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When the Omicron variant first breached Hong Kong’s coronavirus defenses in late 2021, the city stamped it out and solidified its status as one of the world’s toughest “zero Covid” twins.
A few weeks later, however, Omicron came back to the metropolis, this time causing an out-of-control epidemic among cleaners on a housing estate. The blaze of emerging cases is now killing people at a rate that exceeds that of nearly every country since the outbreak of the coronavirus.
Throughout the entire epidemic, Hong Kong’s per capita death toll, which was once much lower than Western countries, is no longer exceptional. A month ago, Americans died from Covid at 90 times the rate of people in Hong Kong. On Monday, the cumulative American toll was three and a half times higher.
Less punitive as the United States prepares on its own increase in casesand mainland china is fighting biggest epidemic of the last two yearsScientists have looked to Hong Kong for clues about the threat Omicron poses in an entirely different environment: a dense city where people are not only largely unaffected by previous infections, but also where its oldest and most vulnerable residents are largely unvaccinated.
Health experts said several critical lessons emerged.
In the era of Omicron and its even more infectious subvariant, BA.2, it remains important to vaccinate a large segment of the population, the scientists said. But vaccinating as many seniors as possible had become a top priority.
They said this message is most urgent in China, where vaccinations in older age groups are also delayed and there is little immunity to previous infections.
But this was also the case in the United States, where below-average vaccination and supplementation rates among older people have worried scientists about a potential increase in BA.2 cases. In part because so many more Americans have been infected and killed by the coronavirus in previous waves, scientists do not expect the United States to face a situation as serious as Hong Kong in the coming months.
Health experts said Hong Kong’s dire outbreak also pointed to the dangers of trying to eradicate the virus without a plan for what would happen next. They said the high contagiousness of Omicron made epidemics almost inevitable.
Hong Kong, which, along with mainland China, is among the last stops in a strategy of stringent restrictions and border controls to eradicate the virus, was vulnerable as few of its residents were immune from previous infections: Before the Omicron surge, scientists estimated that only 1 percent of Hong Kong’s population contracted the virus. .
These low levels of immunity can leave places vulnerable to waves of cases as more infectious variants sneak in or restrictions are lifted. However, University of Hong Kong dean of medicine Dr. Gabriel Leung said governments can still prepare for these waves.
Less than a quarter of people aged 80 and over in Hong Kong were given two doses of the vaccine prior to the rise of Omicron, compared to more than 90 percent of people in Singapore and New Zealand.
Due to the number of unvaccinated seniors in China, there may also be some difficulties in lifting the “zero Covid” restrictions, the scientists said. More than 87 percent of the Chinese population has been vaccinated. However Just over half of people aged 80 and over have been shot twiceLess than 20 percent of people in this age group receive support, Zeng Yixin, deputy minister of the National Health Commission, said on Friday.
Dr. “I don’t think he’s quite ready for the transition,” Leung said.
A number of Asian and Pacific countries largely kept the virus at bay for two years, but faced Omicron outbreaks as the virus was so contagious and their populations avoided previous infections. But high vaccination rates, including for the elderly, have helped many of these countries avoid more devastating fluctuations.
For example, in South Korea, where 87 percent of people are vaccinated and 63 percent are booster vaccines, the overall death rate per capita is one-tenth that of the United States, although South Korea has recorded more than three-quarters of cases in the United States. United States throughout the entire epidemic.
Health experts said Hong Kong’s difficulties in vaccinating the elderly were due to a combination of complacency, given the city’s previous success in containing the virus, and unfounded fears that the elderly and those in poor health face certain risks from vaccines.
Although the city has vaccinated almost two-thirds of 12- to 19-year-olds, 39 percent of residents aged 80 and over have been vaccinated.
Many people in Hong Kong have been given the Chinese vaccine Sinovac, which appears to offer relatively little protection from Omicron infections but better defense against serious illness. Scientists suggested that nearly 90 percent of people who died during the last wave were not fully vaccinated, suggesting that getting the most vulnerable people vaccinated is more important than a particular brand.
A clinical virologist at the University of Hong Kong, Dr. “The problem in Hong Kong is that we haven’t been able to vaccinate our most vulnerable population, the elderly, especially those staying in aged care homes,” said Siddharth Sridhar. As a result, we are in a very bad situation.”
The United States has vaccinated many of its older residents far more than Hong Kong, but has seen and vaccinated less than Western Europe. high death rate. And as immunity from early vaccines wanes and booster vaccines become critical for protecting against Omicron among older people, the United States is finding itself vulnerable in this regard. About 41 percent of people 65 and older have not received a booster shot.
Unlike other parts of Asia, which have gradually lifted restrictions in recent months, Hong Kong is not ready for its defenses to fail, the scientists said.
“From the government’s point of view, there was such a strong obsession with ‘zero Covid’ that the vaccine was not necessarily a priority as long as it worked,” said Ben Cowling, professor of epidemiology at the University of Hong Kong.
Many elderly residents and their families have taken the same view, public health experts said. If Hong Kong’s strict social distancing and careful border controls were to keep the virus out anyway, conventional thinking is gone, is finding a vaccine worth the effort?
A family doctor in Hong Kong, Dr. “If you’re saying people will never get the disease, then there is less incentive to go and get vaccinated,” said David Owens. “To some extent, messages about elimination have confused the need for vaccination.”
University of Hong Kong Dr. Cowling said his city could respond to signs of increasing cases in one of two ways: either double down on “zero Covid” with measures like building better quarantine facilities for overseas arrivals, or accept that Outbreaks are inevitable and increase vaccination rates.
Dr. “Zero Covid is a really good strategy if you can stay at zero,” Cowling said. “But as we found in Hong Kong, it won’t last forever.”
Hong Kong has finally taken steps to persuade the elderly to get vaccinated, after previous incentives such as vaccine passes were ineffective. In January, the government announced it would ban unvaccinated people from entering dim sum restaurants popular with the elderly. But it’s too late.
With the decrease in cases and deaths, Hong Kong announced on Monday He said he would lift some restrictions.
Singapore began to abandon its “zero Covid” policies in the summer. An infectious disease specialist at Duke-National University of Singapore Medical School, Dr. Ooi Eng Eong said a wave of Delta variants is needed to raise vaccination rates and dispel the notion that they don’t need to protect people.
Now, cases in Singapore have increased, but deaths are relatively low.
About Omicron Dr. “I think wearing a face mask is much more contagious — it helps, but not to the extent that it impacts epidemiology,” Ooi said. “Trends are really driven by vaccination.”
Still, even after five or six waves of the pandemic, it remains unclear why some countries have succeeded while others have suffered.
The scientists said, for example, that Japan has falsified cases throughout the pandemic without resorting to full-fledged lockdowns.
The country has benefited from its government’s robust public opinion sharing Health advice early in the pandemic. Taro Yamamoto, a professor at Nagasaki University’s Institute of Tropical Medicine, said that while residents may be weary of the measures, they largely take the advice seriously.
About 80 percent of people in Japan have had their first series of vaccines. However, despite the country’s delay in the introduction of booster doses and an increase in Omicron infections, mortality rates during Omicron remained significantly lower more than nearby South Korea.
“Partly it’s a mystery,” said Professor Yamamoto. “We can’t explain everything.”
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