Despite the various socio-demographic vulnerabilities of Hong Kong to the COVID-19 pandemic, the city has successfully managed four waves of local outbreaks, as shown by its comparatively low numbers of confirmed cases and deaths. In this paper, we identify and differentiate the unique characteristics of Hong Kong’s COVID-19 outbreaks from those of other territories, and analyse the factors that shaped these characteristics. In particular, we examine four local demographic factors – older age structure, high population density, poor housing conditions and a large migrant population – which, according to current scientific evidence, would likely indicate that the city faces a relatively high risk of the significant spread of COVID-19. We analyse and explain how multiple policies related to border controls, social distancing, testing and tracing, partial lockdowns and housing management, as well as sustained community actions, helped to mitigate the effects of these significant disadvantages.

This paper investigates the profile of COVID-19 cases in Hong Kong, highlighting the unique age structure of confirmed cases compared to other states. Whilst the majority of cases in most states around the world have fitted an older age profile, our analysis shows that positive cases in Hong Kong have been concentrated amongst younger age groups, with the largest incidence of cases reported in the 15-24 age group. This is despite the population’s rapidly ageing structure and extremely high levels of population density. Using detailed case data from Hong Kong’s Centre for Health Department and Immigration Department, we analyze the sex and age distribution of the confirmed cases along with their recent travel histories and immigration flows for the period January to April, 2020. Our analysis highlights Hong Kong’s high proportion of imported cases and large overseas student population in developing COVID-19 hotspot areas such as the United Kingdom. Combined with targeted and aggressive early policy measures taken to contain the virus, these factors may have contributed to the uniquely younger age structure of COVID-19 cases in the city. Consequently, this young profile of confirmed cases may have prevented fatalities in the city-state.