Why Hong Kong’s coronavirus measures are out of proportion to the risk

Hong Kong officials’ obsession with reducing case numbers to zero means they have paid scant regard to society’s broader interests
There is no denying the global scale of the pandemic but, unless kept in perspective, the cure may be worse than the disease

Philip Bowring

Published: 6:15am, 24 Jan 2021

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“Lies, damned lies, and statistics” is an oft-used phrase to denote the misuse of statistics, be they wrong or misinterpreted. For the past year, we have been deluged on a daily basis with numbers – Covid-19 cases, deaths and hospitalisations – and then data about the fallout from lockdowns, school closures and attendant unemployment, government debt levels, etc.

Scary headlines about the number of deaths can be misleading if they are taken out of a broader context of past and present measures of health and mortality.

Let us start here in Hong Kong where we are well into another round of mitigation measures which will last at least through the Lunar New Year. During the past year, there had been 167 Covid-19-associated deaths at the last count. That is out of a total number of deaths for the period of around 49,000.

There is scant evidence to suggest that Covid-19 has raised the death rate. Indeed, the rate in the 12 months to June 2020 showed a slight drop compared with 2019 as a whole, at a time when death numbers are rising by 1 per cent to 3 per cent a year due to population ageing and increase.

It is not even clear how far Covid-19 was more than a contributory factor in the deaths attributed to it, given that many people were over 80. The numbers are anyway minuscule compared with pneumonia deaths – the second-largest cause of death after cancers. Like Covid-19, pneumonia mainly kills the elderly who are already weakened by other conditions.

Nor has Covid-19 been notably lethal in Hong Kong compared with the winter seasonal influenza – that killed 356 in 2019, more than Covid-19 did in a year. Of course, Covid-19 deaths would probably have been much higher without government-mandated restrictions and mask-wearing. But even then it is questionable whether they would have made a noteworthy mark on the overall, age-adjusted death rate.

Meanwhile, the longer-term costs in terms of loss of income and education, and treatment of other diseases, remains a worry for future generations – not the old folk such as myself who may have been saved from Covid-19 by the strict measures. Contrary to populist media headlines, not all lives are equal.

Nor are the death figures for Hong Kong unique. The Philippines has been notoriously unsuccessful in controlling the virus spread despite lockdowns. Headlines scarily report a 5.8 per cent rise in the overall death rate in Metropolitan Manila over the past year compared with the five-year average. Yet, for the first six months of 2020, the total deaths in the Philippines were less than in same period in 2019.

And, over the past five years, the total population has increased by 8 per cent and those aged over 65 by nearly 30 per cent. All statistics need context.

Britain appears to have seen a significant increase in death rates, which may not be surprising given the erratic government policies, unwise behaviour by many, and factors such as obesity rates and the numbers in care homes.

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But it has not been as high on the scare scale of “excess deaths” reported in most media, which compared the past year with a five-year average – during which time the total population increased by 3 per cent, and the number of those aged over 65 by 5 per cent.

For sure, lockdowns may have also reduced road and air pollution deaths but that merely tells us how little we normally care about other death threats relative to Covid-19.

The other health statistic usually ignored are the deaths, particularly in developing countries, from other well-known diseases. Tuberculosis kills about 1.5 million people annually, including many young people. Judged (as it should be) by years of life lost rather than crude death numbers, its impact is greater every year than Covid-19 over one year. Malaria’s 400,000 annual victims are mostly children.

Resistance to antibiotics is growing apace, resulting in thousands of deaths annually even in advanced countries. Hospital-acquired infections are one source. Yet the research effort given to new antibiotics is modest compared with the mobilisation against Covid-19.

An obsession with this virus leads to decision-making by bureaucrats led by virus experts with a single goal – reducing the daily case numbers to zero without regard for the broader interests of society. Idiotic decisions by the Hong Kong government include closing beaches and forcing restaurants to shut just as offices are closing, leading to crowded streets and public transport.

The three-week quarantine imposed on most arrivals is out of all proportion to risk and reveals a government determined to show Beijing how tough it can be, regardless of the interests of its own community.

Clusters in overcrowded districts have been blamed on ethnic minority practices, while illegally sacked helpers get no protection. All this from a leadership that has never been willing to make a concerted effort to clean the air, recycle rubbish, or end the unhealthy conditions in subdivided flats.

There is no denying the global scale of the pandemic and the suffering of those with serious and prolonged cases. But, unless kept in perspective, the cure may be worse than the disease and may cause untold mental health damage in particular.

Meanwhile, it should teach us about the importance of public health in general and the pre-emptive role of government in creating conditions which prevent or contain chronic as well as communicable diseases, long- and short-term health threats. The loyalty of Hong Kong’s administrators, its civil servants, should be to the population and society they serve, whoever is the supreme ruler.

Philip Bowring is a Hong Kong-based journalist and commentator