As our Editor sits in the air-lock waiting to re-enter HK, he looks at the now-unconstitutional quarantine regulations and the harm they are doing to HK.

HK is running out of time to re-join the World
5 May 2022

When, early on 20-Mar-2022, I left HK for the first time in over 2 years, daily reported local COVID cases were already down 85% from the early-March peak above 56k. As I gingerly set foot into the no-way-back Orange Zone of the airport, I was making two bets: first, that the insane flight ban from 9 countries would be lifted, avoiding a 4-week "washout+quarantine" journey home to HK; and second, that by the time I had to get home for my next cancer treatment, COVID would be endemic in HK and the quarantine regime would be history.

Well, I got the first bet right; the next day, the Government announced that it would lift the 9-country flight ban on 1-Apr. However, on the second bet, here I am six weeks later, writing this from a quarantine hotel, for reasons that have nothing to do with public health.

Yes, the Government did shorten quarantine to 7 days, mirroring the discharge period for infected residents and their close contacts if they are RAT-negative on days 6 and 7. That removed the anomaly we noted on 26-Feb, that an arriving passenger who tested positive could be discharged in 7 days while one who tested negative throughout had to quarantine for 14 days. But quarantine is still captivity, and it still has to be in hotels, despite the COVID outside them, while close contacts of local cases can isolate at home if living conditions permit.

Daily reported case rates are now down to just a few hundred and will bump along there despite relaxations of social distancing. The virus is running out of soft targets as most residents are well-vaccinated and/or inoculated by infection. For the latter, almost all of them were infected in the 5th wave and are brimming with antibodies. So it is patently obvious that we are ready to open our international border. Inbound quarantine can no longer be justified on public health grounds, which was the legal basis for such Regulations being made under the Prevention and Control of Disease Ordinance (Cap.599).

There is also the small matter of constitutionality if, like myself, you want to uphold the Basic Law. HK residents have a right of return under Basic Law Article 31, and that right is infringed by the testing and quarantine requirements. Rights are not absolute, but any infringement must satisfy a proportionality test, being rationally connected to a legitimate objective and no more than is necessary to achieve that objective. With COVID now endemic, the Quarantine Regulations now crash into the second hurdle - they no longer protect HK public health. Even if HK reaches COVID-zero again, with so many people vaccinated and/or inoculated, the harm of Quarantine Regulations to individual rights is disproportionate to the societal benefits of avoiding COVID cases indefinitely (for the nitty-gritty, see Hysan Development v Town Planning Board, 2016).

Laws aside, the only policy reason for maintaining inbound quarantine is to reach zero-COVID so that (the theory goes) the Mainland will allow HK people to enter the Mainland without quarantine. But for HK people, that's a matter of convenience, not public health, and in any case it remains theoretical because for the last 7 months of 2021, HK had zero local cases and despite that, the Mainland refused to open the boundary. Now, the Mainland is fighting its own outbreaks, and if HK reaches zero then it would risk infection by opening the boundary anyway.

As I sit here, triple-vaccinated and in quarantine after my voyage from the outside and increasingly-free World, the futility of all this is very apparent. The World has moved on. Neighbours Singapore and Malaysia no longer require tests or quarantine for vaccinated travellers to enter. Rightly they have realised that testing people to enter a population where COVID is endemic is pointless. Before COVID, most countries never required negative measles, flu or HIV tests as a condition of entry. Some countries, including UK and Denmark, don't even require proof of COVID vaccination to enter; you swim in the sea at your own risk.

"But what about keeping out new strains?", some ultra-conservative "experts" say. Well, if we took that approach then we would never open up. COVID is very likely to be around in variations forever, as influenza is. Only one virus in humans, smallpox, has ever been eradicated (also, rinderpest in cattle). This is not a reason to stay closed, and improving vaccines and treatments will mitigate the risks.

We must accept that the Mainland, for its own multiple reasons, not least the political capital the leadership has attached to "Dynamic Zero", is not yet ready to open up, despite the increasing socio-economic costs of lockdowns. The difference with HK is that the Mainland has not experienced a full-blown COVID exit wave, while HK has. The majority of our surviving elderly are either vaccinated or were inoculated by infection during the 5th wave.

Even among the over-80s, a cohort of about 391,400 people, our daily vaccination chart shows that 65.5% have had their first vaccine dose, while 83.0% of the 70-79 group have had their first dose. You can bet that a significant portion of the unvaccinated elderly are either recovering from COVID after it swept through care homes, or are too ill with other diseases to be vaccinated anyway. The Government can no longer hide behind that human shield as a reason to keep HK off the map.

For HK, remaining closed amounts to tying us to an unsustainable short-dated strategy. Even the Mainland will eventually have to open. As the only Chief Executive candidate John Lee said last week, "COVID-19 will pass no matter what". There's no reason for HK to hold itself back after its people have been through so much. We should open our international border, and start using that 3-runway airport and cruise terminal again, without quarantine and regardless of vaccination status. The Mainland will catch up when it is ready, but we cannot afford to be left behind by the rest of the World.

With no end in sight, "Asia's World City" has become "Asia's Isolated City", to the benefit of our regional competitors. Once talent and corporations make a decision to incur the extensive costs of relocation, we can't expect them to incur those costs again and return. Not least, that's because past governmental behaviour is a guide to the future. If HK lacks the "high degree of autonomy" to do the right thing for its residents and businesses on this occasion, then we must assume that HK will follow mainland strategy in future pandemics, wherever they begin, and isolate the city again.

As a former COVID-zero city, Singapore in many ways has set the gold standard for emergence from the pandemic: clear messaging from the Premier to the people (examples on 9-Oct-2021 and 24-Mar-2022), early purchase of the two MRNA vaccines, and a road-map to opening which incentivised vaccine take-up. Setting aside all the other factors, which place will growing corporations entrust with their regional headquarters in future?

Outgoing Chief Executive Carrie Lam could at least do one last thing to at least partially redeem the "huge havoc" in her wake. Stop the quarantine, Carrie, and let the World back in, before it is too late.

David M Webb

©, 2022

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