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The COVID-19 isolation facility in Tsing Yi in Hong Kong on March 9.TYRONE SIU/Reuters

Elizabeth’s baby was the sickest she’d ever seen him, but she didn’t dare go to a doctor.

It was mid-February, and Hong Kong’s hospitals and clinics were overwhelmed. After more than two years of minimal COVID-19 cases, Omicron was raging through the city, capitalizing on limited herd immunity and a vaccination rate among the lowest of any advanced economy.

Elizabeth, her husband and one-year-old son all had the virus. Protocol said they were to report to a hospital to be put in isolation until they tested negative. But having seen photos of people waiting for hours outside in the cold, even overnight, they decided to stay home and hope things would be okay.

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“We didn’t know if the hospital environment would end up being more dangerous,” said Elizabeth, not her real name. The Globe and Mail is not identifying her so she could speak freely about breaching Hong Kong’s strict COVID regulations.

Both the adults were vaccinated, and showing few symptoms, but Elizabeth’s son was too young to have any protection. As they waited for the virus to pass, she read stories of babies dying because of COVID-19 and questioned her decision over and over.

Her husband tried to reassure her that beyond having a high temperature and cough, their son seemed okay, even if they would usually have taken him to a doctor.

“The government was in such a state of panic at that point that there didn’t seem to be any hard and fast rules, so we had no idea at all what would happen,” Elizabeth said.

Their decision to stay home was vindicated when both her son got better and news emerged of other parents being separated from their babies, sometimes for days at a time, after the infants tested positive.

While Elizabeth felt they’d made the right decision, she said it was awful “that we were too scared to take our child to hospital.”

Hong Kong is currently grappling with the world’s biggest and deadliest COVID-19 outbreak, one that has been made worse by a breakdown in communications from the government, including conflicting advice and whiplash policy changes.

For the first two years of the pandemic, Hong Kong logged just 13,000 cases and 213 deaths, thanks to a “COVID-zero” approach that included strict quarantines for those arriving from overseas, a mask mandate and limits on public gatherings.

People sleep in hospital beds with temperatures falling at nighttime outside the Caritas Medical Centre in Hong Kong on Feb. 16. Just 30 per cent of Hong Kongers over 80 have received two vaccine doses.PETER PARKS/AFP/Getty Images

Since January, there have been more than 500,000 cases and 2,300 deaths, with researchers warning that the true number of infections could already be pushing two million, and may reach more than 4.3 million – in excess of half the city’s population – by the time the current wave is over.

The current outbreak has also exposed the Hong Kong government’s failure to prepare for an eventuality experts had long warned was inevitable. Even as cases rose, officials insisted on isolating all positive cases, including asymptomatic ones, despite infections vastly outpacing available beds. Testing facilities were also quickly overwhelmed, and the government had to scramble to boost capacity.

“The fact that there was no Plan B has been a really frightening thing about all this,” said Justin Kung, a Canadian Hong Konger who works as a counsellor. “It’s incompetence to a level that I’ve never seen or would have conceived of.”

The biggest problem lies in the vaccination rate. Despite jabs being readily available and free of charge, before the current wave began, only about 62 per cent of the population was fully vaccinated, and few had received booster shots, vital for tackling Omicron.

The problem is particularly acute among the elderly: Just 30 per cent of Hong Kongers over 80 have received two vaccine doses. More than 90 per cent of those who have died since the current wave began were unvaccinated, many of them elderly people living in care homes, where cases are rampant.

A woman wearing a face mask and face shield sits in a train in Hong Kong on Feb. 23, 2022. The current COVID-19 outbreak has exposed the government’s failure to prepare for an eventuality experts had long warned was inevitable.Kin Cheung/The Associated Press

By comparison, New Zealand, another “COVID-zero” holdout currently experiencing an Omicron outbreak, has reported almost no deaths, despite tens of thousands of cases in the past month. Almost 95 per cent of New Zealand seniors are fully vaccinated.

Hong Kong officials have struggled to balance pressure from Beijing to get cases back down to zero – and not move toward living with the virus, as many other countries have – while dealing with the reality of the current wave.

In a leaked letter to Chief Executive Carrie Lam this month, one of her advisers warned against the “confusing messages which keep coming out on almost a daily basis” and were “causing widespread panic.”

“We need very clear messaging giving people hope and direction for an end to this nightmare,” Montreal-raised property developer Allan Zeman wrote to Ms. Lam. “People feel they are getting punished for being infected.”

He later said he was not trying to criticize the government, just voicing concerns, including that the current outbreak, coming as Hong Kong was already facing criticism for its strict quarantine measures, was driving talent to other Asian cities.

A net 71,000 people left the city in February, as arrivals at Hong Kong International Airport slowed to a trickle. Last week, the United States issued guidance warning citizens not to travel to the city because of “COVID-19 related restrictions, including the risk of parents and children being separated.” Diplomats from various countries said the number of inquiries for assistance leaving Hong Kong was through the roof.

A man wearing a face mask enjoys sun bathing at a waterfront park in Hong Kong on March 8. A net 71,000 people left the city in February, as arrivals at Hong Kong International Airport slowed to a trickle.Vincent Yu/The Associated Press

Mr. Kung said that Hong Kong’s tiny apartments made measures taken in other countries all the more onerous. “The basic living conditions that we are used to and okay with in a non-COVID world are extremely difficult when we suddenly have to be stuck in a few hundred square feet of space,” he said, adding that this has made many of his clients reconsider remaining in the city.

A senior Canadian finance executive said many foreign professionals were moving to Singapore, either voluntarily or as a result of pressure from companies that are quietly revisiting their commitment to Hong Kong. After initially pursuing a similar “COVID-zero” approach, Singapore has opened up and had great success with controlling the virus. The Globe is not identifying the individual because they were not authorized to speak publicly on the matter.

The executive said frequent school closings, even when cases were negligible before the current outbreak, had already driven many foreign parents to look overseas. Hong Kong’s international schools are among the most expensive in the world, and recently had to lobby the government to be exempt from plans to start summer holidays early to free up campuses as COVID-19 testing facilities.

“Arbitrarily trying to move summer vacation up two months seemed to break everybody. That broke me,” the executive said. “The hell we’re living in is not the restrictions. The hell is the uncertainty.”

Editor’s note: An earlier version of this article incorrectly said Allan Zeman was born in Canada.

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