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Hong Kong's Social Distancing Success

"As soon as the virus started to break out, and people read 'China' and 'coronavirus', people remembered."
"The social part is one of the reasons why we've been able to keep the virus cases so low, because in some way the public has been able to make the government take measures."
"There is a strong responsibility of people to adhere to social norms and respect the wider community."
Nicholas Thomas, associate professor, City University of Hong Kong

"Social distancing becomes more important if there's sustained transmission in the community and we want to slow it down, because at that point, the first two measures won't be as effective."
"And hopefully the U.S and Europe and other countries can learn from Hong Kong and Singapore in how social distancing can be applied and how our populations can be aware."
Benjamin Cowling, professor, co-director, World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, Hong Kong University School of Public Health

Almost 300 people were killed out of the 1,700 infected with Severe Acute Respiratory Syndrome (SARS) in Hong Kong; the most outside of mainland China. That event had an impact on the psychology of the city, according to Nicholas Thomas. Residents wore surgical masks, avoided gatherings from the very beginning of the outbreak, and that practise during the more current zoonotic novel coronavirus is still ongoing. Which is just as well, considering that COVID-19 appears to have gathered steam and may be re-appearing for a second wave.

Still, Asia appears to have shed most of the anxiety about the exponential spread of this new and sometimes deadly virus; in a steady state where the number of cases are diminishing and control is being rewarded. Its spread in Europe and the United States as its newer destination has placed them in a similar position to which China and Hong Kong found themselves a month earlier. Now, the need to avoid large gatherings is being recognized where recent high-profile infections -- including the Australian home affairs minister and the wife of Canadian Prime Minister Trudeau have become infected -- has certainly raised awareness of self-isolation.

At the end of January when the world was just being introduced to the fact that a new virus had unleashed itself in China, Hong Kong had already put most of its restrictions in place though there were but a handful of cases there. In total Hong Kong, as a result of its swift reaction to cut off the virus, had a total of 139 documented diagnoses. Of that number four deaths occurred in contrast to South Korea which failed to begin taking measures until a month later, February 23, when hundreds of its citizens had already been infected. It registers over 8,100 people infected, with 75 deaths.

Travellers wearing protective equipment enter the arrival hall at the Hong Kong International Airport on March 17, 2020 in Hong Kong.

Hong Kong's relative success came despite a devastating 12 months for the economy and where the virus is further curbing growth, in the wake of violent pro-democracy protests that periodically shut down parts of the city during the second half of 2019. Hong Kong's beleaguered Beijing-appointed leader's popularity is in such high dudgeon that even the effective virus response hasn't lifted her approval rating beyond 13 percent. Carrie Lam had initially resisted shutting the border with China, despite public pressure.

Hong Kong ably demonstrated that the deployment of measures early on would have a dramatic effect. Cities that had implemented multiple 'non-pharmaceutical interventions', closing schools and churches, experienced death rates up to 50 percent lower, with less severe outbreaks than those that did not, during the 1918 influenza pandemic, according to research. Now, according to medical researchers, had China implemented non-pharmaceutical interventions -- from containment and isolation to social distancing -- three weeks earlier, the number of confirmed COVID-19 cases could have been reduced by up to 95 percent.

According to a study released this month, funded partly by the Bill & Melinda Gates Foundation, China's cases could have been reduced by 60 percent if those non-pharmaceutical interventions had been undertaken one week earlier. On the other hand, the number could have increased 18 times had such measures arrived three weeks later.Clearly, social distancing measures are to be regarded as a critical part of halting the virus after other containment measures have been implemented by governments.

Governments are required to conduct tests to identify and quarantine infected people and those with whom they had contact while also reducing imported cases from overseas, pointed out Benjamin Cowling. Once an outbreak occurs it becomes increasingly difficult to track down suspected cases, and social distancing measures like closing schools, working from home and voluntarily avoiding crowded areas are key to success in social distancing.