucial factor in the latest spike.

Prof Peiris agreed, saying that when Hong Kongers were on their guard, small outbreaks did not “burst into flames”.

There had also not been enough testing, Prof Yuen said. As of July 14, Hong Kong had conducted just 58,967 tests per 1m people. By contrast, as of July 13, Singapore had administered 177,100 tests per 1m people, according to the country’s health department.

The Hong Kong government has now employed Chinese mainland and local companies to conduct mass testing with the aim of administering 400,000 tests for higher-risk individuals. Beijing tested millions of residents in the capital after an outbreak in June.

But mass testing comes with a different set of problems. Prof Peiris said some Hong Kong residents with mild cases did not want to get tested as hospitalisation was almost mandatory if they were discovered to be carrying the virus.

“[Hong Kong] is a sobering warning for anyone trying to relax social distancing measures,” Prof Peiris said.