COVID-19 in Hong Kong: Policies and community actions mitigate the effects of age structure and population density

Despite the various socio-demographic vulnerabilities of Hong Kong to the COVID-19 pandemic, the city has successfully managed four waves of local outbreaks, as shown by its comparatively low numbers of confirmed cases and deaths. In this paper, we identify and differentiate the unique characteristics of Hong Kong's COVID-19 outbreaks from those of other territories, and analyse the factors that shaped these characteristics. In particular, we examine four local demographic factors – older age structure, high population density, poor housing conditions and a large migrant population – which, according to current scientific evidence, would likely indicate that the city faces a relatively high risk of the significant spread of COVID-19. We analyse and explain how multiple policies related to border controls, social distancing, testing and tracing, partial lockdowns and housing management, as well as sustained community actions, helped to mitigate the effects of these significant disadvantages.