11th December 2022 – (Hong Kong) Clinical Assistant Professor, Department of Microbiology of HKU Medical School, Dr. Siddharth Sridhar shared on his Facebook page yesterday an article titled “The beginning of the end” with regards to the relaxation of anti-epidemic measures in Hong Kong based on scientific approach and common sense.

The following is the excerpt of his post:

The big news this week is Mainland China clearly signalling a pivot away from Zero Covid. In a bid to prepare the public for imminent large outbreaks, prominent mainland experts and commentators including Zhong Nanshan have stated that the majority of Omicron infections are mild. The National Health Commission has emphasised elderly vaccinations and bolstered intensive care facilities to face the upcoming wave. So, what does all this mean for us in Hong Kong, where Covid policy is inextricably tied to developments in the mainland?HK has long passed the stage the mainland currently finds itself in. We are currently going through our third major Omicron wave of 2022. Nearly every person in HK has been either infected, vaccinated or both, boding well for our immunity wall against severe disease. Although each wave has placed pressure on healthcare, the last few months have been far calmer than the public health disaster of the first quarter. It is clear that the link between caseloads and severe disease has been weakened. The recently issued HA guidance on ‘versatile isolation mode’ and updated discharge criteria will further decrease pressure on hospitals as I discussed in August. This means that we have to carefully evaluate our current epidemic prevention measures in the light of science and common sense.

Some examples of measures that should be reconsidered are listed below: 1) LeaveHomeSafe: It is fair to say that the LeaveHomeSafe app no longer fulfils its original intended purpose of assisting contact tracing or outbreak investigation. If the mainland can stop scanning requirements in many venues, then why can’t HK with its much more stable epidemic situation? 2) Vaccine pass: Many premises are no longer required to scan customer’s vaccine pass, but are still listed as requiring ‘passive checking of vaccine pass’, which basically means that it is not checked. Since such a rule is effectively unenforceable and does not contribute to Covid control, the passive checking category should be done away with. Vaccine pass has been in place since February and it is questionable whether it is actually contributing to current vaccination rates. The only other justification for vaccine pass is that it keeps unvaccinated elderly out of setting where they might contract Covid. However, as the current case wave subsides, a timeline to end vaccine pass is advisable. 3) Community testing notice (CTN): CTNs require large groups of people living in apartment complexes to undergo testing. CTNs are not only expensive, but also proven to be ineffective when community Covid transmission is widespread (3). CTNs should be stopped. 4) Daily RAT in schools: We have a duty to educate the next generation on sustainable solutions to societal problems. Performing RATs daily has generated an enormous amount of landfill waste. As the current wave subsides, the daily RAT requirement should be scrapped. 5) 0+3: Travellers with Covid actually do not significantly add to healthcare burden when there are more than 10,000 cases locally every day. Inbound travel to Hong Kong should be opened up fully.

I must also emphasise that the above Covid control measures come at a considerable operational cost. It is distressing to hear Paul Chan speaking about depleted fiscal reserves when high-cost, low-return measures like CTN are ongoing. Omicron in 2022 is by no means the worst challenge HK will face this century. Climate change, a rapidly aging population, geopolitical tensions, new pandemics are all on the 21st century menu. Let us act as careful custodians of public wealth to help the next generation meet these struggles.