Hong Kong feels like it’s on the edge of a nervous breakdown, and it’s tempting to ask how much more people can take. With reports circulating that authorities will impose some form of lockdown later this month, supermarket shelves are once again being stripped bare and long lines have formed outside pharmacies. More than two years after the start of the pandemic, the return of panic buying is a telling indicator of the government’s failure to win public trust. It raises questions over the longer-term mental health costs of a virus strategy that has placed adherence to mainland China’s Covid-zero policy ahead of all other considerations.
The symptoms of psychological distress extend beyond hoarding noodles and rice. Local media have featured stories of suicide attempts and protests at Penny’s Bay, the government’s bleak, Wi-Fi-free mandatory quarantine camp. In one video that was widely shared, a distraught woman screams and attacks a government worker in protective gear. The rest of the city is far from at ease. Streets and shopping malls have emptied, deterred by a combination of spiraling infections and fear of what comes next. Public gatherings are already limited to two people.
Human beings are social animals. Deprived of the contact we need with fellow members of our species, most people suffer mental deterioration. There’s a reason that solitary confinement is seen as the worst form of imprisonment. Inmates placed in such conditions for long enough typically start to display symptoms of distress ranging from anxiety and depression to anger, paranoia and even hallucinations. Covid-19 has amounted to a giant, uncontrolled global experiment in reducing social contact — and nowhere more so than in Hong Kong, which has maintained some of the world’s strictest social-distancing regulations despite recording month after month of zero cases last year. Now, with infections exploding to more than 50,000 a day and the financial hub reporting one of the world’s highest fatality rates, the government is considering a lockdown later this month. This will coincide with three rounds of compulsory mass testing in an attempt to cut the chain of transmission.
A study of the psychological repercussions from Italy’s first, and most severe, lockdown starting in March 2020 concluded that restricting mobility “can put a significant strain on people's mental health on a scale unprecedented in recent history.” It found that the longer the isolation and the less adequate the physical space where people were confined, the worse the mental health effects were — a salutary observation for Hong Kong, with its prevalence of poor-quality subdivided apartments. And bear in mind that the Italian experience came at the start of the pandemic. Hong Kong is about to go through a similar (albeit probably much shorter) ordeal having already endured two years of social-distancing restrictions.
Few can argue with the government’s objective of saving lives — even if it bears responsibility for the low vaccination rate that has left the city’s elderly population vulnerable to omicron, a Covid strain that is far less lethal for the adequately inoculated. How authorities implement such policies makes a critical difference, though, and this is where Hong Kong’s approach has consistently fallen short.
The mandatory quarantine system (set at an unusually long 21 days until this January) created a profound sense of isolation, loneliness, confinement and financial concern — but these effects were largely driven by lack of openness and transparency, a research paper published last year found. Honest and clear communication would increase the likelihood of public support, particularly if policies are reasonable and people have been involved in decision-making, the study’s author Judith Blaine wrote.
“In the pursuit of protecting the physical, we have perhaps neglected the actual humanity of it and the psycho-social consequences,” Blaine, a South African researcher and consultant who has lived in Hong Kong since 1995, said in an interview. “In life, if people feel they have a sense of autonomy in what they are doing, this mitigates a lot of the negative mental health issues arising from situations such as quarantine and isolation. People need to feel that they are included in the decision-making process.”
The government appears to have learned nothing. The same syndrome of opaque top-down policy-making and confused and contradictory public messaging has marked the lockdown debate. When will it start? How long will it last? Who will be forced to isolate, where, and for how long? Local media have been full of conflicting reports. Pictures of grim-looking makeshift isolation facilities have appeared on social media. The government in turn has bemoaned “rumors” causing “unnecessary fear and irrational behavior,” without acknowledging the role played by its own lack of clarity in communications.
In the end, the adverse mental effects of Hong Kong’s Covid policy cannot be separated from the political changes the territory has undergone. The city as a whole has experienced a loss of autonomy. Freedoms that were long taken for granted have disappeared in the past two years or become radically more constrained as China tightens its grip following large protests in 2019. The city’s political choices have been revoked. Representatives that voters supported by large majorities have been driven from office; many are in prison, charged with offenses under a national security law that China imposed on the former British colony in 2020. Hong Kong’s inclusive Covid slogan is: “Together, we fight the virus.” But the city’s people have no say over a Beijing-mandated policy.
The long-term psychological effects of Hong Kong’s pandemic trial can only be guessed at. Anger is among the negative emotions that social disconnection can produce, though any outbreak of disorder appears unlikely in view of the security regime that has been established. Those unable to join a record exodus and confronted with a negative situation they cannot change may lapse into a passive fatalism, sapping the city’s drive and vitality. That may seem unthinkable for a society that was once among the most vibrant in Asia. But the Hong Kong spirit is being challenged as never before.