The COVID-19 response in Hong Kong.

Richard Horton and the Editors have repeatedly called for closer collaborations in global health. China has been taking decisive, albeit difficult, measures to prevent and manage outbreaks in diverse settings, from city epicentres to rural clusters. Although these policies might be draconian, they resulted in community solidarity and success; with one prerequisite to both solidarity and success being transparency embraced by both the government and the health profession.

For example, the Zhejiang University Affiliated Hospital issued handbooks about COVID-19 prevention and treatment. These free, online, multilingual books cover topics from the construction and operation of a Fangcang shelter to the management of mental health. The earnestness of this university hospital to help supersedes intellectual property restrictions or fears of scrutiny and criticisms.

It might be useful to examine whether the Chinese intervention model transcended political structure. Between January and November, 2020, Macau had merely 46 local cases and no deaths. Most cases were recorded by April 7, 2020, with a single additional case on June 26, 2020. Hong Kong had its first case in late January, 2020, followed by a second wave that peaked with 82 new cases on March 29, 2020, but petered out by late April, 2020. On July 9, 2020, daily cases jumped to 42, and rose more or less monotonically to 149 daily cases on July 30, 2020, which marked the peak of the third wave. July 1, 2020, was the anniversary of the return of sovereignty and commencement of the National Security Law, when activists disregarded physical distancing and challenged the 50-people limit in any public gathering—a limit that was relaxed in June, 2020, probably prematurely. Of course, correlation is no proof of causation.

China pledged US$2 billion and vaccines for global public good. China's Ad5-vectored COVID-19 vaccine has been approved for use in the military after accelerated phase 3 trials. BBIBP-CorV, which contains inactivated SARS-CoV-2, is an equally promising vaccine candidate.

When it comes to public health interventions, Hong Kong leans more towards libertarianism than collectivism, with lock-down measures similar to most European countries. Nevertheless, the Hong Kong Government ran a voluntary test programme in the first fortnight of September, 2020; as of Sept 12, 2020, 1·73 million of 7·50 million residents had been screened, and 36 asymtomatic carriers were identified, despite attempted sabotage of the tests by dissidents.7, 8 About a third of the carriers had cycle threshold values above 35, suggesting spontaneous recoveries, whereas another third had cycle thresholds of 29 or less, indicative of infectivity. To assist with the programme Chinese media reported that more than 570 clinicians came from neighbouring provinces and worked 12 h shifts, sometimes allegedly wearing adult diapers and eating only one full meal a day to meet demands. This work was inspired by the Chinese experience. More than half of Beijing's 23 million people were tested, with a focus on workers in high-risk occupations, followed by a comprehensive assessment of residents in specific districts with new cases. Beijing has had daily new cases in the low tens since Aug 5, 2020. In adopting similar though less severe measures like compulsory testing and buildings lockdown, Hong Kong has also maintained low cases, suggesting that the Chinese intervention model transcends political structure.

I declare no competing interests.