Hong Kong Success

2. Lessons from Hong Kong

You might have expected Hong Kong—densely populated, high median age, tons of international travel, right on the Chinese mainland with direct flights to Wuhan—to have gotten hit hard by the coronavirus. Nope. So far, only 4 deaths and 1,000 confirmed infections. This Medium piece looks at what Hong Kong did right: Hong Kong began shutting down public facilities when there were fewer than 10 confirmed cases. The government acted with urgency when cases began to appear. Hong Kong shut down all schools, parks, and public museums on January 29th, when there were only 9 confirmed cases and 0 deaths. The Hong Kong Marathon was canceled on February 8, when there were only 36 confirmed cases in Hong Kong. This stands in stark contrast with governments elsewhere who were quick to administer travel bans but slow to encourage, much less mandate, social distancing. Examples include President Trump suggesting the threat from COVID-19 was exaggerated and Bill DiBlasio recommending New Yorkers go out on the town in early March. Other examples include the mayor of Los Angeles allowing a 27,000-person LA marathon when there were hundreds of cases in California. Spain also held The International Women’s March in early March. Hong Kong isolates ALL positive cases and quarantines close contacts in government facilities. Every person who tests positive, even if symptom-free, is put into the public hospital system. Patients are then required to remain at hospitals until they produce two consecutive negative tests. Should hospitals run out of beds, the government will isolate patients in other facilities. Details about every case are made public through government websites. All known contacts of the positive cases must spend 14 days in government quarantine. A study of one China province showed that 80% of cluster infections originated from people who tested positive and were told to rest at home. Wuhan began quarantining all mild cases in makeshift hospitals converted from offices, stadiums, and gymnasiums in early February, a move that helped dramatically slow the spread of the virus. Doctor Aaron E. Carroll wrote in the New York Times that a robust system of contact tracing and isolation is necessary to prevent further outbreak and lockdown. Hong Kong’s population has broad virus awareness, largely a result of SARS. The memories and lessons of SARS linger in Hong Kong. Since well before COVID-19, masks have been commonly used by individuals who harbor a common cold. Buttons on elevators are frequently sterilized once if not more times each day. It is customary not to wear shoes within the home and gel sanitizer is widely available throughout shared facilities such as office buildings. The population quickly tapped into virus-prevention mode as soon as the news of the virus circulated from Mainland China. Not wearing a mask is shunned in Hong Kong, and the population takes pride in responsible, virus-preventative everyday behavior. According to a poll by SCMP, the majority of Hong Kong residents believe they have only themselves to thank rather than the government if the city wins its battle against COVID-19. Hong Kong tests all people entering the country and requires them to home quarantine for 14 days. Hong Kong only recently implemented severe travel bans, denying entry to non-residents on March 25. There was, however, a 14-day required home quarantine for people arriving from Mainland China, which was then expanded to arrivals from nearly anywhere in the world. While a delay in requiring home quarantine for European and American visitors led to a second wave of cases, that surge has already begun to flatten. People in home-quarantine wear electronic bracelets that track location. While there were initial glitches with the technology, the spirit of the law is broadly respected and violations are enforced. Three people have already been sentenced to jail time for breaking the quarantine. You will note here that officials in Hong Kong did not insist that the virus was not a threat. Or that only a handful of people had been infected. Or that the liked the numbers. Or that the number of infections was headed to zero. Or that the virus would go away "like a miracle." They took it seriously from the very start, they acted quickly, and as a result they managed the outbreak with minimal loss of life and economic destruction. Just your daily reminder that our experience of the pandemic in America was neither impossible to predict nor impossible to stop. What it is, is the largest executive failure in our nation's history.

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