Coronavirus: The Hong Kong Experience

Covid mortality: Hong Kong vs. United States (IanMSC)

Published: March 15, 2022 (upd.)
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Why Hong Kong has turned from zero covid eldorado into covid death trap.

The Chinese city state of Hong Kong had long been known as a zero covid eldorado. Yet in recent days, the city state of 8 million has reported the highest covid death rate of any country in the world since the beginning of the coronavirus pandemic (excluding micro states). What went wrong?

First, Hong Kong and several other former zero covid bastions were overwhelmed by the highly infectious omicron subvariant BA.2, which, however, has a similar virulence as omicron itself.

Second, Hong Kong has the highest weighted population density in the world, which may boost the amplitude of any covid wave: the weighted median population density is about 70,000, compared to 22,000 in Singapore, 5,000 in Great Britain, 1,300 in Sweden and 400 in Norway.

But third, and most importantly, Hong Kong is one of the few places in the world where vaccination rates in senior citizens are lower than in younger citizens. In fact, prior to the current outbreak, the vaccination rate was about 90% in 50-year-olds, but only about 50% in people aged 70 to 79 and only about 30% in people older than 80 (see charts below) – perhaps due to a lack of trust or interest.

Finally, about half of the vaccine doses administered in Hong Kong were Chinese Sinovac, which is known to have a somewhat lower peak effectiveness compared to Western mRNA vaccines. The fact that Hong Kong has been running a vaccination campaign in parallel to the omicron wave may have exacerbated the situation even further (due to temporary post-vaccination immune suppression).

Thus, within just a few weeks omicron has infected about 75,000 mostly unvaccinated elderly people living in care homes and residential facilities in Hong Kong, with up to 600 care homes experiencing simultaneous outbreaks. 70% of covid deaths were over 80 years old and 90% of deaths were not yet double vaccinated. The total number of deaths is approaching 5,000 or 0.05% of the population.

According to the University of Hong Kong, about 60% of covid deaths occurred in care homes.

A comparison with South Korea and New Zealand shows that these countries have experienced a very similar surge in coronavirus infections but, thanks to very high vaccination rates in senior citizens, a much lower increase in deaths (see charts below). This protection against severe disease and death is a reality that should be acknowledged even by staunch covid vaccine skeptics.

Some analysts have argued that the case of Hong Kong shows that omicron is not in fact a “mild variant”. Yet several studies have already confirmed that omicron is indeed 70% to 90% milder than delta in terms of severe disease and death. Rather, the case of Hong Kong shows that in unprotected nursing home residents, even a generally “mild” virus infection may turn out to be fatal.

Total covid mortality in Hong Kong is still three to six times lower than in most Western countries, but it is quickly catching up. Thus, the case of Hong Kong once again highlights the crucial role of early border controls and the futility of masks and most other “covid measures”.

The covid collapse of Hong Kong doesn’t bode well for mainland China, the last country on Earth to follow a zero covid strategy. The southern Chinese city of Shenzhen (close to 20 million people and third-largest port in the world) has recently been put into total lockdown, while Shanghai (close to 25 million people and largest port in the world) “teeters on the brink of lockdown”.

To get a glimpse of China’s zero covid reality, see the Twitter video channel of Songpinganq.


1) Cases and deaths in Hong Kong and other Asian countries (FT)

Cases and deaths in Hong Kong and other Asian countries (FT)

2) Vaccination and death rates in Hong Kong

3) China: Low vaccination rate in senior citizens (FT)

China: Low vaccination rate in senior citizens (FT)

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