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Arrivals at Hong Kong’s airport wait to be taken to their quarantine hotels. Photo: K. Y. Cheng

Coronavirus: ‘3+4’ – Hong Kong cuts hotel quarantine for overseas arrivals to 3 days plus 4 days of ‘home medical surveillance’, allowing trips to office and malls, starting August 12

  • Uninfected inbound travellers will get yellow code on ‘Leave Home Safe’ risk exposure app, enabling ‘restricted activities in the community’ from Days 4 to 7
  • They must test negative during Days 4 to 7 to go to work, shop, take public transport, but are banned from high-risk areas
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Key points

  • Travellers will be quarantined in designated hotels for three days starting from Friday, after which they can return home and spend four days under surveillance.

  • Their activities will be restricted during the four-day surveillance period. Under a yellow or amber health code, they will be banned from entering high-risk places or joining mask-off activities.

  • But they can still take public transport, go to work and shop at markets and malls, if their daily rapid antigen test results are negative.

  • The health code will change colour to blue when travellers have completed the entire “3+4” arrangement.

  • Scientific data has shown that PCR tests on the third day of quarantine for travellers can uncover most infections. The transmission risk is reduced to less than 1 per cent after that, similar to the community rate.

  • Travellers who have booked a seven-day hotel quarantine do not need to make any changes. Hotels will issue refunds when the government policy comes into force, but this will take time.

  • Hong Kong will continue making use of PCR tests to identify people with infection risks and to refine control measures.

  • The city’s leader has said he is also working on reopening the border with mainland China, stressing that reconnecting with the world and the rest of the country are not contradictory goals.

Hong Kong is easing Covid-19 entry rules for international arrivals from Friday, requiring them to remain in a hotel for three days before undergoing four days of “home medical surveillance” that will allow limited movement into areas where vaccine pass checks are not mandatory.

The long-awaited cut from seven days of mandatory quarantine in a designated hotel was announced at the same time as the launch of a mainland China-style, two-colour health code, following a high-level meeting of top officials last Wednesday.

Current rules require travellers to spend a week in quarantine at a designated hotel of their choice.

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Under the revised scheme, overseas travellers have to complete three days of quarantine in hotels, and serve the remainder of their isolation at home or also in a hotel. However, they will be allowed to leave their home or hotels in the last four days, but not to places that require the “Leave Home Safe” app residents use to show their vaccination status for entry to most public premises, such as restaurants and bars.

They are also banned from entering homes for the elderly and disabled persons, designated medical venues, as well as from joining any mask-off activities.

If travellers test negative daily through rapid kits during the four days, they can take public transport, attend work and go to shopping centres.

City leader John Lee (centre) with officials at Monday’s press briefing. Photo: Nora Tam

Unlike in some places in mainland China, which have a similar system, the code will not cover close contacts of Covid-19 patients, as officials had previously signalled. It will be linked with the existing “Leave Home Safe” app.

Hong Kong health officials have been warning that daily Covid-19 caseloads could double to 8,000 in the coming weeks.

Authorities earlier lifted a “circuit breaker” mechanism applied to airline routes. Flight routes were previously suspended based on a threshold of infected passengers brought in.

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A warning on tests

Health chief Lo Chung-mau said taking polymerase chain reaction (PCR) and rapid antigen tests (RAT) as required were stipulated under the law, and those who broke this rule could be fined up to HK$25,000 (US$3,184) or sentenced to six months in jail.

Chief Executive John Lee Ka-chiu added that authorities would have the personal details of those who had to take the tests. He said he was confident that most people would comply with the new rules.

“We will also increase manpower at the airport, because with the ‘3+4’ policy, more people will be using the airport to travel in and out of Hong Kong,” he said.

Yellow code for close contacts?

Lee said he had no plan to extend the yellow health code to close contacts. This was because resources were already centred on administering PCR tests to those under home surveillance, and the city did not have the capability to cover close contacts, the chief executive added.

Lo said it was more appropriate to classify the arrival day as Day 0. “The travellers have just arrived in Hong Kong, it’s impossible to say that they have undergone quarantine for one day … So considering the arrival day as Day 0 is absolutely accurate,” he said.

‘In the best interests of Hong Kong’

Pressed further on the rationale behind three days of hotel quarantine and why this should not be shorter, Lee said the government recommendations were based on scientific data, which showed travellers’ risk level after three days “is no more than the risk level of transmission in society”.

“Based on this analysis, we consider that the risk is under control, and balance it against the needs for other activities to take place. This new measure of 3+4 will be in the best interests of Hong Kong,” Lee said. “I must emphasise that during the fourth day of medical surveillance, there are also PCR checks, so we will know if there are any changes in risks.”

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Use of scientific data

Asked what technical issue prompted the postponement of the announcement from last week to Friday, Lee would only say his team had considered various factors.

He said to control the pandemic, he would follow the five principles, such as opting for targeted measures rather than adopting across-the-board initiatives.

Health chief Lo said the risk assessment was based on various scientific data. He reiterated that less than 1 per cent of incoming travellers were found to be infected after three days.

This risk was no different, or even lower than the rate of community infections, so arrivals would be allowed to engage in activities after their initial period of hotel quarantine as long as they wore masks, he added.

Further shortening of quarantine?

Lee stopped short of saying if there was room to further reduce the quarantine period, but added: “I try my best not to roll back measures.

“I will be discussing with respective bureau heads to ensure we have taken all considerations regarding threats, risk groups, and implications to society as a whole before we roll out any measures,” he said.

Hong Kong’s competitiveness in mind

Responding to a Post reporter’s question, Lee explained: “The main purpose is that while we can control threats to public health, we also want to ensure society can have the maximum degree of economic and social activities. So that society can return to normal as possible, and the competitiveness of Hong Kong can be maintained.

“It is a balance of factors. We also have a strong emphasis on protecting the high-risk group, the elderly and the very young, and also to reduce serious coronavirus cases and deaths. It is a composite of factors that we take into consideration in designing what we consider to be the best measures for the overall interests of Hong Kong,” he added.

Lee said the government would monitor the situation regularly to examine other measures needed. Authorities will also seek to make better use of PCR tests.

Balancing risks and economic needs

Asked why the government did not take a safer approach by reducing quarantine to five days, Lee cited the need to strike a balance between economic needs and health risks.

He also added that after three days of quarantine, travellers could return home by themselves.

Dismissing critics who questioned if people’s privacy would be compromised under the health-code measure, Lee said the current vaccine pass already collected personal information through the “Leave Home Safe” app.

What about reopening the border with mainland China?

Asked if the further shortening of quarantine for international travellers meant there was no chance for border reopening with the mainland, Lee said the two were not contradictory. Lee said his government was still working hard on this front, but the city needed to respect the “7+3” quarantine measure in China, referring to seven days of hotel quarantine and three days of home medical surveillance.

“When we discuss how we can minimise inconvenience for people travelling back and forth to the mainland, we also need to make sure that we are not passing the risks of transmission to our mainland counterparts,” Lee said. “For me, I will concentrate on how to minimise the inconvenience.”

Advice and refunds for those on seven-day quarantine

Vincent Fung Hao-yin, deputy secretary for health, said incoming travellers who had booked seven days of hotel quarantine did not need to cancel the bookings. They can use the original documents to check out of their hotel on the third day if they test negative.

But Fung also urged travellers to be patient in waiting for refunds from hotels for the remaining four unused nights. Hotel representatives told the government it took time to handle tens of thousands of related bookings and refunds.

‘Leave Home Safe’ app ‘popular’

Technology secretary Sun Dong said under the new policy, the “Leave Home Safe” app had to be updated. Those infected will be issued a red code automatically, while those under home-based medical surveillance will get a yellow code. Incoming travellers have to download the software when they arrive in the city.

Sun added that the app had been popular since it was rolled out, as it was downloaded 8.4 million times, and used by 133,000 businesses.

Tony Wong Chi-kwong, deputy government chief information officer, added that if an infected patient’s phone was not connected to the internet, such users might still see a blue code on their device.

But the scanners at premises requiring the vaccine pass could also identify these patients and remind them that they need an internet connection to update their health code to red.

Seven days of hotel quarantine ‘not cost-effective’

Health minister Lo said according to data collected from July 8 to August 4, about 50 per cent of imported cases were uncovered through PCR tests at the airport. The percentage increased to 80 per cent if taking into account PCR tests conducted after two days for guests in hotel quarantine.

For every 1,000 arrivals, only 4 per cent, or 40 travellers, were found to be infected.

Among those 40 cases, 20 were detected at the airport, 12 more were uncovered at quarantine hotels after two days, while only eight cases out of the 1,000 arrivals, or 1 per cent, were detected on the third day or after.

Lo said the figures showed most of the cases could be intercepted in the first three days of hotel quarantine, proving that the current week-long system was not cost-effective and “would affect the city’s connection with the international world”.

Officials present the two-colour health code system to be rolled out. Photo: Nora Tam

More on the red and yellow health codes

Lo said a two-colour code system would be implemented alongside the new quarantine arrangements. A red code will be given to all infected patients, while incoming travellers will get a yellow code until they finish the “3+4” quarantine period.

If a traveller tests negative via PCR screening on the third day, he or she will be allowed to leave their designated hotel at 9am the next morning and complete the remainder of the isolation at home.

Overseas travellers must then take daily rapid antigen tests until the tenth day of their arrival, and a PCR test on the first, second, fourth, sixth, and ninth days. The yellow code will be activated from the fourth to the seventh day.

Five elements in pandemic policy

City leader Lee said there were five main elements in his pandemic policy.

First, it will not be a “laid-back” approach as the healthcare system has to cope with the increase in the number of infections.

Second, the system will identify people of different risk levels with precise scientific methods.

Third, the administration will seek to balance risk and economic momentum to ensure people’s livelihoods.

Fourth, authorities will minimise serious cases and deaths.

Fifth, high-risk groups such as the elderly, children and those with chronic diseases will be protected.