https://www.stamfordadvocate.com/news/article/Isolated-and-vulnerable-amid-the-covid-crisis-17008347.php

HONG KONG – The three people who took their own lives on the same day last week in Hong Kong used different methods. One hung herself with a cotton rope in the cubicle of a public toilet. The other two jumped to their death.

But they had something in common: police records show all were over 70, and all three tested positive for the coronavirus a few earlier according to local media reports.

Their cases are examples of the acute mental crisis afflicting Hong Kong as it battles one of the worst covid outbreaks in the world, more than two years into the pandemic. Depression stemming from isolation and a sense of hopelessness has hit the elderly population especially hard, a group that has the lowest vaccination rate in Hong Kong and makes up a disproportionate part of the more than 4,900 covid deaths in the city since the start of this most recent outbreak.

Hong Kong’s covid death rate is higher than anywhere in the developed world, at one death per every 20 infections.


Like mainland China, Hong Kong adhered to a “zero covid” policy, which focuses on eliminating the virus or at least keeping local infections as low as possible. But the methods that worked previously, like mandatory masking, social distancing measures, limited foreign arrivals and mandatory quarantine regimes have not stopped the spread of the more transmissible omicron variant.

Since February, infection numbers have been rising exponentially, overwhelming the hospital system which has been forced to scale back accident and emergency services and instead convert most wards to covid treatment facilities.

The social distancing restrictions have led to isolation across the board – especially for the vulnerable elderly. Schools, bars and gyms are closed, and outdoor gatherings are limited to just two people. Meanwhile, overcrowded government quarantine facilities are struggling to process and discharge covid patients, prolonging their forced isolation and leading to protests and a few suicide attempts.

In a news conference on Thursday, Chief Executive Carrie Lam announced an upcoming review and “comprehensive update” next week regarding the social distancing and border control measures, as public morale is at a low point and financial institutions are “losing patience.”

“I have a very strong feeling that people’s tolerance is fading,” Lam said.

Mental health issues are most acute among the elderly, many of whom have faced long-term isolation either in care homes or in small flats for two years. According to government census figures, the number of elderly residents living alone have increased by over 50% from 2006 to 2016.

The closure of elderly centers and other recreational facilities, which is often the main support system for seniors who live alone, heightened their sense of loneliness and led to depression, social workers said. Long-term isolation at home, coupled with grim death reports and images of the elderly lying in outdoor triage areas in the news magnified their fear of getting infected.

Just 66% of seniors aged 70 to 79 and 36% of those over 80, are fully vaccinated, with many still hesitant over the jabs’ reported side effects.

“Some seniors have lots of questions, don’t know how to solve the problems, but don’t want to trouble their adult children,” said the chairman of Hong Kong Patients’ Voices, Alex Lam (no relation to the chief executive). “This could lead them to the ‘wrong path,'” he added, referring to suicide.

According to the Samaritan Befrienders Hong Kong, a suicide prevention group, nearly one-fifth of the 270 people who sought help from them amid the latest wave of infections were seniors. In July last year, the group recorded 438 deaths by suicide among people older than 60, the highest yearly number since 1973.

Joyce Chan, 70, said she was unable to sleep at night after watching the daily news on infections and deaths. Forced to isolate at home everyday, Chan found her mental health deteriorating. The nights alone were particularly hard to bear. Every rash, blister and body discomfort caused panic, Chan said, but she did not want to bother her children. The television became her only comfort, but also a source of stress with constant updates on the rising covid death toll.

“When I hear the sirens of the ambulance passing by my street . . . I feel very scared,” said Chan, who is unvaccinated. “If anything happens to me, no one will know.”

Chan was one of the many elderly residents who reached out to Crystal Yuen, a social worker at the Society For Community Organization, for advice on hospital appointments, emotional support and practical needs like rice and surgical masks. Yuen, who is also a member of the government’s advisory committee on mental health, said a majority of seniors who reached out showed signs of depression.

“There are extreme cases of some seniors who haven’t left their flats for two years,” Yuen said. “With no contact with sunlight and just communication via the phone, they will feel depressed.”

The stress has also impacted elderly couples who only have each other for support. Dede Leung, age 68, is the caretaker of her 80-year-old husband, but herself suffers from chronic ailments. Unvaccinated, the couple has isolated together. Her husband, who has dementia, cannot share her fears and worries.

Leung recalled an accident when her husband fell of his chair. With jammed emergency lines and ambulance services prioritizing severe covid cases, Leung called for help from neighbors in desperation but no one responded. After a half-hour struggle, she managed to leverage her husband back into his chair with a towel wrapped around the sofa edge.

“I sometimes cry because I feel like I am suffering too much, but I’ve pulled myself together,” Leung said. “How else can I be – it’s not like I can consider death, can I?”

Hong Kong’s adherence to the mainland’s zero covid policy, which experts say is unsuitable to the dense and culturally diverse city with a population of 7.5 million, is the root cause of low morale in the city, said Lam of the Patients’ Voices organization.

Constantly shifting government policies, such as a mandatory testing scheme announced weeks ago but with no further details, has caused residents to lose confidence in the government. Rumors of a lockdown continue to bubble up, leading to panic-buying in supermarkets and pharmacies.

The lack of support and uncertainty “doubles or triples the pressure” for the elderly, Lam said, as they are more reliant on feeble government subsidies and far more isolated than the rest of the population.

“Everyone is paying a price,” Lam said. “But is the price we pay worth it?”

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