How Hong Kong squashed its second coronavirus wave

On Monday, Hong Kong reported zero new cases of COVID-19, a milestone that seemed to signal that the Special Administrative Region had contained a “second wave” of coronavirus infections set off by overseas residents returning home. It was the first day in six weeks that Hong Kong, which has 1,026 coronavirus cases total, had no new patients to report.

“Given that the situation of COVID-19 infection remains severe and that there is a continuous increase in the number of cases reported around the world, members of the public are strongly urged to avoid all nonessential travel outside Hong Kong,” the Center for Health Protection (CHP) said in a statement, canceling its daily press briefing, as there was nothing new to report.

Despite the positive news, the CHP urged members of the public to remain diligent about hygiene and social distancing, since another wave could ever be on the horizon.

Swell

Hong Kong has remained a bright spot in effective disease control throughout the COVID-19 pandemic, which has infected nearly 2.5 million people worldwide and claimed over 170,000 lives. Gabriel Leung, the dean of medicine at Hong Kong University, has called the city the “gold standard of infection control.”

In an interview with Fortune in March, Leung attributed Hong Kong’s success to early screening measures at ports, a robust health care system with sufficient isolation wards, extended school closures, and a society-wide adoption of face masks.

All combined, the measures helped keep Hong Kong’s total number of COVID-19 cases to around 120 until March. However, as the severity of the pandemic grew globally, many overseas residents decided to return to Hong Kong, bringing with them a second wave of infections.

By late March, the number of local cases had more than tripled to 411, forcing the Hong Kong government to adopt more stringent measures.

Breakers

Already in March, arrivals from foreign countries were required to wear tracking bracelets and undergo two weeks’ quarantine upon arrival. As case numbers continued to climb, Hong Kong barred entry to all nonresidents—except those from Macau, Taiwan, and mainland China—and required all remaining arrivals to submit to mandatory testing for COVID-19.

Within Hong Kong, restrictions on movement also increased. During the last week of March, the government ordered all cinemas, theaters, arcades, and other entertainment venues to close.

In the following weeks, bars, karaoke clubs, gyms, spas, and virtually all other service providers were shut down. Restaurants remain open but are restricted to operating at half capacity with tables spaced 1.5 meters apart.

Police wielding measuring tapes have brought charges against dozens of rule-breaking eateries while 130 members of the public have been fined for breaking a rule that prohibits gathering in groups of more than four people.

Quarantine breakers are facing stiff punishment too. On Monday, a man was sentenced to four weeks in prison for violating his mandatory two-week isolation period—the first such prosecution in Hong Kong.

Undertow

While the second wave appears to have subsided, the Hong Kong government has decided against easing the restrictions that helped mitigate the infection’s spread. On Tuesday, chief executive Carrie Lam announced that the social distancing rules—many of which were due to end Thursday—will be extended for another two weeks.

Chuang Shuk-kwan, head of communicable disease at the CHP, has said that there should be a 35-day period of no locally transmitted COVID-19 infections before the contagion could be considered under control. The latest locally transmitted case in Hong Kong occurred on Sunday.

“The [Hong Kong] government understands that citizens are upset about the halt in social activities. It is causing inconvenience to daily life, leisure, entertainment, and gatherings with friends. Please be tolerant,” Lam said, noting that Hong Kong has yet to implement a complete lockdown on the scale seen in the U.S., Europe, or much of China.

The extended semi-lockdown will be bad news for businesses, which were reeling from months of protests last year before the COVID-19 pandemic struck in January. In the first quarter of the year, the Hong Kong government released $37 billion worth of relief packages to local businesses and individuals, but the economic toll of the turmoil continues.

On Monday, Fitch Ratings downgraded Hong Kong’s credit from AA to AA-minus, anticipating a 5% fall in real GDP this year.

In that sense, Hong Kong faces the same conundrum as other jurisdictions, as the public health benefits of its standout coronavirus response come at a devastating economic cost.

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