Hong Kong’s relatively low infection rate and even lower number of Covid-19-related deaths have not gone unnoticed in places much more seriously affected. This had been due partly to a factor that really set the city apart until last week – no coronavirus outbreaks in homes for the elderly. Such facilities have proved tragically vulnerable to contagion elsewhere, including the United States, Britain and Australia. It was no mean feat for the city, given that elderly people with underlying health problems are generally most at risk from the disease. This is not the case now after the core cluster of a worrying surge in infections was found in a Kowloon home for the elderly, the operator of which is suspected of sharing staff with another facility in the same building. As most new cases are of local origin, health officials fear the city is facing a major community outbreak. The surge highlights a relaxation in the city’s defences and a sense of complacency arising from an easing of anti-infection measures, which has been reversed this week with a strict tightening of social-distancing rules. Professor Gabriel Leung, a government health adviser and dean of the University of Hong Kong’s medical school, suspects the infection at the care home was brought in by staff, and he wants the government to regularly test at least half of those who work at homes, not just two or three. Given residents are among the most vulnerable, it is to be welcomed that health minister Professor Sophia Chan Siu-chee says the priority of the government is to now go further and test all staff. Fears grow over Covid-19 spreading in hospital as third patient infected The government has understandably tightened guidelines at care homes, directing them to “avoid as far as possible” deploying staff in different facilities. Residents should also avoid leaving “unless deemed necessary”. Kenneth Chan Chi-yuk, chairman of the Elderly Services Association of Hong Kong, said many operators had voluntarily banned patient visits since February but began to relax restrictions last month. Voluntary compliance with guidelines is commendable, but it may take only one seemingly minor violation to prise open the door to infection. Mandatory compliance, with some allowance for constraints faced by homes, is a small price to pay for the welfare of some of society’s most vulnerable members.