26th June 2021 – (Hong Kong) Most people around the world are dying to travel again and they are under the fallacy that if they are fully vaccinated now, they are sort of immune against COVID-19 and can prepare themselves to travel again in the near future.

If you are one of those who are disillusioned travellers-to-be, please read on. Data from Public Health England, the U.K. government’s health executive arm, have shown that single doses of the AstraZeneca and Pfizer vaccines have a reduced efficacy of 33% against infections with the Delta variant, compared with over 85% against the original strain in clinical trials. For those fully vaccinated, the AstraZeneca vaccine also saw a reduction in efficacy—from 67% against the Alpha variant to 60% against Delta—but not to as alarming a degree.  As Delta variant and other variants become the dominant strain across the globe, according to Eric Topol, American cardiologist, scientist, and author, there are 2 patterns emerging: Countries with low vaccination rates are seeing both case and fatality rates increase. Countries with high vaccination rate: some case increase and minimal to no fatality increase. Hence, there is no way that we will get out of this pandemic in the near term and travelling for leisure will still be impractical and risky.

Many European countries and tourism-dependent countries are desperate to resume their air travel by relaxing anti-epidemic measures without considering the severe repercussions. The U.K. has one of the highest COVID-19 vaccination rates in the world, yet it’s seeing a new surge in coronavirus cases largely attributed to the delta variant that first originated in India. Also, the Israeli health ministry has asked people to again wear masks in enclosed public places just 10 days after ending its mandatory indoor masking rule, amid a sustained surge in coronavirus infections attributed to the highly contagious Delta variant. The spike in new infections is a blow for a country that has vaccinated some 55 percent of its 9.3 million population with both doses.

In April this year, a fully vaccinated nurse at Tan Tock Seng Hospital in Singapore was one of the three community COVID-19 cases reported in the country. The Filipino woman had received her first dose of vaccine on 26th January and a second dose on 18th February. The new cluster outbreak impacted the air travel bubble between Hong Kong and Singapore which was already delayed for the second time.

Hong Kong government recently announced that persons arriving at Hong Kong who have only stayed in Group B specified places, Group C specified places or Taiwan on the day of arrival or the 14 days before that day will be subject to a shortened compulsory quarantine period of seven days at designated quarantine hotels if they fulfil the following three conditions. They have to undergo two nucleic acid tests during the quarantine period, followed by a seven-day self-monitoring period as well as compulsory testing on the 12th, 16th and 19th days of arrival at Hong Kong. The three conditions are:

  1. Fully vaccinated with a vaccination record;
  2. Obtained a negative nucleic acid test result during “test-and-hold” upon arrival at Hong Kong; and
  3. Possess positive result proof of a recognised serology antibody test conducted within the past three months.

Also, the EU has recently included Hong Kong and Macao into a white list of safe travel areas. The French Ministry of Foreign Affairs also stated on Thursday (24th) that Hong Kong and Taiwan will be included in the green list of countries.Travellers from the list going to France will not need to be vaccinated to enter and exit the country, and they do not need to be quarantined after entering the country. They can conduct non-essential activities including sightseeing in the local area.

Though it may sound enticing to make travel plans to Paris, a fully vaccinated traveller from Hong Kong (only a fully vaccinated traveller may qualify for shortened 7-day quarantine in Hong Kong upon return) may still be infected while touring the local city and bring back a variant virus as most European cities are very lax in their anti-epidemic measures when compared to Hong Kong. Even though the traveller may be fully vaccinated, he/she may still be tested positive for variant and be subject to hospitalisation either in destination city or back in Hong Kong. If he/she is lucky enough to be tested negative upon returning at the airport, the traveller will still need to check into one of the 34 designated quarantine hotels listed by the Hong Kong government for 7 days before being allowed to enter the community. During the 7-day quarantine,  the person still has to undergo two nucleic acid tests during the quarantine period, followed by a seven-day self-monitoring period as well as compulsory testing on the 12th, 16th and 19th days of arrival at Hong Kong. So, the returning traveller may still get infected during one of the testing sessions due to the long incubation period. Another infected patient may also share the same flight as the traveller and he/she will also be listed as a close contact and subject to longer quarantine period.

Meanwhile, the Centre for Health Protection was notified by the U.K. health authority of a confirmed case in the U.K. yesterday, which involved a fully vaccinated 19-year-old female patient. She departed Hong Kong on 13th June to London via flight CX251. Her specimen collected on 16th June was tested positive for COVID-19. She remains asymptomatic and repeated testing on 22nd June was negative. The Centre for Protection said that she had received two doses of Comirnaty vaccine at Yuen Long Sports Centre on 15th April and 6th May.

This clearly shows that a fully vaccinated traveller may still be infected and will be quarantined/hospitalised after arriving at the destination city or after his/her return to the port of last entry. The fully vaccinated traveller can still bring a variant virus into the community of his/her destination and infect not only those who are fully vaccinated with different types of vaccine which have various degree of effectiveness against variant virus but also those who are not vaccinated. A fully vaccinated person from Hong Kong, if tested positive at the airport will still need to be hospitalised for further tests and quarantined regardless whether he/she has developed any symptoms. All close contacts and residents at his/her apartment will need to undergo compulsory virus testing and quarantine. The building i.e.Tower 2, Springdale Villas, Yuen Long where the 19-year-old student had resided has also been put under a compulsory testing notice (CTN) yesterday. Any person who had been present at the building for more than two hours during the period from 31st May to 13th June, 2021, has to undergo testing on or before 27th June.

If a surge in COVID-19 cases happens during your trip to one of the cities, Hong Kong government may place the country into a Group A specified place and the fully vaccinated traveller will still need to undergo 21-day quarantine period if he/she returns to Hong Kong after the deadline. On 24th June, the Hong Kong government announced that the quarantine requirements for persons arriving from the United Kingdom (U.K) will be tightened from 28th June, while testing requirement for boarding flights from high-risk places will be adjusted from 26th June. So, if you are fully vaccinated and happen to be planning a trip to U.K., you are back to square one.

The Government will specify the U.K, which is currently a Group B specified place, as a Group A2 specified place with effect from 28th June, having closely monitored the epidemic developments there, the prevalence of mutant virus strains and the case importation risks that may be posed to Hong Kong. All persons who have stayed in any Group A2 specified place on the day of boarding for Hong Kong or during the 21 days before that day have to present at boarding negative result proof of a nucleic acid test for COVID-19 conducted within 72 hours before the scheduled time of departure of the aircraft, as well as the confirmation of a room reservation in a designated quarantine hotel in Hong Kong. On arrival at Hong Kong, they will be subject to the “test-and-hold” arrangement at the airport, and on confirmation of negative test results, they will then be required to board the designated transport arranged by the Government to proceed to the designated quarantine hotels for compulsory quarantine. They will be subject to 21-day compulsory quarantine at designated quarantine hotels, with four tests to be conducted during the period, followed by a seven-day self-monitoring period as well as compulsory testing on the 26th day of arrival at Hong Kong at any Community Testing Centre.  The arrangements of shortened quarantine period for fully vaccinated persons are not applicable to persons who have stayed in Group A2 specified places.

Before the pandemic, most people could choose any destination they desire, compare and book the cheapest flights and accommodation to enjoy their vacation. During this period when the pandemic is still severe worldwide, Hong Kong residents can only choose to go to lower-risk countries (there is no guarantee of sudden surge in cases e.g. Taiwan which will change the classification of the country), receive COVID-19 vaccination, undergo virus test, book accommodation at destination cities and also 7-day designated quarantine hotel accommodation in Hong Kong. The traveller may also bring back a variant virus and make it to the headlines in Hong Kong as one of the latest variant carriers. There will also be a lot of variables that will affect the travel plan ranging from circuit breaker mechanism for flights implemented by the Hong Kong government that may disrupt your returning flight, sudden change of specified places to Group A just like in the U.K. due to surge in COVID-19 cases and discovery of new variant such as  new Delta Plus variant recently found in India. If you are an employed person, planning a trip can be very tedious and expensive. Flights can get cancelled and you may get stuck in the destination city as Hong Kong government may cancel returning flights due to activation of circuit breaker mechanism. If you change your returning flight, you also need to extend your stay in the destination city and rebook your designated quarantine hotel in Hong Kong which may be fully booked. You also risk exhausting most of your paid annual leave due to the prolonged quarantine period.

If there are 3 or more passengers on the same flight arriving in Hong Kong or within 7 days, two or more passengers on each of the two flights from the same airline from the same port of departure are diagnosed with COVID-19 after arriving in Hong Kong, passenger planes of related airlines arriving in Hong Kong from the same port of departure will be prohibited from landing in Hong Kong for 14 days. At the same time, the government will add new guidelines for the circuit breaker mechanism for parallel flights. If within 7 days, any passenger airlines arriving in Hong Kong from the same country has a total of 5 or more passengers diagnosed with the variant virus strain after the arrival, all passenger airlines arriving in Hong Kong from this country will be banned from landing in Hong Kong for 14 days.

On 23rd June 2021, Centre for Health Protection announced that a 27-year-old male patient (Case No. 11902) who lives at Wan Hang House in Wan Tau Tong Estate in Tai Po has ben infected with L452R mutant strain which was subsequently confirmed to be Delta variant after genome sequencing. The genetic analysis by the Public Health Laboratory Services Branch (PHLSB) of the Department of Health revealed that the mutant strain belongs to the Delta mutant strain. The PHLSB compared the sequence of this case to the genomes from the previous confirmed cases reported in Hong Kong, and the result revealed that the genomes from Case No.11902 were identical to the genomes of three previous imported cases (Cases No. 11877, 11878 and 11881).  More than 180 close contacts were quarantined. The patient works as a ground staff for Hong Kong Airlines. He also works part time at Uptown Plaza in Tai Po. It was pure luck that no other close contacts were not infected due to the highly infectious nature of the Delta strain.

It seems unavoidable that variant virus such as the Delta strain will be the dominant variant at present and who knows there will be other strains in the near term which are more potent against the COVID-19 vaccines. Hong Kong will definitely experience the 5th wave in the near future when more vaccinated travellers return from high or lower risk area. After 30th June, they only need to undergo shortened 7-day quarantine period and there are bound to be loopholes and leakages.

Herd immunity is a fantasy for governments around the world as there will always be a large segment of population who do not want to be vaccinated due to fear of side effects and other reasons. Even if herd immunity were to be achieved, vaccinated persons who received different types of vaccines with various degree of immunity against variant viruses may still fall sick and infect others. The only blessing in disguise is the lower mortality rate post-vaccination but the light at the end of the pandemic tunnel still seems to be far away. For now, travel plans should only be made for emergency and urgent business purposes. Leisure travel will definitely still be a distant hope for all. However, travel within China and very low risk places where respective governments exercise prudent measures to contain their epidemic situation is still plausible in the near future. Meanwhile, it is vital to get vaccinated to protect yourself and your family members.

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