Imported cases, community action, policy and institutional systems drive Hong Kong’s COVID-19 experience

Abstract

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.