HONG KONG (CHINA DAILY (ASIA)/ASIA NEWS NETWORK) – Hong Kong is being hit by a third wave of Covid-19 infections, with more than 100 new cases per day being recorded – far more than that during the medical workers’ strike a few months ago.

Back then, opportunists tried to incite public resentment against the mainland with a concoction of lore and fallacy, undermining the trust much needed for the special administrative government to coordinate large-scale programs to protect its residents.

Thanks to the new National Security Law, there is one less risk for the Hong Kong government to manage.

Still, six months since the first wave of Covid-19 cases, the health system in Hong Kong is still in shambles.

Public physicians discontentedly call for private specialists to leave their lucrative practices and join the fray.

Small and medium businesses grumble over another lockdown. Residents who just emerged out of home-bound lives grudgingly retreat back to their mini flats.

No discussion heretofore included the efficient allocation of resources. To the dismay of many citizens, measures taken so far have yet to keep the virus at bay.

Neither the health administrations nor the health system is ready for the acute uptick.

Current protocols mandate the Department of Health to trace and test the contacts of infected people. New cases are divided into two groups.

Those old and frail are admitted to hospitals under the Hospital Authority, while the remaining self-quarantine at home for a few days until isolation beds, some space-consuming and expensive rooms, are available.

Many in the latter group cannot resist the urge to backdoor emergency departments and request immediate admission.

A handful of these relatively healthy patients consume the already scarce ambulance services in good faith of minimising the risk of spread to others.

They will then occupy the isolation beds planned for Covid-19-infected patients who are in much poorer conditions.

Resource misallocation breaches the social contract by leaving the needy out in exchange for guaranteeing extra safety to a minority who know how to game the system.

It is not difficult to see why this situation left unattended to is a slippery slope. Positive cases grow exponentially every day.

One-hundred people tested positive today may have already infected 200 people who will in turn infect another 400. Not all of them are detected and isolated.

Many continue to interact with friends and families and infect them. Take precedence from Italy – if this continues, the health system can be inundated and physicians will be put on the spot to make the judgement of whom to put on ventilators and who are beyond salvage.

Such a situation arises from the siloed work of the Department of Health (DH) and the Hospital Authority (HA).

There is no incentive for the DH to communicate to the public, as in Singapore and other countries and regions, about who requires hospitalisation and who may recover at home under constrained social resources for fear of a rare but career-damaging risk if one case dies at home.

It also makes sense that HA administrators who work from afar know this but see no personal gain in rationing resources. In fact, no one does. Hospitalise everyone, as long as their weekends and off-work hours are well-protected.

Unfortunately, medical workers do not enjoy this luxury. For many years, the ossified health system has been an inconvenient truth. Top-level administrators are loath to risk their careers for a much-needed overhaul.

Budget surpluses have been able to suppress this slow-growing pain. Some stakeholders, the physicians and patients, are hoodwinked into the notion that there is merely a shortage of manpower, hospital, and beds – and those in disbelief will find no lever to pull.

There is a clear misalignment of incentives among the decision-makers of Hong Kong’s health system.

It does not help that communication and collaboration between the two organisations have been lacking since 1990 when they were born out of the former Medical and Health Department.

What to do then? The health administrations can take the easy path and sprinkle budgetary excesses on the construction of hospitals, retrofitting spaces for more isolation beds, and hiring more doctors and medical workers – an effort to show, a tale to tell.

Still, this takes time. Nor is it sustainable. Or, they can use windfalls from taxpayers’ hard-earned money efficiently and equitably.

In a runaway pandemic, time and efficiency determine the success to nip cases in the bud. Health systems in the world, including the Chinese mainland and the US, are scrambling to streamline hospital workflow and manage healthcare resources in the face of an ageing population.

The post-pandemic era will once again be dominated by chronic diseases such as heart failure and cancer.

These patients require better care in the form of medication compliance and behavioural

changes, not hospitalisation. In other countries and regions, difficult policies debated for years were enacted overnight to provide telemedicine care and mobile application triage. Amid all misfortune, the pandemic unites people to change for the better.

The National Security Law is seen by some as a sharp sword bestowed upon the chief executive of the Hong Kong Special Administrative Region by Beijing, as well as a gesture of support for the SAR government to lead the region and do good to the people.

The benefits of the National Security Law also vindicate Regina Ip Lau Suk-yee and the pro-establishment parties who have tirelessly explained the law to foreign critics.

Sadly, the weakest link of Hong Kong’s health system remains unresolved not because of, but in spite of the pandemic.

Who should take responsibility? People are dying as the two health organisations bicker over this question. The sword is only as good as the wielder.

The chief executive should see this as an opportunity to demonstrate leadership and prove herself.

The author is a licensed medical doctor in Hong Kong and holds a master of public health degree from Johns Hopkins University. China Daily is a member of The Straits Times media partner Asia News Network, an alliance of 24 news media organisations.

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