Zero Covid now equals more Covid later.
The clearest proof yet of the failure of lockdowns and Zero Covid as a long-term strategy against the coronavirus is now unfolding in Hong Kong. The territory is suffering the worst coronavirus epidemic anywhere since New York City in April 2020. For two weeks straight Hong Kong has had the equivalent of 10,000 American deaths a day.
The breakdown comes after almost two years when Hong Kong tried everything possible to keep Covid out, including aggressive contact tracing, border controls, and rules on gatherings. It damaged its economy, made residents miserable, and drove away expatriates.
And it succeeded. As of late 2021, Sars-Cov-2 had infected barely 1 out of every 1,000 Hong Kong residents, a peer-reviewed study revealed.
Now Sars-Cov-2 is catching up, all at once - even though Hong Kong is highly vaccinated. Since the beginning of March, the city, which has 7.4 million residents, has had over 3,500 Covid deaths. That figure would translate into over 150,000 Covid deaths in the United States - in two weeks.
When Zero Covid goes bad:
The crisis in Hong Kong carries serious implications for China, which after two years of chasing zero Covid is seeing the start of an outbreak that it may not be able to control no matter how hard it locks down.
The spiraling death toll also proves - again - the limits of vaccines against Covid. More than 80 percent of adults in Hong Kong have received either mRNA or Chinese vaccines, though the city’s eldest residents are bizarrely enough the least likely to be vaccinated.
The crisis is unlikely to ease soon. After falling last week, new infections rose again Monday, to 26,000 - the equivalent of more than 1 million in the United States. Authorities predict thousands more deaths through April.
The death toll is especially stunning because the cases are essentially all Omicron, which is milder that earlier variants. Also, Hong Kong has almost no obesity, which trails only age as a risk factor for Covid. About 3 percent of adults in Hong Kong are obese, compared to 40 percent of Americans.
Further, physicians have the benefit of two years of treating Covid cases. They are no longer killing patients by putting them on ventilators too aggressively, a mistake that significantly increased the death total in New York in 2020.
Western media outlets have written only sporadically about the crisis in Hong Kong, and when they have they have generally put the blame on the fact that elderly residents in the territory have much lower vaccination rates than younger adults.
Those stories are accurate.
The rates of vaccination in people over 80 in Hong Kong have been bizarrely low - only about 35 percent of have received two vaccine doses - and it is not clear why. Hong Kong is now an authoritarian state and under increasingly strict and direct Chinese control.
Along with its strict anti-Covid rules, the territory has reported arresting more than 10,000 people for anti-government protests and prosecuted at least 2,500 of them. So why Hong Kong’s public health authorities were unable or unwilling to vaccinate elderly people - who have successfully been the focus of vaccination everywhere else in the world - remains a mystery.
Now Hong Kong is struggling to vaccinate people 80 and over. But in the short run its efforts may only be making matters worse, because of the fact that the first Covid vaccine dose actually raises infection risk - an effect seen in Britain and elsewhere more than a year ago. Meanwhile, with so many people being infected so quickly, a relatively high number of vaccinated people are also dying.
Meanwhile, across the border in China, Covid infections are accelerating.
The sudden surge may be both a medical and political problem for the People’s Republic.
Medical because China’s hospitals are less advanced than Hong Kong’s and may have even more trouble coping with an Omicron wave in a population that has no natural immunity to slow the spread. And political because China has leaned hard on its success against Covid as yet more evidence that freedom is overrated and Xi is the best Supreme Leader in the history of Supreme Leaders.
China has - inevitably - responded with another wave of lockdowns. But it may be about to learn that Zero Covid - like the fentanyl its factories export to the United States - is easy to start and hard to quit.
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