Is Hong Kong about to host a natural experiment on Omicron’s severity?

HONG KONG has done a better job than almost anywhere at keeping covid-19 at arm’s length. Its rigorous test-and-trace regimen, an unflinching policy of sending thousands of people for long stays in quarantine facilities, tightly controlled borders and an overwhelming adherence to mask-wearing, even through the stifling summer heat and humidity, have served it well. All told it has recorded around 13,000 cases and officially suffered just 213 deaths (although our tracker shows its excess mortality to be between 300 and 2,800, with 1,300 our best guess) out of a population of 7.4m. But that success has bred an unfortunate side effect. With little fear of coming into contact with the virus, the territory’s elderly have proven stubbornly unwilling to get vaccinated. Despite both the Sinovac and Pfizer vaccines having been freely available to them for nearly a year, just 25% of Hong Kong’s over-80s have had their first dose, with around half of 70- to 79-year-olds also unprotected. In comparison, over 80% of Hong Kongers aged between 12 and 59 have taken the plunge. Why is the rate among the elderly so low?

Complacency is not the only reason why Hong Kong’s old folk have held back. When vaccines first arrived in the territory in February 2021, the government’s overcaution spooked a lot of Hong Kongers. First, within a month of the vaccination programme beginning, it temporarily suspended the use of the Pfizer jab, after around 50 vials in a batch of over half a million were found to have defective packaging. Then it rejected the AstraZeneca vaccines it had ordered, overplaying fears of life-threatening side-effects. It also released exacting details about people who had died or been hospitalised having recently been jabbed—even when there was little evidence of a connection between the events. In care homes, meanwhile, residents had to opt-in to receiving a jab—unlike for flu shots, where an opt-out system has ensured fulsome coverage.