Hong Kong once seemed like a model for how to control the coronavirus. Schools were open. Restaurants and shopping malls full of crowds. Buses and trains operated as usual, and residents wore face masks on board.
But a new wave of infections in recent days has pushed the city to the limit. Hospitals are now seeing more cases a day than ever during the pandemic. More importantly, health officials are unable to determine the origin of many of these cases, despite having a strong contact locating system.
The government reported 73 cases on Monday, one of the highest totals in a single day since the coronavirus emerged nearly seven months ago in mainland China. In a short time, the virus has spread throughout the city, infecting administrative staff at a government-run eye clinic, residents of an older people’s facility, and airport cleaning workers.
“The situation is very serious and there are no signs that it is under control,” Carrie Lam, Hong Kong’s chief executive, said on Sunday when she announced new restrictions aimed at curbing the spread of the virus.
As governments around the world seek to relax established rules for fighting the virus, the Hong Kong experience provides a warning story.
Lifting restrictions on social distancing too quickly, experts say, can open the door to new outbreaks. And with a vaccine still many months away, they say, even the most vigilant countries are susceptible to sudden increases in cases. China, Japan, South Korea and Australia are dealing with outbreaks of the virus.
“It is really alarming,” said David Hui, director of the Stanley Ho Center for Emerging Infectious Diseases at the Chinese University of Hong Kong, about the recent outbreak. “Once you loosen the restrictions too much, you face a rebound.”
The city had been widely praised by international experts for its response to the pandemic. It moved quickly to narrow its borders and impose quarantine rules, which contained tracked outbreaks first to travelers from mainland China and then to Hong Kong residents returning from Europe and the United States.
But the latest outbreak has baffled top health experts.
Until now, officials have been unable to trace how a significant number of people contracted the virus, a worrying sign, epidemiologists say, making it more difficult to break the chain of transmission. Most people who tested positive for the virus have not traveled and have not been linked to known groups.
Dr. Hui said that the previous outbreaks in Hong Kong were effectively contained before they could spread in the community without control. “You could isolate close contacts, quarantine them and stop the outbreak,” he said. This time, he said, “It is quite difficult because we had a lot of silent transmission that has already entered Hong Kong.”
Many residents have blamed the outbreak on people who have recently entered Hong Kong without undergoing the standard 14-day quarantine. They have urged the government to stop granting exemptions to some business travelers and airplane pilots, but the government, which is battling a recession, has defended the exemptions as necessary.
After easing restrictions on daily life in recent weeks, Hong Kong officials are once again imposing harsh measures aimed at slowing the spread of the virus. Masks are required inside public spaces, and dining in restaurants is prohibited after 6 pm. The government has ordered that gyms, cinemas and swimming pools be closed once again. About 40 percent of government workers have been asked to stay home.
Chuang Shuk-kwan, a senior health official, did not rule out the possibility of imposing a curfew or a blockade if the number of cases grew exponentially. “Of course, we hope that the situation will not come to that stage,” Dr. Chuang said at a press conference on Monday.
The government is expanding its tests to residents, especially those considered to be at high risk for contracting the virus, including older adults, taxi drivers, and restaurant workers. Authorities say they are processing around 10,000 tests per day, and health workers have distributed test kits on residential compounds where groups have emerged.
Medical workers say they are concerned that an influx of coronavirus patients may overwhelm the city’s crowded hospitals. Health officials said Monday that 71 percent of the 1,700 beds in isolation rooms at city hospitals were already in use. However, the majority of coronavirus patients are in stable condition, with only 36 considered seriously or critically ill. A dozen people died from the virus during the pandemic.
In addition to the strain, many isolation rooms in Hong Kong are filled with young patients who show no symptoms of the virus, but are required to remain until they test negative. Doctors fear that this may lead to a lack of space for older patients or those with more severe symptoms who need urgent medical attention.
Hong Kong leader Ms Lam said Sunday that authorities planned to use about 300 beds at a resort to isolate patients with mild symptoms. The government has said it will build a large quarantine center by the end of the year to accommodate 2,000 people, which could help alleviate overcrowding if cases increase later in the year when temperatures drop.
As hospitals move quickly to convert facilities to treat people with coronavirus only, a further increase in such cases could leave patients with other conditions, experts say.
Arisina Ma, president of the Hong Kong Association of Public Doctors, said that some patients with other conditions have waited months for the procedures and may not be able to seek treatment if coronavirus cases continue to rise.
“We have quarantine facilities, but the stress on our hospital services is still tremendous,” he said. “It appears that our healthcare system has been paralyzed by Covid.”
