Hong Kong has fewer coronavirus cases than the US, Singapore or Italy. That might seem surprising for a city that sits on the doorstep of mainland China and has intertwining business, tourism and personal connections with the source of the epidemic. The reason can be summed up in one word: SARS.

The outbreak of severe acute respiratory syndrome in 2003 sowed extreme caution in Hong Kong, a former British colony that had returned to Chinese sovereignty six years earlier. The city, which maintained its own customs and passport controls after the handover, was home to an eventual 299 of the 744 SARS fatalities. That was the highest number worldwide, though the disease originated in southern China. The wariness instilled by that experience has persisted.

Take me. I still compulsively wash my hands, 17 years after the outbreak. I have friends that have been using toothpicks to press elevator buttons for years. Some use tissues to open the doors of public washrooms, or carry spare masks in their handbags in case they catch the sniffles. This is all evidence of the indelible impact SARS has had on Hong Kong’s psyche. For many of us, advice from health officials on how to minimize the risk of Covid-19 infection has been superfluous.

Born in Hong Kong, I returned newly married to the city from a five-year spell in London in late 2002, a couple of months before SARS first appeared in China. People in Hong Kong became aware of the disease the following March after a visiting doctor from Guangdong, the adjoining mainland province, infected visitors on his hotel floor. He later died.

For months between the first infection, of a farmer in southern China, and mid-March when the World Health Organization issued a global alert, we were in the dark about the appearance of this mysterious new pneumonia-like illness. We continued to eat out, hold New Year’s celebrations, and mingle freely. The fear that ensued when the spread of this deadly disease became public knowledge engendered habits many of us still can’t shake off.

Restaurants and bars largely emptied, and stayed that way until SARS receded in the middle of the year. That pattern is repeating itself. Restaurants are suffering, especially after a hotpot dinner led to multiple infections among one family. On the other hand, Hong Kong’s hiking trails have been packed as crowds seek open spaces and fresh air where the chance of infection is lower.

Reminders of SARS are everywhere, from the ubiquitous face masks and near-empty subway carriages to the daily news flow. Officials ordered engineers to inspect toilets at a public housing complex in the city’s northwest after coronavirus infections emerged. That recalled the tragedy at Amoy Gardens, a cramped 19-block apartment development where 329 residents contracted SARS and 42 died after defective plumbing helped to spread the virus.

The vigilance instilled by these memories has contributed to Hong Kong’s relatively low number of Covid-19 infections: 97 and two deaths, out of a population of 7.4 million, as of Friday. Singapore (population: 5.6 million) had 117 confirmed cases and no fatalities. South Korea, with 6,593 infections and 42 fatalities, is the second-worst hit country after China, while Italy had 3,858 cases and 148 deaths, the most deaths after the mainland. Focus has also turned to the spread of the disease in the US, where authorities reported 126 cases and 11 fatalities as of Friday.

It’s debatable how much credit the Hong Kong government deserves for the low infection rate. Arguably, mistrust of the government has played a bigger role in shaping behavior. The administration of Chief Executive Carrie Lam, who has record-low approval ratings after months of anti-government protests last year, resisted public pressure to seal the border with mainland China, feeding suspicions that she was doing Beijing’s bidding rather than placing the safety of the local population first. The government has also given confusing and contradictory messages on the use of face masks, as my colleague Clara Ferreira Marques has pointed out. Hong Kong imposed a quarantine on visitors from the mainland eight days after Singapore.

The government has played a part in encouraging social distancing, and has taken some draconian measures, most notably by closing schools until the middle of April at least.

Still, the part played by individuals can’t be overlooked. With a traditionally laissez-faire economic system and little in the way of social welfare, the people of Hong Kong have been accustomed to taking responsibility for themselves rather than waiting for the guiding hand of the state. It’s that spirit -- and the scars left by SARS -- that have inoculated Hong Kong against the worst of the latest coronavirus outbreak.


Nisha Gopalan
Nisha Gopalan is a Bloomberg Opinion columnist covering deals and banking. -- Ed.

(Bloomberg)