Once COVID-19 success stories, what went wrong in Hong Kong and Korea?

Healthcare personnel work at makeshift COVID-19 isolation facilities in the San Tin area of Hong Kong, March 11. AP-Yonhap

Low vaccination rate among elderly attributed to surge in deaths in HK, while easing of distancing measures cited for Korea's soaring cases

By Kim Bo-eun

HONG KONG ― Using different approaches, Hong Kong and South Korea managed to keep COVID cases mostly under control until late last year. In fact, they did such a good job that the two countries were referred to as success cases of curbing the virus without resorting to draconian measures such as lockdowns, which wreak havoc on the economy.

But the number of infection cases has shot up in both places in recent months, along with the spread of the highly contagious Omicron variant.

On Wednesday, South Korea's new daily cases hit an all-time high of 621,328 ― a 55-percent surge in just one day. Deaths came to a record 429 on the same day. Korea ranked first in the world in the number of daily new cases per 1 million as of Tuesday, according to figures from Our Word in Data.

As of Tuesday, Hong Kong had by far the largest number of daily confirmed deaths per 1 million people at 37.64, data from the same source showed.

Hong Kong had imposed strict measures to curb the spread of the virus since the beginning of the pandemic, such as a 21-day quarantine for people arriving in the city from overseas, tight management of the border, limits on gatherings, required face masks and immediate contact tracing and quarantining for confirmed local cases.

These measures had worked in the city-state for the past four waves, but their effectiveness broke down during the fifth wave that unfolded in December. The highly transmissible Omicron variant overrode even tightened distancing rules introduced in January, such as the closing of restaurants at 6 p.m. The variant took a toll especially among the elderly, which account for a fifth of Hong Kong's population. Government data show that people aged 65 and above accounted for 18.4 percent of the population of 7.5 million as of 2019.

People in Hong Kong were more vulnerable to Omicron infections due to the low vaccination rate at the beginning of the territory's fifth wave. Senior citizens had shunned getting jabbed as Hong Kong up until then had successfully kept the virus out, and concerns had mounted over possible side effects from the vaccinations, amid high levels of public distrust in the government.

These conditions set the backdrop for a rapid spread of the Omicron variant among the elderly, who, by that time, were unable to get immediate access to medical services as hospitals in the city had already reached full capacity, due to most infected people having been admitted.

The Hong Kong government, which had been slow to see the surge in Omicron infections coming, had not prepared hospitals to prioritize the elderly and severe cases.

"Death rates were expected as low vaccination rates among the elderly, low rates of prior infection and an overwhelmed healthcare system converged to create a perfect storm," Siddharth Sridhar, a clinical assistant professor in Hong Kong University's Department of Microbiology, wrote on Twitter earlier this month.

Workers move bodies from a truck into a refrigerated shipping container outside of a public mortuary in Hong Kong, China, March 11. Refrigerated shipping containers have been set up outside some mortuaries as Hong Kong struggles to cope with rising deaths due to COVID-19. EPA-Yonhap

As of Thursday, 91.3 percent of Hong Kong's residents have received their first vaccine dose, 81 percent the second and 35.1 percent the third.

But Hong Kong's battle against the virus is far from over.

Kwok Kin-on, an assistant professor at the Chinese University of Hong Kong's JC School of Public Health and Primary Care, projected that the daily number of new cases would not drop to around 1,000 until late May, and that it would then take another month to fall to about 100.

The government had initially planned a mainland-style universal testing of the population this month as a means to identify infections and prevent further spread, but postponed it to focus on the pending task of reducing deaths and serious cases.

People line up to get tested for COVID-19 at a testing center near Seoul Station, March 13. Newsis

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Korea, in the meantime, saw its daily number of new confirmed infections rise to the five digits in January. But even as cases were climbing over 100,000 in mid-February, the government relaxed social distancing measures, prompting criticism that it had been a political move to secure votes ahead of the presidential election on March 9.

The government initially projected that the country would reach its peak with cases topping 370,000 this week, but experts project that the peak will be pushed back by a week or more. The daily numbers have continued to skyrocket, surpassing 600,000 for the first time, Wednesday.

"This situation should be attributed in large part to the change in the government's policy, as the social distancing measures were eased," Jung Jae-hun, a professor of preventative medicine at Gachon University, said via phone. "The Omicron variant's high transmission rates also contributed to the situation."

The Korean government has stated that measures were relaxed as it had determined that the fatality rate for the cases occurring was similar to that of the flu, given that over 86.6 percent of the population has received two shots and 62.7 percent a third. On Wednesday, it began collecting public opinions from medical experts and groups representing small businesses and the self-employed for a further revision of the distancing measures, to be introduced on March 21.

But given that critical cases and deaths develop and occur weeks after new infections are confirmed, experts state that these numbers will likely continue to rise even after the daily number of new infections peaks.

Another factor posing uncertainty is the BA.2 or "stealth" Omicron subvariant, which already accounts for 26.3 percent of all analyzed cases in Korea over the past seven days. Subvariant BA.2 is estimated to be 25 to 30 percent more transmissible than the currently dominant subvariant, BA.1.

"The government must begin planning how to prepare the medical system for the event that it takes more time (than it predicted) to reach the peak," Lee Jae-gap, a professor of infectious diseases at Hallym University, said on a radio program in Seoul on Monday.