Morgues are nearly full, hospitals are overcrowded, and terrified customers have stripped store shelves bare as concerns of a citywide lockdown rise.
Despite having had more than two years to prepare, Hong Kong, previously heralded as a zero-Covid success story, is now fighting a devastating outbreak reminiscent of the pandemic's early days.
In the previous two weeks, the number of locally transmitted cases in the city of 7.4 million has surpassed 312,000, putting hospitals and overburdened health staff under strain. The numbers are likely to be substantially higher because there are suspicions that people are not disclosing positive test results for fear of being separated from their families and placed in government isolation centers.
Although the less lethal Omicron form has propelled the rampant increase, Hong Kong's mortality are still on the rise, notably among the city's unvaccinated elderly. According to Our World in Statistics, which analyzes data from Johns Hopkins University, Hong Kong had more deaths per million inhabitants than any other country or territory in the week ending March 3.
Carrie Lam, the city's leader, stated that the city is facing a "unprecedented challenge" and that no one could have expected the newest wave. However, clinical virologist Siddharth Sridhar of Hong Kong University described the situation as a "expected and preventable calamity."
For two years, as the epidemic raged around the world, Hong Kong largely contained the virus, and there was a rising fear that the city would be able to keep the virus out indefinitely.
As the number of reported instances increased this year, the government reinstated its harshest policies, such as limiting public gatherings to two, banning restaurants and bars after 6 p.m., and roping off public playgrounds.
As the number of reported instances increased this year, the government reinstated its harshest policies, such as limiting public gatherings to two, banning restaurants and bars after 6 p.m., and roping off public playgrounds.
However, it was insufficient. With few other options, the government intends to launch a required mass testing campaign in an attempt to eradicate Covid. Schools will close early for the summer and be reconfigured into isolation, testing, and vaccination centers. It's also unclear whether a city-wide shutdown is in the works.
"March is going to be a very, very terrible month," Sridhar said. "It's unquestionably an unparalleled health problem in Hong Kong."
And, while vaccines have made Hong Kong healthier than it would have been two years ago, immunization rates among the city's older population remain low, leaving many of the city's most vulnerable people unprotected.
What went wrong in Hong Kong?
Patients at Queen Elizabeth Hospital, one of Hong Kong's largest, sit in a barren, windowless observation room while waiting for a spot in an isolation ward. Two nurses, who asked not to be identified because they are afraid of repercussions for speaking up, told CNN last week that the observation room smells like feces since there are no restrooms and patients are forced to use bedpans.
According to the nurses, staff shortages cause frequent delays in checking on patients as more arrive for care, and there are too many individuals seeking treatment and not enough beds.
"A patient is unlikely to be admitted to an isolation unit unless he or she is on the edge of dying," one staff member explained. "We can't stop since the situation doesn't change no matter how hard we work. The scenario is bleak."
According to one of the nurses, the morgue at the hospital is overflowing and some remains are being stored for hours at room temperature.
The Hospital Authority stated in a statement to CNN that it was facing "extraordinary problems," and it apologized to patients who had faced extended wait times.
Due to an increase in Covid-19 deaths caused by the cold weather, "storage space in hospital mortuaries has reached full capacity," according to the statement.
In a press conference on Tuesday, health officials announced that they are adding refrigerated containers and hastening the construction of a new mortuary to supply at least 800 additional units. Since the start of the pandemic, Hong Kong has registered 1,554 deaths, up from 213 at the end of December 2021.
That surge in cases is also putting pressure on hospital wards.
Previously, all Covid positive cases were placed in hospital, and any close contacts into government-run quarantine -- even if they were asymptomatic. But with soaring cases, it became no longer feasible to quarantine all positive cases and close contacts.
"Our healthcare system is at the edge of collapse," the Hong Kong Doctors Union said in an open letter in February.
But some positive cases are desperate to be admitted to government-run facilities, no matter how sick they are, because for much of the pandemic they've been told that's the right thing to do, Hong Kong University professor Jin Dong-yan said. That's not only putting pressure on the system, he said, but is exposing others to infection.
"They just hang around, come to this or that hospital, just hoping to be admitted," he said last month. "They might spread the virus to others."
The situation is also being exacerbated by Hong Kong's high proportion of unvaccinated people.
As of this week, 78% of the population -- excluding those aged 3 to 11 -- are double vaccinated, but just 48% of people aged 70 or older have received two doses. At the start of this year, just 25% of people age 80 or over had been vaccinated.
On Friday, government officials said vaccinating the elderly was now a public health priority, describing care homes as "hot spots" for the virus. And as of Friday, the wait time between the first and second doses of the Chinese-made Sinovac shot would be reduced from 28 days to 21 days for the elderly.
The low vaccination rate among the elderly appears to be playing out in the city's death toll. Almost all of the city's Covid-19 deaths reported this year are elderly and unvaccinated -- and many of them lived in care homes.
Stephanie Law, an executive committee member from the Elderly Services Association of Hong Kong, said for many older residents, concerns about Covid vaccine side effects outweighed the risks of getting the disease.
"In the past, a lot of people felt that it's not a priority to have the vaccine," she said. Now, care workers feel "helpless" as the virus spreads through homes, where some residents live four or six people to a room, she said.
Karen Grepin, an associate professor at the School of Public Health at the University of Hong Kong, said the narrative in the city had evolved to the point that people had started to believe Hong Kong could keep the virus out forever.
"People really started to believe that even the miniscule risk associated with vaccination was higher than the risk of Covid," she said.
"We are paying for that complacency."
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