The severe wave of coronavirus in Hong Kong

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For several weeks Hong Kong has been dealing with the worst wave of COVID-19 since the beginning of the pandemic. Hospitals are under great pressure, with full wards and patients left in corridors often without the ability to receive adequate care. The high number of cases due in particular to the omicron variant highlighted the government’s unpreparedness to face the emergency, after two years in which the pandemic had been kept under control thanks to the so-called “zero COVID” policy, with immediate lockdown and sweeping tests to stop coronavirus outbreaks.

In the past week in Hong Kong, an average of 285 people have died a day from COVID-19, one of the highest rates worldwide. In Italy, deaths have been on average 140 per day in the last seven days, also due to a new increase in positive cases since the end of February (Hong Kong has 7.5 million inhabitants compared to almost 60 million in Italy).

On average in the last week the positive cases detected in Hong Kong every day were 2,300 per million people, compared to about 900 per million in Italy. Since the start of the new wave, which had started slowly at the end of December, 740,000 cases have been detected in Hong Kong, but according to analysts and observers, the figure greatly underestimates the extent of the infection.

The University of Hong Kong has estimated that the current wave has so far caused at least 3.6 million infections: almost half of the population was therefore infected in a few months.

Doctors and the rest of the medical staff attribute the health emergency to a substantial unpreparedness on the part of the local government, which had not drawn up specific plans for a possible marked increase in cases, dedicating almost all efforts to maintaining “zero COVID” policies. The choice had paid off in these two years of pandemic, with rare outbreaks that the health authorities had managed to keep under control, albeit by imposing strict isolation rules on entire neighborhoods for weeks or months depending on the case.

Temporary Isolation Facilities for Coronavirus Positive People, Near Hong Kong – March 11, 2022 (AP Photo / Kin Cheung)

To stop the infections immediately, starting from the first months of 2020 Hong Kong had foreseen that anyone with an infection should be hospitalized in a health facility, even if without symptoms. People who eventually came into contact with the infected individual had to be transferred to quarantine facilities, with the obligation to remain there for variable periods up to a maximum of three weeks. Some of these rules had changed over time, also following the introduction of systems for carrying out mass tests in entire neighborhoods.

However, the advent of the omicron variant at the end of last year has significantly changed things. As happened in many other countries, the variant was immediately more contagious than the previous ones, with a capacity to spread very quickly, forcing the health authorities to chase rather than prevent.

The rapid increase in cases had caused serious organizational problems and prompted the government to switch to the “dynamic zero COVID” strategy, a plan that involved greater use of population testing and the opening of new quarantine facilities. The choice had led to criticism, considering that in a phase of high circulation of the coronavirus it is appropriate to strengthen above all health facilities, in order to be able to take care of people who develop severe symptoms.

Hong Kong (AP Photo / Vincent Yu)

For days the information has been patchy and contradicting each other, leading to some confusion and sometimes panic among the population. There was a significant increase in purchases of long-life foods, fearing that a severe lockdown could be launched, and those who could have left the city to spend a few weeks elsewhere.

After days of unclear news, Hong Kong Governor Carrie Lam had last week announced the postponement of new policies linked to tests for the entire population, at the same time as new measures to contain infections and deaths. Part of the plan provides for the rapid vaccination of the older population, which until now had not undergone the vaccine, believing they were sufficiently protected by the “zero COVID” strategy, which had shown good results since the beginning of the pandemic.

In Hong Kong, only 35 per cent of the population aged over 80 had been vaccinated so far, a rather low proportion if we consider that in the general population over 12 years of age, the rate of fully vaccinated it is around 80 percent. The low percentage of older adults with vaccines partly explains the increase in deaths in recent weeks, given that older people have a higher risk of developing severe forms of COVID that require hospitalization and can cause death.

The Hong Kong government hopes to change things by relaunching the vaccination campaign among the elderly, with various initiatives including an increase in administrations in nursing and retirement homes. The initiative calls for vaccination teams to visit all of them by the end of this week.

Healthcare workers in temporary isolation center for coronavirus positive people in Hong Kong – March 11, 2022 (AP Photo / Kin Cheung)

A little less than two years of “zero COVID” have had a visible social impact and they are conditioning how part of the population is experiencing the current wave. After having received for months communications on the dangers of positive people, on the need to isolate them and on the importance of taking maximum precautions even with asymptomatic people, many people immediately call for help as soon as they discover that they are positive, blocking the telephone assistance lines and especially hospitals.

Fearing to end up in isolation for a long time and to force relatives and friends with whom they came in contact to the same fate, others decide to do the exact opposite and if they discover with do-it-yourself tests that they are positive they do not declare their condition. , providing for self-isolation at home. The phenomenon seems to be quite widespread and is one of the explanations for the underestimates of the people actually infected during this wave.

However, as there are not enough places available in the quarantine facilities, the Hong Kong government has relaxed some of the rules. Now people who have come into close contact with a positive individual can begin isolation at home, if there are no places in the facilities, even if their close positive contact is a cohabitant.

The changes to “zero COVID” and the intensification of the vaccination campaign resulted from strong pressure from the Chinese central government, dissatisfied on the recent management of the coronavirus emergency. Hong Kong is a special administrative region and maintains numerous autonomies, but still undergoes some control by China.

The Chinese government itself has faced a marked increase in cases in recent weeks, with the highest rate of positives since the early stages of the pandemic in 2020. In Shenzhen, a metropolitan area north of Hong Kong where 17.5 million people live , on the weekend it was willing a lockdown, after 60 positive cases were reported in the city on Sunday. Much of the shops, excluding those selling food and other essential goods, will be closed, while local authorities have ordered mass tests to try to identify new cases.

China is trying to maintain a “zero COVID” approach at this stage, but it is unclear whether it will be enough to keep the spread of the omicron variant under control, which as widely seen in the West spreads very quickly, albeit with mild symptoms. especially in vaccinated people.

In the last 10 weeks, China has detected more positive cases than in all of 2021: about 14 thousand. The Jilin region, in southern Manchuria, is one of the most affected areas and there are strong doubts about the possibility of containing the infections thanks to “zero COVID”. Many cities are setting up temporary hospitals to house the infected and the sick, but there are concerns above all for the elderly, who, like in Hong Kong, have few vaccinated people.

Last week the Chinese health authorities have granted some openness to do-it-yourself antigen tests, which can be used to determine whether or not they are positive in place of molecular tests, which take longer to analyze. On Tuesday 15 March it was also decided to allow people with mild symptoms to remain in quarantine in dedicated facilities instead of actual hospitals, to avoid clogging them.

Street Sanitation Activities in Changchun, Jilin – March 12, 2022 (Chinatopix Via AP)

Since the start of the pandemic, China has reported about 4,500 deaths from COVID-19 and 120,000 positive cases, mostly concentrated in 2020. The data probably underestimate the actual size of the pandemic in the country, but the use of the “zero COVID” formula “Has allowed for a long time to keep the situation under control. For this reason, an increase of about a thousand cases per day as recorded for some time is considered worrying, although the percentage of completely vaccinated is around 85 percent.