The government’s COVID management strategy, based on zero infections and voluntary vaccination, is dead. I want to be clear here, not “struggling” or “under pressure”, but dead as the Dodo.
The numbers are conclusive. From the outset once effective vaccines were available the aim should have been for 50,000 first jabs per day. After three weeks, a million part-vaccinated people would be in the pipeline. The pace could then have been stepped up to 100,000 per day, split evenly between first and second shots. By now we would have reached herd immunity.
Hong Kong has never achieved anything remotely close to these numbers. Our best was a brief flurry in the 70-80,000 range. We are now down to a little over 20,000 first doses a day which means the pipeline is dwindling.
The result is plain for all to see. As at the end of last week Hong Kong had achieved 46 per cent fully vaccinated and a further 10 per cent with first jab, making a total of 56 per cent. The equivalent figures for Singapore were 78, three and 81. In its most recent announcement the government reported 60 per cent of “eligible” persons had been vaccinated. The qualification is understandable but as far as the virus is concerned, everyone is eligible. Bearing in mind efficacy varies between the different vaccines, we need a weighted average somewhere in the high 80s to achieve adequate community protection.
It is clear from the above numbers and slow-down in first jabs, that a significant percentage of Hongkongers have resolved not to get vaccinated. Under present policies, we will never reach herd immunity and resume normal life.
There are two urgent priorities: new cogent measures to drive up first vaccinations; and booster shots for those already jabbed.
As regards achieving a step change in vaccination rates, we need a combination of sticks and carrots. As regards incentives, what on earth persuaded us to give $5,000 consumption vouchers to everyone no strings attached? The milk of the first $2,000 is spilled, but let us not make the same mistake with the next two instalments. To further reward the fully vaccinated, how about allowing them to go out mask free one day per week, everyone else to stay home and hide in shame.
Now for the sticks: everyone entering Hong Kong should be fully vaccinated on arrival, and that includes the 40,000 already exempt from quarantine. People who arrive unvaccinated should get their first jab on landing and the second at the end of the 21-day quarantine period. All medical personnel must be vaccinated as a condition of their being licensed to practice. Everyone seeking to employ a domestic helper must produce vaccination certificates for all adults in the household. There are still thousands of unvaccinated civil servants. The government should follow the example of some employers in the private sector: no promotion or bonus for those not vaccinated. The equivalent of bonuses for the civil service would be annual increments. Make their award conditional.
The private clubs have done a good job with getting staff vaccinated in order to support government efforts. How about a clear signal from the government that they should extend the requirement to members as a condition of entry to club premises?
Other levers are available wherever citizens interact with the government. You want a passport? Vaccination certificate please. Same for driving licences.
The government is reported to be considering making vaccination a requirement for entry to nightclubs, bars and restaurants. These are obvious targets and the measure should be implemented immediately. But what about patrons of public sector facilities. Every day, thousands of unvaccinated people turn up for free or highly subsidized treatment at government clinics and Hospital Authority hospitals. They expect to draw on community resources to fix their health problems. That is reasonable because a healthy citizenry is a benefit to society. In return it would be reasonable to require that they contribute to the overall health of society by rolling up their sleeves.
Just as important as individual measures to drive up vaccination rates is the need for a clear articulated strategy informing people how we are going to live with COVID in the long term. And a timetable for how we intend to implement that strategy. One reason so many people remain unvaccinated is that we have basically achieved zero spread in the community. They have no sense of danger and are willing to ignore the negative impacts on others.
For example, the international business community is hamstrung as staff movements become virtually impossible. People can leave, but no one is willing to stomach the three weeks incarceration on return, or first posting. Children in schools are now starting the third academic year of disrupted education.
We need to change the narrative by announcing dates for social distancing measures to be relaxed and for quarantine restrictions to be phased out. Limits on social gatherings should be reduced in time for Christmas and withdrawn by Chinese New Year. Quarantine to be reduced to 14 days from November. Cut to seven in December, then eliminated in the new year.
There will be complaints that we are inviting a new wave of infections, and there will be an increase in locally transmitted cases. But the longer we delay in reaching herd immunity the more chance of new mutations. We have already seen from the Delta variant how dangerous this could be. The case for booster shots is now becoming overwhelming as there are reports of lower antibodies after several months. There are some suggestions that the booster should be of a different type of vaccine from the individual’s first round. If that theory needs to be subject to a controlled trial, then so be it, I am happy to be in the first tranche.
The point is we need to call a halt to this endless drifting, and get on with the job, or better yet, jab.