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HK Covid-19 policy long game - endemic?

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  1. #1

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    HK Covid-19 policy long game - endemic?

    Given how there have been first signs of changing policies in many months - namely that covid positive patients can now home quarantine for 14 days after testing due to shortages in space for Penny's Bay, it's interesting to see how the government will (or will not) change policy in the coming months.

    It's evidently unsustainable to send every single possible close contact to an isolation facility for 21 days especially with Omicron R0 reproduction rate of 6-8, as a mere 4 generations of spread will lead to thousands of infections and possibly tens of thousands of close contacts. As more mutations are likely to surface in the coming months, covid is increasingly likely to turn into an endemic where it would be highly unpractical (if not outright impossible) to keep this virus out of 7+ million people. A flare up of 10 cases can no longer ground a city to a halt - closure of bars, ban in evening restaurant dining, gyms and recreational facilities closed etc.

    Small businesses can weather temporary disruptions (i.e. 2-4 weeks emergencies), but it is a huge ask to ask small businesses to stay afloat as we are approaching the 24th month of covid in Hong Kong. This idealistic pursuit of covid-zero to appease the powers up North is unsustainable, even they are having issues containing it themselves. Does Hong Kong idealize to become Xian style of governance in handling covid?

    The recent Bloomberg article summarizes it best:
    Hong Kong Faces Worst of Both Worlds as Omicron Ruins Covid Zero - Bloomberg

    How should the government change their policies in the new reality? Omicron also has a shorter incubation period (3-4 days on average). Maybe 10 day quarantine for external travelers with PcR tests every other day? Contained spread with strict parameters in case numbers acceptable in place of zero covid policy?

    While it is a viewpoint that would be hard to fathom a few months ago, it is time to start thinking about treating covid as an endemic and move on with life, than to be stuck in a limbo of permanent paralysis in 2022 or even 2023. Hong Kong was built on a laissez faire economy and relatively hands off government policy, so maybe they should start adopting that with their pandemic policies too. As of now, covid will not go away before a new variant comes about somewhere else in the world, so it's hopeless to put sandbags in front of your house when you know a tsunami will hit soon.

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  2. #2

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    I think everyone has misunderstood the incredibly clever and scientific strategy of the Hong Kong government.

    Zero covid policy is enforced until a milder but more infectious variant arrives. Then encourage its spread through the unbelievably brave and patriotic selfless act of a noble few having a pretend party.

    Then in a preplanned move get them released early from quarantine. A masterstroke of amazing leadership from Carrie.


  3. #3

    Going off my current experience in London, there are three things that the HK Gov needs to do ASAP for when COVID becomes endemic in Hong Kong:


    • Free rapid antigen tests (LFT): was a really controversial policy here with Operation Moonshot in 2020, but one of the few policies that the UK govt got right from the get go. The main test kits they give for free (Flowflex) are 93% accurate in detecting positive cases and only take 15 minutes to do. I've been using them to meet up with friends and for university, since worst case if you have caught COVID but are negative on an LFT it's very likely you aren't infectious. It also no longer makes sense to rely on PCR tests when these are accurate and quick too.
    • Antivirals: the Hong Kong govt was going to procure molnupiravir but the overwhelming majority of countries have abandoned it now. Would be worthwhile to purchase antivirals that are effective including PAXLOVID by Pfizer., which reduces hospitalization by 89%.
    • Vaccinations: pretty obvious one but there's now a need to get as many people (especially the elderly) vaccinated + boostered so they don't overwhelm the healthcare system. Last thing the HA, which is already struggling with long wait times, is a COVID wave that delays specialized treatment. It might be useful to see if J&J can be procured quickly since it would only take two months to take one full course of J&J and a MRNA booster, instead of 21 days + 3-6 months with three doses of Pfizer/Moderna. Also it would be helpful if they re-opened any CVCs that were shuttered so they can get more doses into arms.
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  4. #4

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    Quote Originally Posted by ThatOneGuy:
    Going off my current experience in London, there are three things that the HK Gov needs to do ASAP for when COVID becomes endemic in Hong Kong:


    • Free rapid antigen tests (LFT): was a really controversial policy here with Operation Moonshot in 2020, but one of the few policies that the UK govt got right from the get go. The main test kits they give for free (Flowflex) are 93% accurate in detecting positive cases and only take 15 minutes to do. I've been using them to meet up with friends and for university, since worst case if you have caught COVID but are negative on an LFT it's very likely you aren't infectious. It also no longer makes sense to rely on PCR tests when these are accurate and quick too.
    • Antivirals: the Hong Kong govt was going to procure molnupiravir but the overwhelming majority of countries have abandoned it now. Would be worthwhile to purchase antivirals that are effective including PAXLOVID by Pfizer., which reduces hospitalization by 89%.
    • Vaccinations: pretty obvious one but there's now a need to get as many people (especially the elderly) vaccinated + boostered so they don't overwhelm the healthcare system. Last thing the HA, which is already struggling with long wait times, is a COVID wave that delays specialized treatment. It might be useful to see if J&J can be procured quickly since it would only take two months to take one full course of J&J and a MRNA booster, instead of 21 days + 3-6 months with three doses of Pfizer/Moderna. Also it would be helpful if they re-opened any CVCs that were shuttered so they can get more doses into arms.

    All this stuff was obvious over 18months ago, and you write like it's the latest thought leadership.

    HK has wasted an entire year of everyone's lives, most likely simply because of their sham elections.

    Lateralflow tests might be a good idea if the govt has no access to the results, but even then I would never use one in HK because of the risk of long term incarceration.

    So cut the shit (antivirals aside) and get to the main point - Govt. Quarantine needs to be scrapped and reduced to 7 days Q at home (and of course open the borders) like real countries and then we can talk about more widespread testing.

    Getting more people vaxxed is also bullshit, a widespread outbreak will achieve that as long as vaxx's are available. And where it doesn't will be because the risk STILL doesn't make it vital (it's no worse than the flu for the majority) or because they're too thick to learn - good riddance.

    Naturally a pressure relief valve installed for hospitals would benefit the vax take up rate too, but that's not the intent. Said valve should be a tier system of priority just like they do in A&E. If you're unvaxxed you automatically get a minus 1 or 2 applied to your priority. - A likely death sentence for a very small minority - them's the breaks folks.
    Last edited by Sage; 09-01-2022 at 03:41 AM.
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  5. #5

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    They will just follow whatever the mainland does and they have already moved on from zero COVID, to zero food.

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  6. #6

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    People should read up about molnupiravir.

    I'd rather be vaccinated with mRNA.

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  7. #7

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    If they’re going to hospitalise all Covid positives at least let the asymptomatic ones have 5 day monitoring then, say, 7 days self quarantine with a negative PCR test after that being their ticket to freedom.

    Asymptomatic transmission is minimal as with all similar viral infections. The purpose of five days would be to ensure they didn’t develop the symptoms that would exacerbate possible transmission.

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  8. #8

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    Quote Originally Posted by ByeByeEngland:
    If they’re going to hospitalise all Covid positives at least let the asymptomatic ones have 5 day monitoring then, say, 7 days self quarantine with a negative PCR test after that being their ticket to freedom.

    Asymptomatic transmission is minimal as with all similar viral infections. The purpose of five days would be to ensure they didn’t develop the symptoms that would exacerbate possible transmission.
    I'm sorry but this doesn't do much more than demonstrate how accepting of bullshit the HK population has become.

    For endemic covid, about the first thing they need to do is stop hospitalising; it's an utter waste of capacity in a stretched system even when covid free, when endemic . . .the mind boggles.

    The quarantining of people after they test negative, is, in of itself, just shit piled on top of shit, (providing there is a minimum stay in Q, for those genuinely positive).

    Because HK doesn't publish it's CT policy, lot's of people simply don't understand what they're being subjected to:

    HK tests to a CT value of 45 to catch all people it claims are positive. Whist the definition of what is 'positive' can be debated, it is already clear that they are unable to infect a lab culture with virus sampled from someone with a CT value above 34. 35 is clinically uninfectious - zero risk to anyone, this is not a matter of opinion.

    HK currently only releases people from hospital (into further Q.) who test negative at CT values of 40, twice in a row - utter bullshit, and I'd say criminal when you have already had the victim in Q. for 10+ days.

    Everyone needs to understand that isolation serves two purposes:
    1) to ensure infectious people don't infect others.
    2) To ascertain where the person lies on their covid cycle. Are they at the beginning becoming more infectious or at the end becoming less? Importantly, a 10 day period of isolation in total is enough to know for sure that a person is not infectious even without a PCR test (in the vast majority of cases)

    Because the UK isn't testing at the end of their home Q's is the reason why it's 10 days, and not 7 or 5. If they did test, many would be proven to be non-infectious days earlier.

    Therefore The PCR test upon discharge is the proof that 100% of cases that test at 35 and over are uninfectious and won't become re-infectious.

    The real dangerous suprsepreadter types - the immuocompromiosed (and why it is they who need to be kept away from the rest of us) are the group that pushes the average infective periods beyond the 5-10 day norm. But the PCR test in HK would catch this at 34 or below, so why the fuck is anyone accepting of further home Q? - I have the answer, but you won't like hearing it.

    FYI 3 points of CT test cycle roughly correlate with 10 x less genetic material (virus dead or alive), so CT40 represents a viral load 100 x less than is required to be infectious and in HK this is at the END of a minimum isolation period.

    So alongside post isolation Q, that's the next thing that needs to be scrapped CT values.

    Currently the testing system is utterly stacked against you and I'm pretty sure you still don't appreciate how unsustainable it is when case numbers rise.

    If you watch the video from the recent Bloomberg article, you'll see the report of a guy isolated in a room with 4 others in North Lantau. He's aysmptomatic, whilst others in his room are symptomatic (coughing). Imagine if you will that you've picked up a small amount of virus, that your body immediately fights off - you're not 'asymptomatic' at all, you're un-infected - a HK PCR test can ping you as positive, and HK's jackboot monkeys can then imprison you for 2 weeks with genuine cases.

    CT values are further complicated by the assay type in use, but everything written above holds true for molecular assay's which are the most commonly used for detecting 'infectivity' or not:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454768/
    Last edited by Sage; 09-01-2022 at 12:40 PM.
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  9. #9

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    Dear Sage,

    I’m sorry This coming from the same ‘I don’t wear masks’ bullshit as your comment that if you were to do 14 days home quarantine you wouldn’t hesitate to go out. I saw that comment around 2am but I can’t find it again so I suspect you have edited it out.

    It’s not an acceptance of the process it is the reality that the journey from zero Covid and total hospitalisation of Covid positive and total imprisonment of close contacts, plus the ridiculous 2 week flight bans and country bans (why is Africa not on that list?) is going to be small steps at a time not a Big Bang approach.

    I’ve served a 21 night washout plus 21 days QT and this time around, having run around at 2am one morning last week, 4 nights Penny Bay and now have 13 more nights in the QT hotel. You serve up and have done for 2 years theories and comments which work in a normal world. HK is no longer a normal world.

    For the sake of those residents, students etc, now trapped AGAIN, chasing hotel refunds which in some cases won’t be forthcoming and some now already doing 21 day washouts again not knowing whether the washout country is going to be added to the exclusions stop spouting shit that is just not going to happen.

    It will fall on deaf ears so I think I’ll pursue the ignore function. You’ll be number 2 on that list, soon to be number one because the incumbent ignoree appears to have changed behaviour.

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  10. #10

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    Quote Originally Posted by ByeByeEngland:
    Dear Sage,

    I’m sorry This coming from the same ‘I don’t wear masks’ bullshit as your comment that if you were to do 14 days home quarantine you wouldn’t hesitate to go out. I saw that comment around 2am but I can’t find it again so I suspect you have edited it out.

    It’s not an acceptance of the process it is the reality that the journey from zero Covid and total hospitalisation of Covid positive and total imprisonment of close contacts, plus the ridiculous 2 week flight bans and country bans (why is Africa not on that list?) is going to be small steps at a time not a Big Bang approach.

    I’ve served a 21 night washout plus 21 days QT and this time around, having run around at 2am one morning last week, 4 nights Penny Bay and now have 13 more nights in the QT hotel. You serve up and have done for 2 years theories and comments which work in a normal world. HK is no longer a normal world.

    For the sake of those residents, students etc, now trapped AGAIN, chasing hotel refunds which in some cases won’t be forthcoming and some now already doing 21 day washouts again not knowing whether the washout country is going to be added to the exclusions stop spouting shit that is just not going to happen.

    It will fall on deaf ears so I think I’ll pursue the ignore function. You’ll be number 2 on that list, soon to be number one because the incumbent ignoree appears to have changed behaviour.
    Your post clearly started with "If they are going to..."
    Sage's reading comprehension is dire at times.
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