Hong Kong’s Covid-19 death rate highest in the world due to unvaccinated elderly


By the time he gave the green light in January, after the Omicron variant had breached the city’s defences, it was too late. Hours after finally receiving the vaccine in late February, Mr Ling’s father, who suffers from hypertension and dementia, tested positive for Covid-19.

Half a million people over the age of 70 were unvaccinated when Omicron started hitting the city. Like other places, Hong Kong has prioritized its elderly for vaccinations, but continued fears over vaccine safety, fueled by local media reports of deaths from vaccinations, and the low number of cases in Hong Kong have led many people to delay.

“For so long, getting vaccinated seemed more risky than getting vaccinated here,” Ling said. “Now everything has changed and there is a scramble to get vaccinated.” His father is recovering, he added.

Low vaccination rates among the city’s elderly have made Hong Kong’s death rate the highest in the world: Its seven-day rolling average of confirmed Covid-19 deaths as of March 6 was 25.5 to 1 million people, more than five times that of the United States and topping a global ranking maintained by Our World in Data, a project based at the University of Oxford.

More than 90% of people who lost their lives in the current outbreak were unvaccinated, health officials said. The vast majority were over 60 years old. On Wednesday, city chief executive Carrie Lam said her government’s priority now would be to protect the elderly and reduce deaths and serious illnesses from infected cases, delaying a mandatory testing plan at the city ​​scale. Dated.

As the number of sick people has exploded, Hong Kong has been plunged into a crisis which it has sought to avoid by isolating itself from the rest of the world using strict travel restrictions and quarantines. Helplines go unanswered, ambulances take hours to come, patients are crowding into hospitals and morgues are running out of space. In one case, a woman had to bring feeding tubes for an elderly relative being treated for Covid-19 at a public hospital. The cases are rampant in crowded housing estates and nursing homes across the city, which have accounted for around 60% of deaths.

Many health experts say Hong Kong has contributed to its own predicament by wasting months of zero cases without sufficiently preparing for an inevitable large-scale outbreak.

“We simply haven’t done enough to protect our most vulnerable citizens,” said Karen Grépin, associate professor at the University of Hong Kong’s School of Public Health.

Public health experts have repeatedly told the government that it must do more than rely on strict border controls and contact tracing. They urged an exit plan from Zero-Covid policies such as that developed by Singapore: Slowly open up once the most vulnerable are protected with vaccines to keep deaths low.

Singapore’s vaccination rate was over 90% for people over the age of 70 in mid-February, bolstered by restrictions on unvaccinated mobile vaccination teams and even home visits. The death rate per million in Singapore, which is also currently in the throes of an Omicron wave, was about 1/13 that of Hong Kong in the week to March 6, according to the Oxford dataset.

The Hong Kong Civil Service Bureau, which manages the vaccination programme, said it has taken proactive and vigorous measures to encourage vaccination of the elderly, including publicity campaigns and the setting up of mobile stations.

The spread of Omicron in densely populated Hong Kong has been fierce. In 2020 and 2021 combined, the city has had 13,000 cases and 213 deaths. Since the start of the last outbreak in late December, the city of 7.4 million people has recorded more than 500,000 cases – a number that health officials acknowledge is vastly underestimated due to bottlenecks in tests – and 2,365 deaths.

The spate of deaths offers a warning for mainland China as Beijing begins to explore ways to exit its Zero-Covid strategy. Although nearly 90% of China’s population is fully vaccinated, barely half of the country’s 35.8 million citizens over the age of 80 are, according to official data.

The biggest criticism leveled by public health experts at Hong Kong officials is that they have not done more to steer the elderly away from a wait-and-see attitude.

While private companies in Hong Kong offered apartments and raffles to incentivize inoculations last year, it was only after Omicron began to spread that government officials came forward with plans for a mandate. of vaccine. Since February 24, unvaccinated residents have been barred from restaurants, supermarkets and shopping malls, a move that has helped spur a surge in those seeking vaccinations.

Wong Siu-fan, an 80-year-old woman, said it prompted her to finally book her vaccine, which she had delayed because she was worried about side effects.

“Who would have known the outbreak would be so severe?” Ms Wong said, leaning on a cane outside a vaccination center on February 22. “I gave in because the new rules meant everyday life would become so inconvenient without the vaccine. And now I’m also very scared of catching Covid.”

Many residents chose to wait in part because local media and government press releases initially highlighted the death of anyone who had been vaccinated, either with a vaccine co-developed by BioNTech SE and Pfizer Inc. or CoronaVac from Sinovac Biotech Ltd in China.

In one case, a newspaper reported that a man who had drowned while swimming had been vaccinated two months earlier – events that were clearly unrelated – said Dr Grépin, the health professor.

The government issued press releases for a time in the weeks after the vaccines were first made available in the city, reporting deaths or medical issues that it called “suspected serious adverse events.” after vaccination against Covid-19″.

Public fear of vaccines escalated and persisted throughout the pandemic.

Hong Kong government officials have also suggested residents speak to their doctor before getting the shot if they have any concerns.

A whole industry of “Covid-19 pre-vaccination” health check-ups has been created, a phenomenon that Dr Grépin says he has not seen elsewhere. Such records led some seniors to opt for elective surgeries, such as heart procedures, months before. they would consider the vaccine again, exasperated health officials say privately.

With isolation centers and hospitals over capacity, the city’s cramped nursing homes are coping with the brunt of the city’s outbreak.

Around 60,000 elderly people live in nursing homes in Hong Kong, which has one of the highest life expectancy levels in the world, at 82.9 years for men and 88 for women in 2020. Some are sleeping in dormitories and sharing bathrooms, while social worker numbers are dwindling as others are infected.

As of Tuesday, Omicron had found its way into nearly 87% of the city’s 800 retirement homes. And without enough spaces to properly isolate infected people, it continues to spread.

Officials said on Friday they would prioritize vaccinating older people within the next two weeks and transferring infected older people to isolation. Many care home operators say help cannot come fast enough.

“We have to race against time and Omicron,” said Stephanie Law, who runs several nursing homes in the city, adding that many of her colleagues feel exhausted and helpless. “We are losing.”

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