“S” was midway through his shift two Sundays ago when he was called to an isolation facility where an 18-month-old baby and her parents – all three of them Covid positive – had been admitted. The toddler was gasping, a high-pitched wheeze filling the negative-pressure room.
“The mum told me she had been like that for two hours,” S, a surgeon in a public hospital’s accident and emergency (A&E) department, said. “But no matter how hard she tried to call for help, nobody answered.”
The baby was taken to the paediatric intensive care unit, a transfer that S said should have happened “after two minutes or maximum 20 minutes, not two hours.” She was suffering from a respiratory illness that could have been life-threatening, he added.
Across Hong Kong, a raging Covid-19 wave has pushed medical facilities to a tipping point. As public hospitals become increasingly overcrowded, frustration has grown among frontline medics who said the government continues to stand by the same Covid-19 policy as two years ago, when little was known about the virus and vaccines were not available.
Under dynamic zero-Covid, politics first
Hong Kong’s fifth wave, fuelled by the much milder Omicron variant, has left frontline health workers scrambling – but not quite to the right places, some medics say.
Resources and manpower are being deployed from hospitals to isolation facilities for patients with minimal symptoms, while inconsistent government messaging has sent healthy Covid-positive patients rushing to emergency units, causing days-long waits for those needing urgent attention.
“People have developed more severe illnesses because they didn’t get the care that they could have,” S said, speaking to HKFP from home isolation after testing positive for Covid-19. He asked to remain anonymous.
Frontline medics told HKFP that the devastation was a result of the city’s zealous pursuit of dynamic Covid-zero, an approach that appears embedded in politics.
Chief Executive Carrie Lam said in January that the dynamic Covid-zero strategy was mainland China’s “requirement,” while state-run media has called the policy – of detecting all potential infections and quarantining them – the “scientific choice” for the city of 7.4 million.
“Everything from vaccination to our zero-Covid policy to the way we triage patients, all of those things have a lot to do with politics,” WK Wong, an internal medicine resident who used an alias, said.
Since the virus emerged, the government has attempted to hospitalise every Covid-19 patient even if they are asymptomatic. That has proved impossible in the face of tens of thousands of daily cases.
But with citywide compulsory testing planned for March, anti-epidemic teams from mainland China are building nine “community isolation and treatment facilities.” The first, in Tsing Yi, began admitting patients on Tuesday. It provides 3,900 beds and caters to those with mild or no symptoms.
“There’s no reason to waste so many resources and manpower to lock these people up,” said “C,” an A&E doctor. “They can essentially live at home.”
Asked whether all the facilities will only admit healthy patients and if doctors will be stationed there, the Hospital Authority (HA) told HKFP on Monday to ask the “relevant government departments.” It did not say which departments those would be.
After following up, the HA confirmed on Wednesday that it “has established a medical post in the new community isolation facility in Tsing Yi to support the medical needs of citizens under isolation arrangement.”
In response to a question from HKFP posed during Wednesday’s Covid-19 press briefing, the HA Chief Manager (Integrated Clinical Services) Larry Lee said that “ill patients” would be hospitalised, but the “community treatment facilities” can “look after cases in between [patients with mild and severe cases of the virus].”
It is unclear how many of the nine premises will be used for healthy patients and how many will cater to those “in between.” On Friday, authorities said a new facility at the Kai Tak Cruise Terminal will admit elderly with mild symptoms.
Lee also said that the Hospital Authority would deploy doctors to the facilities. He did not respond to a question about whether this would reduce manpower at hospitals, but said the government would consider recruiting private care doctors on an ad hoc basis.
Meanwhile, C said some non-frontline medical staff – including surgeons and orthopaedic doctors – had already being sent to Asia-World Expo and North Lantau Hospital Hong Kong Infection Control Centre, which admit stable patients.
The transfer of doctors to these makeshift facilities, he said, could worsen the crippling manpower shortage.
“They could otherwise be deployed in hospitals and actually care for severe cases,” C, who also requested anonymity, added.
A climate of fear
Public hospitals are overwhelmed as they are, and a steady flow of people testing positive for Covid-19 and turning up at emergency departments – but who do not require attention – is adding to staff’s heavy workload.
At any given time, C said, “around one-third” of those who come to his hospital “don’t really have to be here.” The Fire Services Department, which runs ambulance services, has urged the public not to dial 999 if they are not severely ill.
“People in Hong Kong are genuinely scared,” C added. “Hong Kong and China have hyped up the scariness of Covid. Not saying it’s not scary, but the fear should be proportional to what’s happening.”
Since the pandemic began, health authorities have held near-daily press conferences announcing the number of new Covid-19 cases and deaths. But less focus is given to emphasising that many experience minor symptoms or are asymptomatic.
“This panic is absolutely unnecessary,” S, the surgeon, said, adding that he thought the government and health experts were “fearmongering.”
The government’s contradictory messaging has compounded anxiety, medics say. On February 7, the Hospital Authority advised those who test positive via a rapid test to go to a hospital to take a nucleic acid test. Two days later, the official body backtracked, appealing to the public to stay at home as hospitals were overwhelmed.
Frontline medics that HKFP spoke to said there is a general consensus among their colleagues that the “dynamic zero” policy is unsustainable – but their hands are tied.
“We voice [our views] to our boss. They say they’ve voiced them to their boss,” C said. “But there’s no way to change the overarching government policy.”
In recent weeks, Hong Kong authorities have welcomed teams of experts from mainland China to help the city battle the outbreak. The most high-profile arrival was Liang Wannian, one of the architects behind the mainland’s dynamic Covid-zero strategy.
But Wong, the internal medicine resident, is critical.
“Telling people that we have mainland teams coming to help you, all these take the focus off what we should be doing right now, to help the people who need the most care,” he said.
As Covid-19 infections continue to mount, it has become increasingly clear that the Covid-zero strategy is untenable, Wong said. Epidemiological modelling from the University of Hong Kong has predicted a peak of 182,900 daily cases this month, while the city’s coronavirus death rate – with most of the fatalities being unvaccinated elderly – is believed to be the highest in the developed world.
The government had over two years to prepare a robust Covid-19 response, Wong said, but did not deliver.
“It was always a very stupid idea to think we could have zero Covid forever,” Wong said. “I think we’ve had a lot of very stupid decision making by the government and health authorities.”