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The pandemic is not over

THE FIFTH WAVE OF COVID-19 in Hong Kong has been largely contained, with daily cases down to daily three-digit figures for more than a week now. The debate between “dynamic zero-covid” and “living with the virus” seems to be irrelevant to Hong Kong now.

Most Covid outbreaks appear to have a natural upward and downward cycle which usually takes about six to eight weeks. While the government responses in this wave were far from perfect, resulting in millions of infections and thousands of deaths, people are looking forward to a gradual opening up and life resuming to normal, as evidenced by the crowded streets, shopping malls and countryside in last weekend.


Yet business will never be as usual in the after-Covid era.  It is a matter of fact that more than a million people (which the Hong Kong Chief Executive agrees is a gross underestimation) have been infected and most of them had mild or no symptoms, and recovered.

Pagel, UCL

But we should never treat Covid as a mild disease like flu. The severity and mortality rate for certain sectors are still much higher than flu, sectors which include chronically-ill people, unvaccinated elders, and children.  

Christina Pagel (right), Director of University College London’s Clinical Operational Research Unit recently warned that coronavirus is still an unpredictable disease as humans still don’t fully understand it and it is impossible to predict how the virus will evolve in future.


Hong Kong eased social-distancing curbs on April 21 which allowed for the reopening of gyms, beauty and massage parlours, cinemas, game centres, theme parks and places of worship. But groups are limited to four people. However, Hong Kong has not carried out a single round of compulsory universal testing, and the daily number of cases are deemed to have been underestimated.

Also, in Hong Kong, Omicron hit all age groups equally. In each age group, the infection rate varies from eight per cent to 16 per cent, which is very different from the early “Coronavirus attacks mainly older persons” trope. Middle-aged people between the ages of 20 and 60 have slightly higher rates of infection than children and the elderly, depending on their social network. It seems premature to be complacent that we can consider the epidemic over and return to normal life.

Medical scientists oppose a full abandonment of restrictions. Image by Matilda Wormwood/ Pexels


The after-effects of COVID-19 are not well known, and there are both pathological and socio-economic sequelae (a medical term for secondary effects).

Omicron is milder in average individuals, but causes more deaths in average populations. Image by Anna Shvets/ Pexels

Moreover, from the perspective of pathology, we cannot treat coronavirus as a common cold. And just as we come to think of coronavirus as being milder,  it is important to consider that novel Coronavirus variants have emerged rapidly in the past two years. This resulted in greater severity for Alpha and Delta, and less severity for Omicron, but it was an evolutionary accident. That does not mean the next variant won’t be more severe.

In Hong Kong, Omicron did not become prevalent until the second half of 2021, and the fifth wave of the outbreak did not begin until the Chinese New Year of 2022. As a result, Omicron’s secondary effects are under-studied, as it will take more time to understand their duration and intensity. At the same time, although Omicron is so far considered mild in individuals, it statistically shows more fatality in populations.


As more and more people are vaccinated worldwide, viruses will evolve to improve transmission by becoming better at avoiding our immune systems. This means that existing vaccines against older strains may one day no longer protect us as well. So we must develop better, longer-lasting vaccines, rather than relying too much on boosters.

Compulsory universal testing is actually a good idea. Picture by \ Edward Jenner/ Pexels

As we move forward with COVID-19, we must rediscover the ambition to improve public health system by realizing that this battle against the virus is a long one and is not over. Other countries gave up on zero COVID policy due to the lack of sophisticated quarantine and tracking systems. 

With the central government’s support, the Administration should still pursue the option of Compulsory Universal Testing. There have been no shortage of proposals which could minimize disruption to the whole population, such as conducting rapid tests rather than PCR during lockdown, or starting from a district level to gain experiences for local mobilization, etc. While there were numerous reasons for not doing it, if there is a will there is a way. And it is the only way to achieve zero-Covid in the foreseeable future.

Now read this: Data says China’s and New Zealand’s strategies are better than Living with Covid in terms of deaths, population health

Image at the top by Anna Shvets/ Pexels

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