A representative from the Hong Kong government didn’t immediately respond to a request for comment.

President Xi Jinping has called for the city of about 7.5 million people to take “all necessary measures” to contain Covid, as the widening outbreak — which came after months of being virus-free — undermines China’s zero-tolerance approach to keeping the pathogen out. While other parts of the world start to live alongside Covid, Beijing is continuing to pursue elimination, including testing as a key tool in an arsenal that also includes effectively closed borders and lengthy mandatory quarantines.

Why China Is Sticking With Its Covid Zero Strategy: QuickTake

A health worker wearing personal protective equipment (PPE) holds a sign marking the end of the line as residents queue at a Covid-19 testing facility in Hong Kong, China, on Tuesday, Feb. 15, 2022. Hong Kong’s leader said the city had no plans for a citywide lockdown to help bring cases back to zero, even as she acknowledged that a growing omicron outbreak has exceeded its capacity to respond.

Some experts worry Hong Kong’s move will come too late.

Outbreaks on the mainland have been successfully contained through frequent and mass testing, but China has never used the strategy in an outbreak of this size. It’s also unclear where Hong Kong, which is currently struggling to find more isolation and quarantine units, would house those who test positive, even as the city insists on its pursuit of the Covid Zero approach.

“At current rate of spread, there could be tens of thousands of new cases each day in early March, and we know that not every infection is being confirmed so the number of infections picked up in mass testing could be very large at that point,” said Benjamin Cowling, a professor and chair of epidemiology at the University of Hong Kong. “Doing mass testing in April or May, when the fifth wave will have subsided and we would then have capacity to isolate the positives, might be able help the city return to zero daily cases if that were the objective.”

First Time

It would be the first time since the pandemic began that Hong Kong has enforced citywide testing, with the more contagious omicron variant providing the steepest challenge yet to maintaining the Covid Zero approach. Hong Kong’s infections tally continues to set records, with local media saying about 5,000 new cases will be reported Thursday. New infections reached 4,285 on Wednesday and there were 16 patients in a critical condition, all adults. Officials announced 10 deaths, including a three-year-old girl.

Read more about Covid and kids here

The requirement to isolate all positive cases is already straining the city’s medical system. Hong Kong Chief Executive Carrie Lam has asked major property developers to make thousands of hotel rooms available to house positive cases, according to a person familiar with the discussions. Omicron has exposed Hong Kong’s lack of preparation for a major outbreak, with policy shifting on an almost daily basis to try and maintain a strategy that other places have left behind in favor of treating Covid as endemic.

Healthcare workers wearing personal protective equipment (PPE) loads a patient onto an ambulance outside the Accident and Emergency Department at Pok Oi Hospital in Hong Kong, China, on Wednesday, Feb. 16, 2022. President Xi Jinping called for “all necessary measures” to get Hong Kong’s virus outbreak under control, an unusually direct intervention that leaves the city’s leaders even less room to deviate from Chinas Covid Zero policy.

Hong Kong Seeks Property Tycoons’ Help to House Covid Patients

The chaos of the current outbreak — with hospitals overwhelmed and elderly patients housed in makeshift tents outside — has undermined already-damaged public confidence in the Hong Kong government’s abilities following unprecedented unrest in 2019, says Joseph Cheng, a retired political science professor and veteran democracy activist. Many may be dissuaded to participate in the testing drive by the long queues already being seen at testing sites, he said.

“There’s a lot of worry about the lack of competence, the lack of preparation of this government — there’s a lack of hospital beds, and people are having to wait up for days to be contacted if they’re positive,” said Cheng, who left the city for Australia when China imposed a national security law on Hong Kong in 2020, adding that “the majority of the people are willing to cooperate.”

“They are pragmatic, they are practical,” he continued. “If tests are made compulsory, they’ll be willing to accept that. They just want to be able to go back to work. Hong Kong people will grumble a lot, but most people will still go and queue up.”