Intellasia East Asia News – ‘Unprepared and disorganised’: where did HK government go wrong in its fight against fifth wave of coronavirus?

After Hong Kong leader Carrie Lam Cheng Yuet-ngor declared on Wednesday universal mass testing was no longer a top priority, many Hongkongers were left staring balefully at their overstuffed freezers and medicine chests and towers of cup noodles.

It was less than two weeks ago when a bout of panic buying prompted residents to empty out shelves of supermarkets and pharmacies of such items. The trigger: a remark by health minister Sophia Chan Siu-chee that a large-scale lockdown was possible and that government departments were preparing for a citywide testing exercise for Covid-19.

Days before that, Lam said such screening could be conducted over three rounds of testing in March. Schools, which were to be the venue for such a screening scheme, were then ordered closed.

But on Wednesday, after two weeks of not facing the media, Lam did a U-turn, saying her pandemic strategy was now about “reducing deaths, severe symptoms and infections”, adopting wholesale the recommendations of mainland Chinese officials, including visiting top epidemiologist Liang Wannian.

The move meant an immediate setting up of designated hospitals for Covid-19 patients, provision for more community isolation and temporary care facilities, a clear vaccination timetable for elderly people and enlisting private hospitals.

Han Zheng, the state leader overseeing Hong Kong affairs, had also given similar advice on minimising deaths and severe infections, when he recently urged for stronger and more decisive leadership in the health crisis.

Lam on Wednesday said universal testing was still on the cards but it would be done later, with no date set.

The shift in strategy was only the latest in a couple of policy U-turns in the government’s fight against the worsening fifth wave.

Political academics from across the spectrum agreed that while the latest change of strategy was necessary, it also exposed how unprepared and disorganised the government had been. Worse, its reactive mode was only further undermining its credibility, forcing trust levels to dip even lower among the public.

Analysts added that while Lam repeatedly suggested she was the one taking charge of the anti-pandemic fight, the full endorsement of Liang’s suggestions proved “Beijing is in the driver’s seat now”.

“It proved Lam’s administration underestimated the severity of the fifth wave while overestimating her own ability to handle it, and that has left her no choice but to seek help from the central government,” said Lau Siu-kai, vice-president of semi-official think tank the Chinese Association of Hong Kong and Macau Studies.

The city was once proud of its achievements in containing Covid-19, managing to keep infection rates among the lowest in the world. But with caseloads growing rapidly since February, the public health care system had been pushed to the brink of collapse, with patients forced to wait outside hospitals while many unvaccinated elderly succumbed to the virus.

The number of daily infections grew exponentially, breaking the 50,000 threshold this month. As of Friday, the city’s official tally stood at 646,800 cases, while there were 3,444 Covid-related fatalities.

The rapid worsening of the situation showed the government was grossly underprepared, had not learned from the experience of other countries coping with Omicron, and failed to put things under control quickly, analysts said.

“The public hoped to see some progress, but they were instead left with a lot of empty promises,” Lau added. “People are saving themselves on their own.”

In early February, Lam made a public appearance when the city logged more than 100 cases in a single day. In that press briefing, she said the government was procuring rapid antigen test (RAT) kits and all residents would be able to get one. But the kits could not replace lab tests for residents subject to mandatory screening.

The citywide distribution of test kits has yet to materialise, as only certain districts received them while others did not. Meanwhile, the government made a U-turn and decided to accept RAT results as part of the official numbers from late February. This was after long snaking queues that had people waiting for up to six to seven hours were seen for days outside community testing centres.

Then, there was the promise to set up a website for people to register their RAT results. The date for the launch was delayed with no clear explanation given and meanwhile, residents who tested positive using the tests had no choice but to isolate themselves at home without help from the government.

Many said they were also cured of the virus without receiving a single phone call from the health authorities, despite trying to get in touch, and ended up self-medicating.

On universal testing, which triggered not just the panic buying but also prompted people to leave the city for fear of further infections or being caught in a lockdown, Lam changed her stance at least twice in the past month.

For months, she had rejected the idea of universal testing, pointing to difficulties in implementing a citywide lockdown, and favoured instead mass screening according to individual buildings, or ‘restriction-testing declaration’ exercises. But on February 22, she told the public a mass screening exercise would be carried out in March.

Yet on Wednesday, Lam made the now famous U-turn, saying the focus was on saving lives, not mass testing.

Lam also admitted her mainland counterparts had noticed some of the government’s shortcomings, such as a lack of synergy, or not being able to centralise treatments and resources for patients in serious condition.

Finally too, in an admission of a communications failure, Lam said she was conducting daily press briefings to clear up doubts and provide proper information on the fight.

“You can blame the fast-changing situation, but this has proved that the government failed to understand their ultimate goals, and also lacked the determination to carry out draconian measures until Beijing gave an order,” pro-Beijing Lau said.

Echoing Lau, University of Hong Kong emeritus professor John Burns, who specialises in public administration, said the fifth wave had revealed a failure of leadership, planning and coordination.

“This government values more incrementalism and bureaucratic process, less on achieving results. Yet the pandemic requires extraordinary measures, to which leaders at the top in Hong Kong were apparently oblivious,” he told the Post. “The consequences are clear for everyone to see: an astronomical death toll.”

He added: “Liang’s recommendations have been very clear and pointed. Only after the central government took direct action to push the Hong Kong government did it prioritise reducing elderly deaths and serious illness.”

Burns said such a string of policy U-turns clearly further undermined the government’s credibility, as it showed a lack of communications strategy, leadership, planning and coordination.

“The government failed to anticipate the fifth wave, although the world was awash with Omicron; failed to make vaccinating the elderly the highest priority and failed to continue expanding isolation and quarantine facilities,” he added.

This could date back to last December when health minister Chan chaired a meeting before Christmas, saying the government had already “prepared for the worst” with a response plan in case of a widespread outbreak.

Authorities by that time had expected to use the 3,500-unit Penny’s Bay quarantine camp for Covid-19 patients if caseloads grew rapidly and prepare a protocol for at-home treatment. But the outbreaks spread faster than expected and clearly “the worst” scenario was not properly mapped out.

Speaking to the Post, a source familiar with the matter disagreed with the criticism that the government had not made proper planning for isolation facilities.

“For a long time, Penny’s Bay and other government quarantine facilities were left empty. How do you expect the government to build more isolation facilities at that time? Again, hindsight is easy.”

But the insider agreed the failure to vaccinate the elderly on time was a bad move.

“If one wishes to find fault, I would say the government could have been more persistent with vaccinating the elderly particularly at homes for the elderly,” the source said.

Ben Cowling, chair professor of epidemiology at the University of Hong Kong’s School of Public Health, agreed that the failure to get as many of the elderly vaccinated was the weakest link in the government’s approach to containing the virus.

This goes back to the early days of the vaccination drive, where no real or forceful initiatives were made to push the elderly to get jabbed and instead the emphasis was just on getting herd immunity. In the end the most vulnerable were the least protected and ripped apart the weak foundations of the exercise.

Now, fatalities have been most common among the unvaccinated elderly, pushing the city to have the highest death rate in the world.

Authorities’ own studies on the deaths of the first 1,153 cases during the fifth wave showed that 90 per cent of those who died were not vaccinated, while the fatality rate among those jabbed was five times lower.

“If you compare the various Covid statistics between Hong Kong, Singapore and New Zealand, the major difference is vaccination coverage in older adults,” Cowling said. “Singapore and New Zealand do not have issues with lack of preparation or lack of medical beds or isolation facilities.”

Jean-Pierre Cabestan, a research professor of political science from Baptist University, said he believed the city’s lack of planning came also from the mainland’s containment policy of “dynamic zero” infections, which created a lack of physical and psychological preparedness for living with Covid-19, resuming normal life and opening the borders. There was a lack of a clear exit strategy.

“So now both the mainland and Hong Kong need to become more courageous and face the risks of living with Covid, which means accepting more cases for some time before overcoming the fifth wave, if they want to be in sync with the rest of the world,” he suggested.

In an exclusive interview with the Post, visiting epidemiologist Liang said the “dynamic zero” strategy was not about zero infections but saving lives and this could be achieved in stages without sacrificing the city’s economic and social stability. He also said the policy was not cast in stone, but took into account the changing situation.

Asked about universal testing, he also suggested that it was a massive undertaking requiring thorough planning, having checklists to make sure a system was in place.

Analysts said Liang was again giving much-needed guidance to the administration, even as Beijing had been urging the local government to shoulder the “main responsibility” in battling the crisis. Earlier, it had also called for courage and for officials to live up to their oaths.

Lam bristled on Thursday when asked if the government should reflect on its failure to curb the fifth wave. She insisted the city had dealt with the previous four waves successfully.

“I not only understand what is the main responsibility, I have been taking up the main responsibility every day,” she said. She was making the decisions on how best to use the support and resources offered by the mainland, she added.

Burns of HKU said: “Judging from the chief executive’s press conference, the government continues to rely on ‘hopes for the best’, rather than planning for the worst.

“Will we learn from this experience? To do that, we need a thorough review of the government’s Covid preparations and planning, the agility of our Hospital Authority system, the sustainability of our system of public health, and the interface of public and private medicine.”

https://www.scmp.com/news/hong-kong/health-environment/article/3170036/unprepared-and-disorganised-where-did-hong-kong

 

Category: Hong Kong


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