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The recent coronavirus fatality rate is around 0.098 per cent, according to several health experts. Photo: Xiaomei Chen

Coronavirus: row erupts over whether Covid is deadlier than flu, as Hong Kong’s health chief accuses experts of misleading public into thinking both are similar

  • Health secretary fires salvo on official blog, refuting experts who had challenged city leader’s claim the coronavirus was much deadlier than influenza
  • Infectious disease specialists estimated current fatality rate for coronavirus in Hong Kong was only 0.098 per cent, close to 0.1 per cent recorded for influenza
Hong Kong’s health chief has fired back at experts who claim the city’s leader is mistaken in stating Covid-19 is much deadlier than the flu, accusing them of encouraging the public to treat a pandemic that has killed nearly 10,000 residents far too lightly.

Medical specialists earlier put the city’s coronavirus fatality rate at 0.098 per cent, close to the 0.1 per cent recorded for influenza, but on Thursday Secretary for Health Lo Chung-mau took aim at what he called faulty reasoning.

Hong Kong health minister Lo Chung-mau. Photo: Felix Wong

“Simply comparing the Covid-19 death rate of 0.1 per cent since May this year with the average death rate of seasonal flu is making the serious mistake of selection bias,” Lo wrote on his official blog.

“It is ignoring the misfortune of the thousands of people who died from Covid-19, and misleading the public to take the pandemic lightly. If we are comparing apples to apples, Hong Kong’s influenza death rate since May is in fact zero.”

Hong Kong has recorded 9,836 deaths related to the virus since the first infections were detected in January 2020, the bulk of them during the fifth wave that began in December. Six more deaths were announced on Thursday, along with 8,187 new cases, including 164 imported ones.

Earlier in the week, Chief Executive John Lee Ka-chiu warned against equating Covid-19 with the flu and described the epidemic situation as still “critical”.

“People should not just think that Covid is a normal flu, because if you look at our figures we have lost 9,000 lives just because of Omicron, when every year we lose about 300 lives because of flu,” he said.

Lee maintained the coronavirus fatality rate stood at 0.6 per cent, but that figure was disputed by Dr Leung Pak-yin, a former chief executive of the Hospital Authority, who said it “failed to differentiate between this current wave and the fifth wave in February and March”.

“With the build-up of the immunity barrier in the community, the [Covid-19] death rate in Hong Kong since May has been similar to that of flu,” Leung said on social media.

Dr Leung Pak-yin, a former chief executive of the Hospital Authority. Photo: Nora Tam

Health chief Lo insisted on Thursday the pandemic was not as mild as seasonal influenza, citing facts and indicative data. Covid-19 was more transmissive, with a higher speed of mutation and better ability to evade immunity provided by vaccines or previous infections, he said.

More than 9,500 Covid-19 deaths had occurred during the fifth wave, Lo added, noting seasonal influenza had only caused between 211 and 812 deaths annually from 2015 to 2019.

The minister warned that children were twice as likely to be admitted to intensive care or die from the coronavirus than influenza, which also did not result in any long-term health conditions.

In disputing the city leader’s figure, Leung had explained Lee calculated the mortality rate by dividing the overall number of coronavirus-related deaths as of September 4, which was 9,511, by the total number of cases over the same period, which stood at 1,569,768.

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Leung said a more accurate number would be found by dividing the 356 deaths since May 15 by the 363,469 cases from the same period, which would put the mortality rate at 0.098 per cent.

The latest surge in infections started in mid-May, as officials relaxed several social-distancing curbs and cases declined to their lowest point since the fifth wave began, he said.

Another fact to consider was the surge was largely driven by the Omicron subvariant BA.5, instead of the BA.2 strain, which was increasingly reported during February and March, Leung argued.

“Analysing data has to be precise,” he said. “Death rates vary according to the mutation of the virus and the community infection situation.”

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Professor David Hui Shu-cheong, a government pandemic adviser, said the same, noting the recent coronavirus fatality rate remained low due to the prevalence of hybrid immunity among the population, referring to a level of natural resistance achieved through a combination of inoculation and past infections.

According to the latest government figures, about three-quarters of all eligible vaccine recipients in Hong Kong have taken the recommended three doses, while more than 90 per cent have received two shots.

Dr Joseph Tsang Kay-yan, chairman of the Medical Association’s advisory committee on communicable diseases, said the recent death rate could be lower than 0.098 per cent because of under-reporting of infections. He said it was pointless to include fatalities from previous waves, since different strains of the coronavirus, such as the more deadly ones, were involved.

Heath experts have said calculating the coronavirus fatality rate in Hong Kong requires breaking up figures according to different stages of the city’s epidemic. Photo: Sam Tsang

The number of related deaths per day in Hong Kong has remained below 20 for the past two weeks, while critical cases have hovered between 45 and 65, even when the daily infection tally passed the 10,000 mark.

Dr Albert Au Ka-wing of the Centre for Health Protection sided with Lo, saying that when calculating the mortality rate, one should look at the overall situation, rather than picking a specific season or time period.

Even influenza variants, which had triggered different waves of infections over the years, had different death rates, he noted, adding it would be inappropriate to simply take a certain period into account.

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Respiratory medicine specialist Dr Leung Chi-chiu said that while the figures for the flu and Covid-19 were similar, it was the result of “active intervention, and not the intrinsic attribute of virus or by lying flat”.

Such interventions included government efforts to boost vaccinations, earlier case detection and the increasing use of antiviral medicines to treat patients, he said.

Hong Kong’s Covid-19 tally stood at 1,682,896 infections.

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