As COVID-19 circled and recircled the globe throughout 2020 and 2021, one territory remained stubbornly impervious to its assaults. It was not a backwater rural nation protected by low population density. Nor was it a remote island like Fiji able to insulate itself from the outside world. Surprisingly, it was one of the most densely populated metropolises on earth and one that shares a border (and a central government) with the country where the virus originated. For nearly two years, Hong Kong served as one of the greatest COVID success stories, able to maintain a zero-COVID strategy long after many other countries had given it up and without resorting to measures as shocking and draconian as mainland China. By February, only 213 people had died of COVID in a city the size of New York City. That changed calamitously in the month that followed.
Once the Omicron variant breached Hong Kong’s public health defenses, COVID spread like lightning, overwhelming hospitals and killing 7,000 in March alone. Admittedly, this was less than half the death toll in New York City in April 2020, but given Omicron’s diminished severity and a whole year to build up vaccination immunity, it represented a shocking failure of policy. The point of Hong Kong’s strategy, after all, had been to keep the virus at bay long enough to vaccinate all vulnerable residents, but by the time the Omicron surge hit, only a quarter of residents over the age of 80 had received two vaccine doses. What went wrong?
