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Published: 00:50, November 11, 2021 | Updated: 12:53, November 12, 2021
Controlled borders are a proven pandemic barrier
By Richard Cullen
Published:00:50, November 11, 2021 Updated:12:53, November 12, 2021 By Richard Cullen

The necessity for Hong Kong to open its borders and start living with COVID-19 is increasingly being urged from some quarters. International Chambers of Commerce based in the Hong Kong Special Administrative Region have argued this need, for example. And the international media, including CNN and The Economist, have recently run stories supporting the up-to-date wisdom, as they see it, of “living with COVID-19 ”. 

The Economist argued in mid-October that “China has decided it does not want to live with the virus”. This was odd as China’s top respiratory disease expert, Professor Zhong Nanshan, had, two weeks earlier, explicitly discussed the opening of China’s borders, stressing the need for very high vaccination rates to be fully achieved. He spoke about the process of living with COVID-19 in China once this was accomplished.

 The Economist also noted how other jurisdictions with zero-COVID policies had “moved to relax them”, while “China is holding out”. The clear tilt in such stories is that the likes of Hong Kong and the Chinese mainland are now, under this revised, media-approved, “relaxed” policy, somehow behind the times.

These narratives, explicitly or implicitly, advance the idea that the cited jurisdictions which have relaxed, have wisely done so after completing international, comparative due diligence. In fact, all the named jurisdictions that have moved to live with COVID-19 have done so primarily out of necessity. In Singapore, Australia and New Zealand, for example, the authorities lost control over the spread of COVID-19, despite their best efforts, after the arrival of the highly infectious Delta variant. The necessity of living with COVID-19 has since been re-presented, in a number of cases, as a virtue. 

The drawbacks of semi-closed borders are clear. ... These drawbacks are real but they are also selectively stressed. The wider, sustained benefits of the zero-COVID approach are very great indeed but because of a failure to pay comprehensive attention to the complete picture, they are largely overlooked — or taken for granted — by those preoccupied with opening up to many international jurisdictions

Even more starkly missing from most living with COVID-19 advocacy is a candid squaring of the ledger. Those taking this sort of position rarely, if ever, pay attention to the patent advantages Hong Kong has enjoyed from largely maintaining a zero-COVID policy for almost two years.

These benefits are exceptionally important.

Hong Kong has the longest life expectancy in the world, surpassing Japan. It has increased from 72 years in 1971 to 85 years in 2020. Studies that have looked at why this is so almost always note that wide access to good public health care is a key factor.

The total population living in low-cost, public rental housing in the HKSAR is still over 2.2 million. Those worst off, around 220,000 people, live in over 100,000 subdivided units. More than 1.4 million people, about 20 percent of the population, live below the poverty line.

Public hospitals and clinics handle millions of individual outpatient cases every year. More than 40 public hospitals provide around 30,000 beds — over 70 percent of the total. These services are always stretched — and waiting times are long for non-emergency illnesses. But this system does a vital job in looking after the medical welfare of Hong Kong’s huge low-income population. The work pressures on staff within these institutions are always very high.

Ask anyone who uses this system and they will grumble about waiting times; and confirm that over the last two years, it has continued to do its same often-unsung, extraordinary work. Without question, Hong Kong’s successful zero-COVID approach has underwritten the ability of this system to continue looking after its huge, vulnerable client base so well.

Here is a short thought experiment that helps add further perspective. Suppose Hong Kong had managed COVID-19 in the way the United Kingdom has — the UK was one of the first to begin living with COVID-19, after all. Hong Kong’s population is 11.4 percent of the UK population. Based on UK figures to date, one would expect to see, following the British approach, around 16,000 deaths and over 1 million COVID-19 infections in the HKSAR instead of 213 deaths and less than 12,500 cases. One further grim consequence of the huge pressure placed on the British National Health Service is the large numbers simply turned away from COVID-overwhelmed hospitals. Apart from doing such an exceptional job of protecting Hong Kong’s public health system from massive additional stress (not least on staff), the zero-COVID policy has arguably prevented many thousands of deaths and over 1 million infections. Lost sight of in much of the COVID-19 debate is that the right to life is paramount among all human rights.

There is no question that Hong Kong’s COVID-19 policies have been shaped by the primary need to open the border with the mainland, and this has reinforced the need to control movements into Hong Kong so strictly. This is, however, manifestly the most important border Hong Kong shares. In 2018, before the violent political upheaval began, over 50 million mainland visitors made up almost 80 percent of total arrivals (of 65 million). This is also the border that the vast majority of Hong Kong residents wish to see reopened as a priority. And for many professional expatriates residing in Hong Kong, this is also a crucial business border.


The drawbacks of semi-closed borders are clear. Extended quarantine periods, for example: make business significantly more difficult; have a clear adverse effect on separated families; and they add additional stress to daily life. These drawbacks are real but they are also selectively stressed. The wider, sustained benefits of the zero-COVID approach are very great indeed but because of a failure to pay comprehensive attention to the complete picture, they are largely overlooked — or taken for granted — by those preoccupied with opening up to many international jurisdictions. Influential American literary critic H.L. Mencken once observed that for every complex problem there is always a simple solution — and it is always wrong. 

My fellow commentator Ho Lok-sang recently noted that the Hong Kong government has faced many tough choices in dealing with the complexities of the pandemic (“HK’s pandemic situation demands tough choices”, Oct 26, 2021, published in China Daily Hong Kong Edition, https://www.chinadailyhk.com/article/244563). Getting the balance right remains challenging — there are no seamless answers. Full opening-up will come, however. In the meantime, a wide range of remarkable benefits have been securely banked — based on Hong Kong’s zero-COVID approach.

The author is a visiting professor in the Law Faculty of the University of Hong Kong.

The views do not necessarily reflect those of China Daily. 

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