Western experience shows the highest risk of Covid-19-associated death among those who are older, male and with impaired cognitive and physical function. We need to address the potential impact of a Hong Kong outbreak of Covid-19 infection among the 74,500 elderly people living in some 750 residential care homes. These senior citizens need, at best, regular, or in some cases round-the-clock, attention to their daily activities. Should they fall ill with Covid-19, pre-existing illnesses, such as heart, lung and other diseases, would also flare up. Locally, a high mortality rate of 28 per cent has been reported among the 137 infected nursing home residents. Covid-19 spreads like wildfire in nursing homes, as seen in the West. A typical Hong Kong nursing home has 100-200 residents, and a single cohort of such Covid-19 patients would thus create a heavy burden on our health care system. As these individuals already suffer from pre-existing chronic diseases, Penny’s Bay or other less equipped sites would be unsuitable for them, and they would require hospitalisation. A Covid-19 outbreak at a home with 200 residents could create demand for 200 hospital beds. Each of the 17 public hospitals would admit 12 such patients, requiring not only the usual precautions of isolation, but also the heavy use of medical and nursing resources. If there are two Covid-19 infected nursing homes, it will mean sending 24 such highly dependent and highly infectious patients to each of these hospitals. These frail patients are unlikely to enjoy a rapid recovery and prompt discharge. While many would unfortunately die from Covid-19 and complications of their pre-existing illnesses, a substantial proportion could still survive, requiring further prolonged rehabilitation. Public hospitals will be left with no capacity for other patients in Hong Kong and the already stretched and stressed services will be further overwhelmed. We must continue to implement infection control measures, and seek properly proven oral treatment which could be given to infected patients en masse in the future. The current rate of vaccination among these most vulnerable nursing home residents is merely a low 26 per cent , which constitutes a major potential breach in our fight against Covid-19 infection. Even if we could achieve 100 per cent Covid-19 vaccination tomorrow, there would still be a six-week interval for proper immunity to emerge among our nursing home residents. The government should urgently and proactively vaccinate these senior citizens to make Hong Kong safe. Dr Kenneth Tsang, specialist in respiratory medicine and honorary clinical professor, Department of Medicine, University of Hong Kong Shift to a more compassionate ‘zero-Covid’ policy I write to support the Hong Kong government in its approach to fighting Covid-19. Its efforts have saved many lives and minimised the number of people being infected with the disease. This is in sharp contrast to the approach adopted in other countries, where many people have lost their lives, suffered or are suffering from the disease. However, while I do not support that “let it rip” approach, I believe the “zero-Covid” approach adopted in Hong Kong and mainland China can be enhanced and modified. Some of the mechanisms adopted need to be refined because of their impact on people’s mental health and social well-being. These impacts include but not are limited to higher numbers of people suffering from depression and anxiety in Hong Kong, of people feeling helpless and hopeless, and of suicide and drug addiction cases. It is important to consider not only the physical health impact of our Covid-19 policy, but also the impact on people’s mental health, emotional and social well-being. I’d like to make two suggestions. Firstly, the government could offer better mental health support, through the Social Welfare Department’s Clinical Psychological Services, to those currently in hotel quarantine and/or isolation. Secondly, the flight ban on eight countries is scheduled to end on February 18. I appeal to the government not to extend it again and to allow Hong Kong residents there to return. If it must, it could impose a three-week quarantine instead of two weeks, a more stringent testing regime, such as daily testing in the first week in quarantine, and home isolation for a week after the mandatory quarantine period. These are Hong Kong residents who pay taxes and have contributed to the community in the past who are currently stuck abroad. There are also residents who have genuine and legitimate reasons for wanting to travel back to Hong Kong. Speaking personally, my grandmother passed away recently in Hong Kong and I am heartbroken about the circumstances. I am prepared to do whatever is required to be allowed to travel back from Australia to a place I love so dearly. Wing Cheung, Tai Koo Shing Millions of rapid antigen tests will come too late The government has finally ordered millions of rapid antigen tests. This is too late. This should’ve been done before Christmas, and at the latest, before the Lunar New Year. If everyone had tested themselves before leaving home, the spread would have been reduced greatly. This is a clear failure by the government to tackle this pandemic proactively. Jayant Golchha, Tseung Kwan O Do asymptomatic patients make other people seriously ill? Now that people who feel perfectly healthy and show no symptoms of Covid-19 are being sent against their will to Penny’s Bay and now that ordinary people’s lives are being, to an extraordinary extent, disrupted by this forced entrapment, it is time to not only ask some questions, but also to have them answered. How likely is it for asymptomatic people to transmit Covid-19 to someone else, and how serious will the resulting illness be? What the general public does not want, and does not deserve, are meaningless platitudes, but answers based on medical knowledge linked to meaningful statistics. If the pandemic has become endemic, whatever the government does isn’t going to change the situation to a great extent. Get all those who are not vaccinated, and do not punish those who have been fully vaccinated with measures that are so disruptive and, depending on the answers to the above questions, unnecessary. Chris Stubbs, Discovery Bay