How Hong Kong controlled the coronavirus without a lockdown
Alok Gupta

Hong Kong Special Administrative Region (HKSAR) efforts to manage the novel coronavirus pandemic without enforcing any lockdown could act as a model for countries struggling to flatten the epidemic curve.

One of the most densely populated cities of the world, with 7.5 million people, recorded 715 confirmed COVID-19 cases and only four deaths as of March 31. Such a low death rate despite being a prominent tourist and business hub has become a success story in controlling the virus, saving its hospitals from getting overwhelmed with an influx of COVID-19 patients.

The authorities implemented a combination of border entry restrictions, quarantine and isolation of cases and contacts, together with some degree of social distancing, helping in keeping the death and hospitalization rate low in HKSAR, according to a study published in The Lancet Public Health.

These measures, if replicated simultaneously, could also assist resourceful countries struggling to control the novel coronavirus transmission.

"By quickly implementing public health measures, Hong Kong has demonstrated that COVID-19 transmission can be effectively contained without resorting to the highly disruptive complete lockdown adopted by China [Chinese mainland], the USA, and Western European countries," said Benjamin Cowling from the University of Hong Kong.

"Other governments can learn from the success of Hong Kong. If these measures and population responses can be sustained, while avoiding fatigue among the general population, they could substantially lessen the impact of a local COVID-19 epidemic."

While the HKSAR government started screening of people crossing the border, they also launched surveillance within the city. Nearly 400 outpatients and 600 inpatients were tested every day in early March.

Close contacts of infected persons were tracked down, and quarantine centers were identified to ensure self-isolation of suspected cases.  Visitors coming from infected countries were required to undergo a compulsory 14 days of quarantine and wear a tracking band.

Unlike other coronavirus affected countries where people flouted social distancing norms, Hong Kongers adhered firmly to the government advisories.

A survey by the researchers found that 85 percent of respondents avoided crowded places. Nearly 99 percent used face masks when leaving home—up from 75 percent and 61 percent, respectively, from the first survey in January.

During the Severe Acute Respiratory Syndrome (SARS) epidemic in 2003, face mask use was 79 percent. "These changes in behavior indicate the level of concern among the population about COVID-19," researchers said.

Dr. Peng Wu, a co-author of the study, pointed out that as one of the most heavily affected epicenters during the SARS epidemic in 2003, Hong Kong is better equipped to contend with an outbreak of COVID-19 than many other countries.

"Improved testing and hospital capacity to handle novel respiratory pathogens, and a population acutely aware of the need to improve personal hygiene and maintain physical distancing, put them in good stead," she said.

(Cover: People wearing face masks to help protect themselves from contracting the coronavirus COVID-19 as they cross a street in Hong Kong, April 18, 2020. /AP)