The purpose of the vaccine pass is to protect unvaccinated individuals rather than punish them because these unvaccinated persons might potentially die from virus exposure. This would markedly reduce disease burden on our medical service because the infection of just 5 percent unvaccinated out of the 1.37 million elderly population could mean 68,500 patients reporting to hospital within one to two months during another wave. Assuming that anywhere from 20 percent to all of them would require admission within a six-week period, each of the18 major hospitals with emergency rooms would have to shoulder a mean of 13 to 65 elderly admissions a day, which looks manageable.
By that time, when a 95 percent vaccination rate is achieved, our surge capacity for isolation, quarantine, inpatient and outpatient services should be ready for this post-vaccination “sixth wave”. This wave could be started by a superspreading event from a residual cryptic transmission chain from the fifth wave due to the Omicron virus or from another incoming traveler or a new post-Omicron variant. As long as this post-vaccination wave is due to an Omicron-like variant, there should be little panic or disruption when a more normal life can go on, which has been the case in Singapore.
Whether we should still do compulsory universal testing would depend on whether all supporting logistics are ready and whether our contact tracing ability to mop up any residual cases is foolproof. Hong Kong had been very successful in achieving nine months of zero Covid-19 in 2021 with border control, universal single-masking, testing of symptomatic cases, contact tracing, isolation and quarantine against the third and fourth wave due to the Alpha and Delta variants. This past strategy, however, has obviously failed to control Omicron.
Compulsory universal testing has been very successful in the mainland in achieving zero because of their closed-loop management of isolation and quarantine premises. More important have been their very rapid and comprehensive contact-tracing capability by mobile phone, CCTV monitoring with facial recognition, artificial intelligence and epidemic management committee in every street and housing estate.
If Hong Kong is not ready with the supporting logistics for universal testing and the capacity for rapid multilayer contact tracing, the fifth wave will lead to a relapse or a sixth wave will readily come when another variant appears. If such an expensive exercise is soon followed by another spike in case counts or another wave, this would trigger an extreme degree of disappointment among our pandemic-fatigued citizens which would be the most undesirable outcome after two years of subnormal living.