What next?

For the third day in a row, there are no new COVID-19 cases in Hong Kong.  Things already seem to be returning to normal, with more people out and about at the weekend.  The rules on restaurants capacity have been removed, but tables are still supposed to be 1.5 metres apart (or with a physical barrier to separate people).  Bars are still closed.

According to the FT, most government services will resume next week and outdoor sports facilities and libraries will reopen.  Ah, here it is in the HKFP: Coronavirus: Majority of Hong Kong gov’t staff to return to work next Monday

This is a rather good summary (from David Webb):

COVID-19: where do we go from here?

Hong Kong is now at or close to zero local transmissions. The latest known local transmission was probably case #1026 inside HK Airport, a 47 year-old Virgin Atlantic ground crew member, probably infected by an arriving passenger from the daily UK flight. She recalls coughing on 6-Apr but she didn't visit a doctor until 14-Apr and was confirmed on 19-Apr. There were 3 cases on the Virgin flight on 6-Apr but then none until 12-Apr, so given an incubation period, it is more likely that she was infected on 12-Apr. Not all coughs are COVID-related.

Outside of the airport, the last known transmission was case #1008 reported on 13-Apr, when he was asymptomatic but already in government quarantine, because he is the 66 year-old father of case #884, who had symptoms on 30-Mar and was confirmed on 5-Apr. That means his father caught the virus on or before 5-Apr and was then placed in quarantine.

Webb thinks that people from Mainland China will be allowed into Hong Kong before long.  This afternoon it has been announced that the current restrictions will continue till 7 June, but “cross-border teachers and students, and people whose business activities are ‘beneficial to Hong Kong’ will be allowed to enter Hong Kong without having to undergo 14 days of quarantine.”  [RTHK]

This all sounds quite positive, but it’s not long ago that Hong Kong and Singapore were being used as examples of how to handle COVID-19.  Unfortunately Singapore now has 15,000 cases, mainly migrant workers living in dormitories. 

And now a rant…

My problem with much of the reporting on COVID-19 is that it can be difficult to see the "big picture".  For example, the front page of The Guardian (right) seems to have been designed by someone who wants to draw attention to 14 different blue-coloured panels (all with COVID-19 stories).  Can they all be really important?

Cold hard maths

Paul Christensen posted a comment and directed my attention to something he had written in the SCMP

The cold, hard maths of whether a coronavirus shutdown is worth everyone’s loss of quality of life

Do the benefits of the Covid-19 economic shutdown justify the costs? This is a fundamental question that governments need to address, and they should address it explicitly, regardless of how uncomfortable it may make people feel.

In his comment he said that “Much more rational analysis is needed on whether the years of poverty that will result for many people from this lockdown are worth the lives saved.”

Rational analysis like this?

An argument for lockdowns is that the alternative would be an overloaded hospital system. But this shouldn’t be a factor that overrides all others.

There is no doubt that a rigorous triage system could be put in place to keep the hospital system functioning for cases where larger numbers of QALYs are at stake. If society keeps running, then the government could spend the tax revenue it receives on expanding hospital capacity so that fewer hard decisions have to be made when, say, Covid-25 comes along.

Yes, sure, a rigorous triage system would solve the problem.  

And after a few thousand (mainly old) people had died we'd definitely spend more money on hospitals and facilities and nurses so we’d be ready next time.

No, of course we wouldn’t.  Both in the US and the UK (and elsewhere, no doubt) there have been exercises done to test readiness for a pandemic.  And governments have decided not to spend the money needed to be fully prepared.  Hospitals in the UK were running at close to full capacity when it is recommended that they should be operating at around 85% in order to be able to handle any emergencies.  That, of course, is because of lack of money.

Currently hospitals in most developed countries are just about coping, but many staff are exhausted from over-work, and tough decisions have to be made about who can be transferred to Intensive Care.  

This is with lockdowns in place.  What would it be like without them?

Lockdowns aren’t just needed to ensure that hospitals will be able to handle the outbreak.  There’s also the hope that better treatments can be identified and a vaccine can be found (and progress seems fairly encouraging on both fronts).

Paul Christensen seems to be getting carried away:

The current restrictions on economic activity are condemning many thousands of people who had basically comfortable lives to years or decades of poverty. There may be significant increases in suicide, divorce and domestic violence rates as people are cooped up to an unprecedented degree in small living spaces

Decades of poverty?  Restrictions apply to a relatively small part of the economy.  We are talking about Hong Kong here, aren’t we?

[To summarize what I wrote in my response by Paul's comment, I accept that some people will suffer significant hardship from the lockdown (UK) / restrictions (HK).  But the solution to that is not to accept more deaths it's for the government to make payments to people who lose their jobs.]

And Hong Kong apartments are definitely small, but we don’t have a lockdown and the only people who can’t go out are those who are in quarantine.  Those social problems are real, but they existed before COVID-19 and they will be there afterwards.  The impact of a few thousand people being in quarantine for 14 days is not really significant.

Certainly the restrictions everywhere will be eased in the coming weeks and months and maybe Hong Kong (and Singapore) offer a template for how it can be done:

‘Suppress and lift’: Hong Kong and Singapore say they have a coronavirus strategy that works 

Despite setbacks, Hong Kong’s and Singapore’s targeted strategies for fighting COVID-19 may yet succeed—and provide a model for other countries emerging from their first wave of cases.

Day 80

In the last three weeks the number of COVD-19 cases in Hong Kong has increased from around 270 to 1,001.  That sounds a bit scary, but other countries have seen much larger increases over the same period (25x in US, 15x in UK).

The biggest factor by far has been the large number of people who returned from overseas, but there have also been “local” cases in Lan Kwai Fong and karaoke bars. 

The government has responded in typically haphazard manner.  Our great leader Carrie Lam Cheng Yuet-ngor wanted to ban the sale of alcohol because “people get intimate when they’re drunk.”  Hemlock explains that this was a typical over-reaction to a specific case of a “super spreader”.  It’s a Hong Kong thing, to be sure, but we still have to take off our shoes for airport security checks in some countries because of one failed terrorist incident nearly 20 years ago. 

Oh, and don’t be fooled by this headline (from news.gov.hk) CE explains alcohol sales ban - she doesn’t.

It took a few days for the government to figure out that they actually needed to close bars and pubs because, er, large number of people gathering in small spaces will spread COVID-19.  

They also ordered Karaokes, clubs, and mahjong parlours to close but it took longer to get round to beauty parlours.  Cinemas have also been ordered to close, even though they had already blocked alternate rows and were a long way from being full. 

More sensibly, restaurants have to keep tables 1.5 metres apart and no more than 4 people can sit together.  That’s obviously a rather arbitrary set of rules that works better in some places than others, and there have been suggestions that police have been rather over-zealous in applying this in “yellow” restaurants, but the basic idea is sound.

It seems inevitable that the restrictions will be eased based on the number of cases and then re-imposed (or possibly tightened) based on evidence of where it is spreading.

Visitors are also banned from Hong Kong and residents have to go to quarantine camps or “self-isolate” for 14 days after arrival.

Meanwhile, the rest of the world is slowly coming round to the idea that wearing masks might be a good idea.

• Asia may have been right about coronavirus and face masks
• The Spanish government plans to hand out facemasks at metro and train stations from Monday as some non-essential workers begin returning to their jobs.
• In Austria, masks are being given to people as they enter supermarkets
• The CDC is suggesting people wear home-made masks

Of course, masks are just part of the solution, but it’s hard to see how anywhere can properly emerge from lockdown without them.  “Social distancing” simply isn’t practical if you have large numbers of people in public places.

And, of course, there are other benefits: Hong Kong’s coronavirus response leads to sharp drop in flu cases

Not normal

Three weeks ago Hong Kong had around 100 cases of the Coronavirus, and only a handful of new cases each day.  The trend looked much better than in many other countries (with typically around 33% daily increases)

Recently the daily increases have been more dramatic (15% on 18 March, 23% on 20 March), mainly because of people returning home from overseas.  But there have also been more locally transmitted cases, presumably because people had become a little complacent.  Most notably there have been photos circulating of large crowds in Lan Kwai Fong (mainly expats) with no masks in sight.   

There’s no doubt that people who stayed at home during the early days of the outbreak are going out more.  However, things are certainly not back to normal - the MTR are still running trains less frequently (and they are still less crowded than normal).  Many shops are opening later and closing earlier. 

Bars are still open, cinemas are mainly still open (but only alternate rows of seats are available for purchase, and there aren’t many customers).  One chain of gyms has closed temporarily, and the public sports facilities that had been re-opened a few weeks ago are closed again.  Libraries are also closing again.

So, life in Hong Kong is still much more normal than in many other large cities worldwide.  But not looking as good as it was 3 weeks ago.

Masks

About 6 weeks in, we are now up to 100 total cases of Coronavirus in Hong Kong.  We haven’t experienced any dramatic increases in cases, but neither is there any sign of it going away. 

The “panic buying” of rice, toilet rolls and cleaning products seems to have passed, and the supermarket shelves are full again.  Shops and restaurants seem to be a little busier than before, but life is clearly not back to normal. 

Everyone here is still wearing a face mask when they are in a public place, even though this is apparently a bad thing: 

'Seriously people - STOP BUYING MASKS!': Surgeon general says they won't protect from coronavirus

The Centers for Disease Control (CDC) does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19.  “Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others."

Coronavirus: can face masks protect you from catching deadly virus?

Dr Jake Dunning, head of emerging infections and zoonoses [infectious disease spread between humans and animals] at Public Health England, told The Independent that there is “very little evidence of a widespread benefit” in members of the public wearing masks.

Ah, yes, the “deadly virus”. 

Want to avoid the coronavirus? Forget face masks, top airline doctor says

David Powell, medical adviser to the International Air Transport Association, says masks and gloves do a better job of spreading bugs than stopping them.  “There’s very limited evidence of benefit, if any, in a casual situation. Masks are useful for those who are unwell to protect other people from them. But wearing a mask all the time will be ineffective. It will allow viruses to be transmitted around it, through it and worse still, if it becomes moist it will encourage the growth of viruses and bacteria.”

And yet…almost everyone in Hong Kong is wearing a mask and the Coronavirus outbreak seems to have been contained.  Plus, there has been a huge drop in cases of Influenza (and similar infectious diseases).

Is it just the masks?  Clearly not.  People are staying home more, and taking greater care with general hygiene (lessons learned from SARS).  This addresses one of the common concerns about masks - that they make people complacent about the risks (much as wearing seatbelts  encourage dangerous driving). 

They’ve been doing this in Japan for a very long time, where it’s considered polite to use a mask when you are sick, and totally acceptable to wear one to try to protect yourself.  It was fairly unusual to see them in Hong Kong before SARS, but ever since they have become commonplace - and rumours of a SARS-like disease in Wuhan caused people to stock up on masks. 

Surely it isn’t a coincidence that Hong Kong has (so far, at least) avoided any major spike in cases.  We have seen how quickly it can spread (in South Korea, more recently in Italy and Iran, and the awful case of the Diamond Princess - where it seems that the lessons of Amoy Gardens weren’t heeded).  Wearing a mask and taking a few other simple precautions is just common sense.

But, people, don’t move your mask down below your chin. 

Just a travel agent

Relatives booked flights to Hong Kong on a Very Famous Hong Kong Airline (VFHKA). 

Next we booked a package (flights and hotels), also with VFHKA - so that we could all go together to another city in Asia. 

Then last week VFHKA cancelled relative’s flights to Hong Kong, so we have to cancel the package.  I called VFHKA and provided them with all the details and told them we need to cancel.

When I finally got through, the conversation went something like this:

VFHKA:	Yes, that’s OK, but there’s a 50% cancellation fee.
Me:	But your airline cancelled the flights to Hong Kong.
VFHKA:	We are just a travel agent.
Me:	But…..it’s the same company!
VFHKA:	No, we are a separate company within VFHKA group.
Me:	(laughs)   (gets a bit shouty)  (calms down)
VFHKA	Sorry, this is company policy.  There’s a 50% cancellation fee.
Me:	Can I speak to your supervisor?
VFHKA	OK (long wait).
VFHKA	We’ll call you back later.

So the next day we had another call.  Some “highlights’:

VFHKA:	We didn’t cancel the flight to (Asian City).
Me:	Correct, but this is a family holiday.  If they can’t get to Hong Kong we can’t all go to (Asian City).
VFHKA:	Can you give me the flight details?
Me:	I did give you all this information yesterday, but, sure, I can read out this random collection of letters and numbers one more time.  Hang on, is that a ‘B’ or a ‘5’ in the Booking Reference?
VFHKA:	Yes, that’s the same people.  We need to check with the airline and the hotel.  We’ll call you back.

They did call me back, but still only partial success.

VFHKA:	We can give you a full refund for the hotel but there will be a cancellation fee for the flights.
Me:	But your airline cancelled the flights to Hong Kong.  We only need to cancel this package because of that!
VFHKA:	I need to check with my supervisor.  We’ll call you back.

Of course after all this nonsense they did call me back and offer a full refund (though it will take 4-6 weeks).  

I suppose it’s not really any worse than most so-called “customer service” in Hong Kong.  If you are persistent you can probably get what you want, but you need to wait for your call to be answered (and listen to the repeated announcements that most things can be done on the website).

Having said, it’s a special kind of audacious for them to claim that they are “just a travel agent” when (amongst other major clues) bookings are made through exactly the same website as the airline.  That’s a very high standard of disingenuous nonsense.     

We are just a travel agent.  No you’re not.

2019-nCoV

Hong Kong streets and shopping centres are strangely quiet and traffic is light. 

Yes, we’ve been here before, but last time (just a couple of months ago) it was the protests whereas now it’s Novel coronavirus (2019-nCoV). 

Many local people are choosing to spend more time at home (with some employers telling staff not to come into the office), there are far fewer visitors from the Mainland, and Carrie Lam has said that Hong Kong’s Foreign Domestic Helpers should stay at home on their one day off every week.  That’s fair, right?  

There have been long queues in supermarkets, with some panic-buying of food and cleaning products.  As far as I can tell, although some food items are temporarily unavailable at times, there are no actual shortages (so far).

Surgical masks are a different matter.  They started disappearing off the shelves in early January and now there are long queues for any that become available, and some crazy prices in less reputable pharmacies.

Alcohol hand rub is also very hard to find (even Cathay Pacific seems to have run out). 

It’s a sensible precaution to wear a mask on public transport and in shopping centres (or anywhere that is crowded), but in the last couple of days I’ve even seen people wearing them outside in places where it would be almost impossible to be in close contact with anyone for more than a few seconds.

But we all remember SARS, and so it’s totally understandable that’s there’s an excess of caution.       

The New York Times has a timeline here: As New Coronavirus Spread, China’s Old Habits Delayed Fight

Boiling the frog

In the early weeks of the protests, damage generally got cleared up very quickly so everything could return to normal.  MTR stations re-opened the next morning and services ran normally.  Damaged traffic lights were repaired within a few hours.

By September, things had changed.  The MTR started closing stations near to protests (both planned as well as ongoing).  In October large number of shopping centres were shut, which made life very inconvenient.   

Then we moved to the next phase. 

• The whole MTR network closed early every night. 
• There were large signs to say that MTR facilities had been vandalized (even when actually they were still working).
• Traffic lights were left unrepaired, often causing gridlock and extensive delays.
• The Festival Walk shopping centre in Kowloon Tong has been completely closed for weeks, and damaged facilities in other malls have been repaired very slowly.    

Presumably the idea was that the silent majority would blame the protestors.

That didn’t work.

However, the reality is that the government has the power to do whatever it chooses, and Hong Kong people can’t do much about it.

The proportional voting system for the Legco elections, coupled with the large number of legislators who are not directly elected, mean that it is unlikely that opponents of the government could ever get a majority.  And we have seen that there an endless number of ways that Legislators can be disqualified, and by-elections can be delayed indefinitely, further reducing the ranks of the opposition.

On top of that, many large companies in Hong Kong are reluctant to do anything that might offend the PRC government.  Early in the protests Cathay Pacific was the most prominent example (mainly because of their subsidiary Cathay Dragon), and the MTR is not only 75% owned by the HK government but it also operates the Shenzen Metro (and parts of other metro system in the PRC). 

If Hong Kong people can’t effect change by marching in vast numbers, by the protests, or by voting, what is left? 

Well, the Hong Kong Institute of Asia-Pacific Affairs (at the Chinese University of Hong Kong) say that 42% of Hong Kong people want to emigrate (pdf), up from 34% last year

Over 3 million are entitled to the currently useless BNO passport (which looks like a British passport, but doesn’t give the holder the right to settle in the UK, which is quite some limitation).

There is the possibility that the British government might do something about that.  However, Foreign Secretary Dominic Raab (did someone say “useless”?) apparently thinks that might “antagonize China and fall foul of the ‘one country, two systems’ approach”.  

That could be very annoying for the PRC government.  Troublemakers leaving, to be replaced by an inexhaustible supply of shiny new citizens from the Motherland.  Yes, that would be a bad outcome, definitely.

Of course there are plenty of others here with real passports for Australia, Canada, New Zealand, the United States, and, yes, the UK.  Many of these were acquired back before the Handover when prospects looked bleak. 

But the handover went smoothly, and the talk of Chinese troops being sent in to quell the protests has (at least so far) proved to be nothing more than rumour.

The story of the last 22 years has been of Hong Kong slowly becoming more like Mainland China.  Putonghua (Mandarin) is now widely used, and there is a quota of 150 “one-way permits” per day for PRC citizens to settle in Hong Kong.  That’s 50,000+ per year, and more than one million since the handover in 1997.

On top of that, many thousands come to Hong Kong for the day, and they are very important for the retail sector.  In fact, one of the biggest economic impacts of the protests was the absence of those visitors. 

Which might help to explain why building fences to protect the railway (see right) is a higher priority than repairing traffic lights.

Exit Sainsburys, enter Monoprix

Marketplace by Jasons (your actual upmarket Wellcome) started stocking Sainsburys products less than three years ago (early 2017). 

It doesn’t seem to have been a big success. According to this link, they now only stock 10 of their fresh and frozen products, and only 100 items in total (compared with at least double that in 2017).  

The good people at Dairy Farm (owners of Wellcome, Market Place, Olivers and 3hreeSixty) have moved on, and are now seeing other foreign retailers: 

• French cheeses, meats and, er, pasta from Monoprix (France) at better prices than the disappeared Sainsburys products
• and IKEA meatballs, salmon, etc.  Yes, really.  But not so surprising when you realize that Dairy Farm operate the IKEA stores in Hong Kong.

Meanwhile, ParknShop have started stocking products from Woolworths (Australia), and of course they also have been selling French and British supermarket brands (Casino & Waitrose) for quite a long time.        

ParknShop do seem to be making rather tentative attempts to develop their own brand, Food Nation (including those “Special Offer” eggs).  But for now, both they and Wellcome seem to have far more faith in other retailers’ own brands than their own.

ParknShop - hundreds of good things

Special offer!

Half a dozen eggs for HK$35.90

Or a dozen eggs for HK$62.90

Or a special offer of HK$38 for one carton.

Or there’s this mysterious item:

Who doesn’t love a Data Error?  So good they named it twice.