It was not long ago that Hong Kong officials were bragging about having done a better job in curbing the spread of Covid-19 than they did with severe acute respiratory syndrome (Sars) in 2003. We were repeatedly reminded that there were neither major outbreaks in hospitals and nursing homes, nor community-wide infections of unknown origin. Unfortunately, the situation has rapidly declined over the past 10 days. Yesterday, another 56 confirmed and preliminary cases were reported, bringing the total number to more than 1,600. The latest concern stems from three patients in the general ward of Queen Elizabeth Hospital, the first cluster at a public hospital since the coronavirus outbreak. It may be on a much smaller scale than the Sars infections at Prince of Wales Hospital 17 years ago, but it is yet another sign of the contagion getting out of control after staff and residents at a Tsz Wan Shan home for the elderly came down with the disease. Mandatory tests on high-risk patients upon admission to hospitals must now be a priority. The 92-year-old index patient of the Queen Elizabeth cluster was only found to be infected with Covid-19 after she was admitted for heart disease. The environment was thought to have been contaminated as she coughed and walked around and infected at least two others. Medical experts said the usual multiple symptoms among elderly patients had made diagnosis difficult, and the Hospital Authority has pledged to step up surveillance as a result. With community infections on the rise, the risks facing our strained public health care system also increase. Covid-19 situation ‘getting a bit out of hand’ in Hong Kong, officials warn Unlike the previous spike in March when virus sources could still be identified, about one-third of 200-plus recent local infections have not been traced. The disturbing trend deepened yesterday with another seven cases of unknown origin. Officials must be prepared to take further action if new rules on dining out and wearing face masks on public transport fail to reduce infections. Reports of customers and passengers continuing to flout such measures already show they are not being taken seriously. Unless the government and the community work together to bring the situation under control, Hong Kong will pay a higher price.