Select List of Covid Restriction Offences in Hong Kong (Updated: 24 February 2022)

This blog post aims to help persons in Hong Kong navigate the various Covid-19 restrictions and offences imposed under the law.  Click here for the lists of premises in Hong Kong specified for compulsory testing (Centre for Health Protection). As from 24 February 2022, the Chief Secretary for Administration has a power to grant an exemption in writing from any requirement under any enactment for purposes of preventing, protecting against, delaying or otherwise controlling the incidence or transmission of COVID-19 or treating patients with COVID-19.  Last Updated: 24 February 2022.

A. Complying with Vaccine Pass Direction (Cap 599L) (expiry date)

• A person must not (a) enter or remain on any specified premises unless the person has been vaccinated in the specified manner for the purposes of a vaccine pass direction in relation to the premises; or (b) board or remain on any specified public transport carrier unless the person has been vaccinated in the specified manner for the purposes of a vaccine pass direction in relation to the carrier.  Secretrary's direction.  Maximum punishment: $10,000 fine.  Does not apply to these persons.  Specified medical exemption certificate.  
• The person in charge of any specified premises or specified public transport carrier must comply with any requirement made in a vaccine pass direction in relation to the premises or carrier.  Secretary's direction. Maximum punishment: $50,000 fine and 6 months imprisonment. Defence available. 
• A responsible person for a vulnerable person must use the responsible person's best endeavours to ensure that the vulnerable person complies with section 5(1) (prohibition on entering or remaining on specified premises unless vaccinated, etc).  Maximum punishment: $10,000 fine. Defences available.  

B. Prohibition on Group Gatherings (Cap 599G) (expiry date)

• Group gatherings of more than 2 persons at a public place are prohibited during a specified period (24 February to 9 March 2022).  Offences to participate in gathering, organise the gathering, and to knowingly allow the taking place of the gathering as one who owns, controls or operates the place/premises at which the gathering takes place.  Maximum punishment: $25,000 fine and 6 months imprisonment. Defences available. List of exemptions. Chief Secretary's permission.

C. Prohibition on Multi-Household Gatherings (Cap 599G) (expiry date)

• Multi-household gatherings (i.e. a gathering of persons ordinarily living in more than 2 households) at any private premises are prohibited during a specified period (24 February to 9 March 2022).  Offences to participate in gathering, organise the gathering, and to knowingly allow the taking place of the gathering as one who owns, controls or operates the premises at which the gathering takes place.  Those solely providing care and support to any other participant of the gathering ordinarily living in another household who has particular needs are not counted when counting households.  Maximum punishment: $25,000 fine and 6 months imprisonment. Defences available. Exemptions available. Chief Secretary's permission.

D. Requirements and Directions in Relation to Catering Businesses (Cap 599F)  (expiry date)

• Person responsible for carrying on a catering business contravening requirement to cease selling food or drink or close premises as directed by the Secretary for Food and Health for a specified period (24 February to 9 March 2022).  Secretary's direction.  Does not apply to certain premises.  Maximum punishment: $50,000 fine and 6 months imprisonment.  Defences available. 
• Person responsible for carrying on a catering business contravening requirement to comply with direction issued by the Secretary for Food and Health for a specified period (24 February to 9 March 2022).  Secretary's direction.  Maximum punishment: $50,000 fine and 6 months' imprisonment. Defences available. 
• Person who enters, or is present on, any catering business premises contravening requirement to comply with direction issued by the Secretary for Food and Health for a specified period (24 February to 9 March 2022). Secretary's direction. Maximum punishment: $10,000 fine. Defences available. 

E. Directions in Relation to Scheduled Premises and Specified Events (Cap 599F)  (expiry date)

• Manager of any scheduled premises (other than event premises), or the organizer of a specified event held on event premises, contravening requirement to comply with a direction issued by the Secretary for Food and Health for a specified period (24 February to 9 March 2022).  Secretary's direction. Maximum punishment: $50,000 fine and 6 months imprisonment.  List of scheduled premises.  Defences available. 
• Person who enters, or is present on, any scheduled premises contravening requirement to comply with direction issued by the Secretary for Food and Health for a specified period (24 February to 9 March 2022). Secretary's direction.  List of scheduled premises.  Maximum punishment: $10,000 fine.  Defences available. 

F. Wearing of Mask (Cap 599I) (expiry date)

• On public transport carrier/MTR paid area. Person contravening requirement to wear a mask at all times, during a specified period (24 February to 9 March 2022), when the person is (a) boarding or on board a public transport carrier; or (b) entering or present in an MTR paid area.  Exceptions and defences.  Maximum punishment: $10,000 fine. 
• In a specified public place. Person contravening requirement to wear a mask at all times, during a specified period (24 February to 9 March 2022), when the person is entering or present in a specified public place.  Exceptions and defences.  Maximum punishment: $10,000 fine.

G. Compulsory Testing for Certain Persons (Cap 599J) (expiry date)

• A person who fails to comply with a requirement under a compulsory testing direction commits an offence.  Maximum punishment: $10,000 fine. Power of specified medical practitioner to issue written direction requiring a person to undergo a specified test.  Defences available.
• A specified person who fails to comply with a requirement under a compulsory testing notice commits an offence.  Maximum punishment: $10,000 fine. Latest testing notices.  Power of Secretary to issue testing notices.  Defences available.
• A person who fails to comply with a requirement under a compulsory testing order commits an offence.  Maximum punishment: $25,000 fine and 6 months imprisonment.  Power of prescribed officer to order testing for non-compliance with testing direction or notice. Defences available.

H. Premises Subject to Restriction-Testing Declaration (Cap 599J) (expiry date)

• A restricted person leaving any restricted premises commits an offence.  Maximum punishment: $25,000 fine and 6 months imprisonment. Power of Secretary to make restriction-testing declaration.  Prohibition does not apply in certain circumstances.
• A person, other than a prescribed officer or person specified under section 19M(3), entering any restricted premises commits an offence. Maximum punishment: $25,000 fine and 6 months imprisonment.  Power of Secretary to make restriction-testing declaration.  Prohibition does not apply in certain circumstances.

I. Restrictions During Quarantine (Cap 559C) (expiry date)

• A person must not leave the place of quarantine in which the person is placed under quarantine without permission given by an authorized officer. A person who, without reasonable excuse, contravenes this prohibition commits an offence. Maximum punishment: $25,000 fine and 6 months imprisonment. Compulsory quarantine of certain persons arriving at Hong Kong. 
• A person must not, without permission given by an authorized officer, knowingly enter an assigned place of quarantine in which another person is placed under quarantine unless (a) the person is an authorized officer or a health officer; or (b) the person is to be placed under quarantine in the place.  A person who, without reasonable excuse, contravenes this prohibition commits an offence. Maximum punishment: $25,000 fine and 6 months imprisonment. Compulsory quarantine of certain persons arriving at Hong Kong.  Written permission of an authorized officer.
• A person against whom a quarantine order is made must not contravene the terms of quarantine specified in the order. A person who, without reasonable excuse, contravenes this prohibition commits an offence. Maximum punishment: $25,000 fine and 6 months imprisonment. 

Roda Mushkat on China and the Elusive Search for a Viable Governance Regime in the Era of Coronavirus (Eur J of Comp L and Gov)

"From China’s “Political Meritocracy” to “Just Hierarchy”: the Elusive Search for a Viable Post-Democratic Governance Regime in the Era of Coronavirus"
Roda Mushkat
European Journal of Comparative Law and Governance
Published online on 26 May 2021

Abstract: Students of comparative constitutional design grapple with myriad complex normative and empirical issues. Prominent among them is the relative effectiveness of different governance regimes. Concerns stemming from the perceived malfunctioning of modern democracies have intensified efforts to diagnose and rectify the supposedly proliferating ills. The seemingly solid post-1978 Chinese record of steadily managing intricate societal challenges has highlighted the possible advantages of the country’s tightly controlled top-down institutional apparatus and its potential value as a model worth broadly exploring and even embracing on a meaningful scale. This view, authoritatively and vigorously articulated by an influential and prolific political philosopher and his academic associates, has evolved to a point whereby the Chinese constitutional order and contemporary experience are portrayed as being capable of fruitfully supplanting democratic structures or, alternatively, productively revitalising them. Yet, on the whole, this remains a controversial politico-legal proposition, conceptually problematic and lacking sufficient factual support.

Stephen Thomson, Eric Ip & Shing Fung Lee on Comparisons of COVID-19 Data and the Effectiveness of Non-pharmaceutical Interventions (Journal of Biosocial Science)

"International comparisons of COVID-19 case and mortality data and the effectiveness of non-pharmaceutical interventions: a plea for reconsideration"
Stephen Thomson, Eric Ip and Shing Fung Lee
Journal of Biosocial Science

Published online on 27 October 2021

Abstract: International comparisons of the effectiveness of coronavirus disease 2019 (COVID-19) non-pharmaceutical interventions (NPIs) based on national case and mortality data are fraught with underestimated complexity. This article calls for stronger attention to just how extensive is the multifactorial nature of national case and mortality data, and argues that, unless a globally consistent benchmark of measurement can be devised, such comparisons are facile, if not misleading. This can lead to policy decisions and public support for the adoption of potentially harmful NPIs that are ineffective in combating the COVID-19 pandemic and damaging to mental health, social cohesion, human rights and economic development. The unscientific use of international comparisons of case and mortality data in public discourse, media reporting and policymaking on NPI effectiveness should be subject to greater scrutiny.

Eric Ip on Courts, Proportionality and COVID-19 Lockdowns (IACL-AIDC Blog)

"Courts, Proportionality and COVID-19 Lockdowns" 

Eric Ip

IACL-AIDC Blog
September 23, 2021

The COVID-19 pandemic and domestic legal responses to it have inflicted widespread suffering across the globe. States, democratic and authoritarian, most of them signatories of international human rights instruments, including the International Covenant on Civil and Political Rights (ICCPR), the International Covenant on Economic, Social and Cultural Rights (ICESCR), and the United Nations Convention on the Rights of Persons with Disabilities (CRPD), have imposed drastic emergency responses that include quarantines of entire towns, cities, provinces, even nations unprecedented in the modern era.

    Mass quarantine, called ‘lockdown’, can be said to be an invention of the Chinese authorities who shut down transport systems in Wuhan, the first known epicentre of the COVID-19 outbreak, in January 2020. Though differing from state to state, such measures generally feature significant restrictions on citizens’ personal liberty, freedom of movement, work, family life, education, and ironically even health due to the delay in treating other diseases. Displacing individuals, families, and social networks may very well prove, in retrospect, to have caused a devastating public mental health crisis. The economic slump, mass unemployment, domestic violence, and other repercussions that ensued on lockdowns that disproportionately hit the less well-off may ramify in more long-run health issues and early deaths than the pandemic itself.

     It has become commonplace in public debate that a public health emergency is a legitimate justification for suspending fundamental rights and freedoms at all costs. In fact, to adopt an ‘all-or-nothing’ approach to combat a public health emergency using non-pharmaceutical Interventions is incompatible with most international human rights treaties, especially the ICCPR. Article 4 of the ICCPR explicitly forbids such restrictions, even during a ‘public emergency which threatens the life of the nation’, if it should involve ‘discrimination solely on the ground of race, colour, sex, language, religion or social origin’; or derogations from the right to life, freedom of thought, conscience and religion; or from the prohibition of torture, cruel, inhuman or degrading punishment, medical or scientific experimentation without consent, slavery, slave-trade, servitude, imprisonment due to inability to fulfil a contractual obligation; or from recognition of everyone as a person before the law and the principles of legality in criminal law. What is more, the Siracusa Principles on the Limitation and Derogation Provisions in the International Covenant on Civil and Political Rights, approved in 1984 by the United Nations’ Commission on Human Rights, states that the ‘severity, duration, and geographic scope’ of any emergency response that derogates from the rights guaranteed by the ICCPR must be ‘strictly necessary’ and ‘proportionate’ to the threat defended-against... Click here to read the full post.

Calvin Ho et al on Immunity Certification for COVID-19: Ethical Considerations (Bulletin of the WHO)

"Immunity certification for COVID-19: ethical considerations"
By Teck Chuan Voo, Andreas A Reis, Beatriz Thomé, Calvin WL Ho, Clarence C Tam, Cassandra Kelly-Cirino, Ezekiel Emanuel, Juan P Beca, Katherine Littler, Maxwell J Smith, Michael Parker, Nancy Kass, Nina Gobat, Ruipeng Lei, Ross Upshur, Samia Hurst & Sody Munsaka
Bulletin of the World Health Organization (2021) 99(2): 155–161.

Abstract: Restrictive measures imposed because of the coronavirus disease 2019 (COVID-19) pandemic have resulted in severe social, economic and health effects. Some countries have considered the use of immunity certification as a strategy to relax these measures for people who have recovered from the infection by issuing these individuals a document, commonly called an immunity passport. This document certifies them as having protective immunity against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the virus that causes COVID-19. The World Health Organization has advised against the implementation of immunity certification at present because of uncertainty about whether long-term immunity truly exists for those who have recovered from COVID-19 and concerns over the reliability of the proposed serological test method for determining immunity. Immunity certification can only be considered if scientific thresholds for assuring immunity are met, whether based on antibodies or other criteria. However, even if immunity certification became well supported by science, it has many ethical issues in terms of different restrictions on individual liberties and its implementation process. We examine the main considerations for the ethical acceptability of immunity certification to exempt individuals from restrictive measures during the COVID-19 pandemic. As well as needing to meet robust scientific criteria, the ethical acceptability of immunity certification depends on its uses and policy objectives and the measures in place to reduce potential harms, and prevent disproportionate burdens on non-certified individuals and violation of individual liberties and rights.

WHO Policy Brief on Emergency Use Designation of COVID-19 Candidate Vaccines: Ethical Considerations for COVID-19 Placebo-controlled Vaccine Trials and Trial Unblinding

"Emergency Use Designation of COVID-19 candidate vaccines: Ethical considerations for current and future COVID-19 placebo-controlled vaccine trials and trial unblinding"

Policy brief by the World Health Organization (WHO), 18 December 2020

Associate Professor Calvin Ho is a member of the WHO ethics expert group which produced the policy brief. He also shared on the ethical and regulatory issues in the vaccine race in a webinar on "International Law, Science and Technology in the Time of COVID-19" hosted by the Lauterpacht Centre for International Law of the University of Cambridge on 4 December 2020. Click here for the recording.  

Introduction: The grave public health threat posed by COVID-19 has spurred the development of dozens of COVID-19 candidate vaccines, and the conduct of numerous accelerated COVID-19 vaccine trials, many of which are in Phase 2/3 of testing. Given this severe threat, some drug regulatory authorities including the United States Food and Drug Administration (FDA) and the European Union’s European Medicines Agency (EMA) have indicated that, if interim data are sufficiently compelling, they are prepared to issue COVID-19 candidate vaccines conditional / emergency / early approval prior to completion of Phase 3 trials. In such instances the regulatory authority signals that the balance of risk and benefit to designated target populations justifies deployment of the vaccine pending the registration / licensure of that product on public health grounds. Similarly, to assist World Health Organization (WHO) Member States and UN procurement agencies in decision-making on the acceptability for use of specific products in the context of a public health emergency, WHO has established an Emergency Use Listing (EUL) procedure to expedite the availability of interventions needed in public health emergency (PHE) situations. The validity of a WHO EUL in the context of a public health emergency is generally 12 months. All decisions to grant an EUL are reassessed at 12 months (or sooner, if further data become available that could alter the original opinion). EUL is contingent upon the vaccine developer completing the development of the product and its trial, and submitting the candidate vaccine for registration/licensure and WHO prequalification.  EUL is not equivalent or an alternative to WHO prequalification, and should not be thought of as such. For the purposes of this policy brief, all mechanisms that facilitate the public accessibility of investigational vaccines prior to the conclusion of their respective clinical trials or their licensure, shall hereinafter collectively be referred to as ‘Emergency Use Designation’ or EUD... Click here to download the policy brief.

Solutions to COVID-19 Data Sharing (The Lancet Digital Health)

"Solutions to COVID-19 data sharing"
Greg Fegan, Phaik Yeong Cheah and the Data Sharing Working Group (of which Calvin Ho is a member) 

The Lancet Digital Health 

2021, Vol 3, Issue 1, E6

We read with interest The Lancet Digital Health Editorial regarding transparency during global health emergencies, and we wanted to bring to your readers' attention our work on data sharing.  After WHO's declaration of COVID-19 as a global pandemic, the COVID-19 Clinical Research Coalition was established on April 2, 2020. The Coalition is made up of global health researchers working in, or allied with, resource-limited settings across multiple continents. This umbrella group has grown, with working groups now spanning nearly a dozen interest areas including ethics, clinical pharmacology, and data sharing. Here, we outline the rationale and aims of the Data Sharing Working Group, which comprises researchers working on ethics, regulatory, and operational aspects of data sharing... Click here to read the full correspondence.

Calvin Ho & Chia-Chin Lin on How the COVID-19 Pandemic Could Reshape Palliative Care Into High-Tech and High-Touch Care (Cancer Nursing)

"How the COVID-19 Pandemic Could Reshape Palliative Care Into High-Tech and High-Touch Care: An Ethics of Care Perspective"

Ho, Calvin Wai-Loon & Lin, Chia-Chin

Cancer Nursing, 

2020, Volume 43, Issue 6, pp. 429-430

Introduction: Coronavirus disease 2019 (COVID-19) disrupted palliative care and other healthcare services as health systems were quickly overwhelmed with patients and by public health measures requiring social distancing and restricting face-to-face contact. These challenges have spurred the adoption of digital health (DH) in many health systems across the globe. Digital health is mainly concerned with the use of routine and innovative forms of information and communications technology to address health needs. Digital health has become an umbrella term that encompasses eHealth, telemedicine, mobile health (or mHealth), and emergent technologies such as big data analytics and artificial intelligence.

Shitong Qiao on A New Age for the WHO? Comments on "The WHO in the Age of the Coronavirus: (USALI Perspectives)

"A New Age for the WHO? Comments on The WHO in the Age of the Coronavirus"

Shitong Qiao
USALI Perspectives
4 January 2021

In a paper recently published by the American Journal of International Law, USALI Faculty Director José E. Alvarez offered five reasons the World Health Organization is in crisis as well as suggestions for reform. Professor Alvarez also discussed his analysis in this USALI Perspectives essay, and in this October 28 talk. Professor Shitong Qiao of Hong Kong University served as commentator in the October 28 program. This essay summarizes his observations. 

     There is much to agree with in Professor José E. Alvarez’s argument that COVID-19 may ultimately drive organizational change at the World Health Organization (WHO). Indeed, nation states are currently discussing how to reform the WHO, with even China supporting a comprehensive review of the WHO regime. From the starting point of a shared vision of the WHO as defined in the WHO Constitution, I would like to provide a realistic assessment of how China might respond to Professor Alvarez’s proposals for WHO reform... Click here to read the full text.

Amanda Whitfort on COVID-19 and Wildlife Farming in China (Journal of Environmental Law)

"COVID-19 and Wildlife Farming in China: Legislating to Protect Wild Animal Health and Welfare in the Wake of a Global Pandemic"

Amanda Whitfort

Journal of Environmental Law

Published on 12 January 2021

Abstract: Coronavirus disease 2019 (COVID-19) has exposed serious deficiencies in the current legal framework to protect wild animal health, and consequently human health. As noted by the World Organisation for Animal Health (OIE), animal health and welfare are inextricably linked. However, there is no international agreement to promote animal welfare and neither the Convention on International Trade in Endangered Species of Wild Fauna and Flora nor the Convention on Biological Diversity, adequately address the welfare of the species they seek to conserve. While the OIE provides guidance on animal health and welfare standards for common agricultural species, it has provided limited guidance for the farming of wild species. China’s wildlife farming industry has been linked with the spread of COVID-19 but, to date, China has introduced few national welfare controls to protect the health of wild animals bred for human consumption. In the wake of COVID-19, these omissions must be remedied to provide appropriate safeguards to ensure animal health and welfare and protect public health.

Douglas Arner Discusses the Ant Group IPO Failure, FinTech 4.0 and the Effects of Covid-19 on Digital Finance (Video & Podcast)

Video - Looking Back Looking Forward: Ant Group & Global Digital Finance Platforms by Professor Douglas Arner

 

Summary: In this episode of Looking Back Looking Forward - the last of 2020 - Professor Douglas Arner discusses how COVID-19 has driven digitisation of finance to new levels, marking the emergence of FinTech 4.0. In finance, the impact of COVID-19 on digitisation can be seen in dramatic increases in e-commerce and digital communications, with particularly dramatic increases in: 1) electronic payment and digital currencies; 2) regulatory technology (RegTech); 3) non face-to-face transactions, and 4) data and concentration. FinTech 4.0 is characterised by the emergence of increasingly dominant digital finance platforms benefiting from network effect and economies of scope and scale while integrating finance and technology. The best example is China's Ant Group and the dramatic halt of its IPO - which would have been the world's largest - by Chinese regulators in November 2020 as a result of the fact that these platforms bring not only benefits but also huge new risks and concerns. 

     These concerns and possible approaches are highlighted in a new paper: 'Digital Finance Platforms: Toward a New Regulatory Paradigm', available at: https://papers.ssrn.com/sol3/papers.c... For more information on the University of Hong Kong's financial technology programme, visit http://www.hkufintech.com and discover the transformation of information technology's ever-growing impact on finance.

      Listen to the Podcast - All you need to know about Ant Group (and its canceled IPO) by Professor Douglas Arner. Arner joins the Fintech Beat podcast to talk about the origins of Ant Group, its regulatory shortcomings in the Chinese financial system, and when he expects to see an IPO. The paper 'Governing Global Digital Finance', available at https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3678518​ projects the background of both the video and the podcast.

RGC funded Collaborative Research Project on Insolvency Law Implications of Covid-19 in Hong Kong

Congratulations to the research team recently awarded a RGC Collaborative Research Fund (CRF) Grant of $3.11 million for the project "Hong Kong Insolvency and Restructuring Law and Policy in Times of COVID-19 and Beyond".  The project collects data on the impact of the pandemic on businesses in Hong Kong and considers whether reforms to Hong Kong's laws of insolvency and business restructuring are needed.  It is led by Professor Wai Yee Wan of City University of Hong Kong School of Law and includes Co-Principal Investigators from HKU Law (Mr Alwin Chan and Mr Kelvin Kwok) and City University of Hong Kong, and other collaborators from Oxford University and Leeds University.  This is yet another good example of a collaborative research project between HKU Law and CityU Law.  There are very few law-related projects supported by the CRF fund, so well done to the team and hopefully we will see more CRF collaborations between legal academics in Hong Kong.

Stephen Thomson & Eric Ip on COVID-19 Emergency Measures and the Impending Authoritarian Pandemic (J of L & Biosciences)

"COVID-19 emergency measures and the impending authoritarian pandemic"

Stephen Thomson & Eric Ip 

Journal of Law and the Biosciences 

Published 29 September 2020

Abstract: COVID-19 has brought the world grinding to a halt. As of early August 2020, the greatest public health emergency of the century thus far has registered almost 20 million infected people and claimed over 730,000 lives across all inhabited continents, bringing public health systems to their knees, and causing shutdowns of borders and lockdowns of cities, regions, and even nations unprecedented in the modern era. Yet, as this Article demonstrates—with diverse examples drawn from across the world—there are unmistakable regressions into authoritarianism in governmental efforts to contain the virus. Despite the unprecedented nature of this challenge, there is no sound justification for systemic erosion of rights-protective democratic ideals and institutions beyond that which is strictly demanded by the exigencies of the pandemic. A Wuhan-inspired all-or-nothing approach to viral containment sets a dangerous precedent for future pandemics and disasters, with the global copycat response indicating an impending ‘pandemic’ of a different sort, that of authoritarianization. With a gratuitous toll being inflicted on democracy, civil liberties, fundamental freedoms, healthcare ethics, and human dignity, this has the potential to unleash humanitarian crises no less devastating than COVID-19 in the long run.  Click here to read the full article.

Daisy Cheung & Eric Ip on COVID-19 Lockdowns: a Public Mental Health Ethics Perspective (Asian Bioethics Review)

"COVID-19 Lockdowns: a Public Mental Health Ethics Perspective"

Daisy Cheung & Eric Ip

Asian Bioethics Review
Published in August 2020

Abstract: States all over the world have reacted to COVID-19 with quarantines of entire cities, provinces, and even nations. Previous studies and preliminary evidence from current lockdowns suggest that emergency measures protecting the public’s physical health by dislocating individuals, families, and social networks could well be causing a devastating public health crisis of mental ill-health in the months and years to come. This article is the first to take a public mental health ethics perspective in examining these lockdowns, the lodestar of which is the right to mental health, rooted in the concept of human dignity. Even the strictest lockdowns are not necessarily unethical but are prone to damage mental health disproportionately, with vulnerable and disadvantaged populations being at particular risk.  Click here to read the full article.

Stephen Thomson & Eric Ip on COVID-19 Emergency Measures Hurting Democracy Globally (American J of Public Health)

"COVID-19 Emergency Measures Are Hurting Democracy Globally"

Stephen Thomson & Eric Ip

American Journal of Public Health

Issue 110, Volume 9, p 1356

Published online in August 2020

Abstract: As necessary as effective COVID-19 emergency measures are, governments around the world must never lose sight of the need that a proportionate balance ought to be struck between population health goals on the one hand, and “the fundamental rights and freedoms that are the lifeblood of transparent, accountable, and democratic government”, on the other.

Eric Ip on Hong Kong's COVID-19 Health Regulations (Public Law)

"Hong Kong - the unprecedented promulgation of public health emergency regulations against the COVID-19 outbreak" 

Eric Ip

Public Law

July 2020, pp.580-582

Abstract: Examines the public health emergency regulations passed by Hong Kong in response to the COVID-19 pandemic under the Prevention and Control of Disease Ordinance s.8. Details the scope of the powers, their key features, such as a compulsory quarantine period for new arrivals, and the context in which they were made. Reviews the constitutional principles available to prevent such measures from violating the rule of law, including proportionality.​

Eric Ip & Daisy Cheung on Global Mental Health Security—Time for Action (JAMA Health Forum)

"Global Mental Health Security—Time for Action"

Eric Ip & Daisy Cheung

JAMA Health Forum 

Published in June 2020

Global health security has been concerned predominantly with organizing transnational collective action to prevent the risks of bioterrorism and infectious disease outbreaks, such as the Ebola crisis of 2014-2016.1 One confounding omission in global health security has been mental health. The Global Health Security Agenda (GHSA), currently a partnership of more than 60 sovereign states plus the World Health Organization (WHO), other international institutions, nongovernmental organizations, and private companies, is committed to “a world safe and secure from infectious disease threats.” Of its 8 Action Packages, from antimicrobial resistance to biosecurity to zoonotic disease, none pertains directly to mental health. The WHO’s Global Preparedness Monitoring Board, which gauges global preparedness not just for outbreaks but also health emergencies, makes no meaningful reference to mental health in its first annual report, released in September 2019.2 None of the 6 indicators on the Global Health Security index, developed by the Johns Hopkins Center for Health Security, the Nuclear Threat Initiative, and The Economist Intelligence Unit, even mentions mental health... Click here to read the full article.

Eric Ip & SF Lee on Preparing for the Coming Transnational Cancer Crisis Amid the COVID-19 Pandemic (Cancer Causes & Control)

"Preparing for the coming transnational cancer crisis amid the COVID-19 pandemic"

Eric Ip & Shing Fung Lee 

Cancer Causes & Control

Published in May 2020

https://doi.org/10.1007/s10552-020-01310-3

Abstract: The continuing outbreak of the coronavirus disease 2019 (COVID-19) caused by the novel coronavirus SARS-CoV-2 has inflicted considerable burdens onto the health system of China, the world's most populous country. Remarkably, among spectrum of potential mitigation strategies, the Chinese government has implemented all-out lockdowns on large geographical areas, unprecedented in the modern era. This inevitably undermined the right to healthcare of many who now faced great difficulty in getting treatment, especially those with cancer or other life-threatening issues. We elaborate and discuss the medico-legal and human rights consideration triggered by the lockdowns, the unprecedented mass quarantine of Hubei province in China, and the suspension of normal healthcare services. We argue that the same challenge will now be faced by other countries, particularly the USA, Italy, Spain, and France, as the epicentres of COVID-19 has shifted to Europe and the Americas.

     It has been estimated that by 2020, China will have over 4.5 million cancer patients and in consequence some 3 million cancer deaths [1]. That number may surge in consequence of the 2019 coronavirus (COVID-19) outbreak, which has been declared a public health emergency of international concern and then a global pandemic by the WHO, as cancer patients have been found to suffer poorer outcomes from COVID-19 than those without cancer [2]. Alarmingly, Wuhan, the epicentre of the pandemic, has exhibited mass neglect of treatment of all other patients not infected with COVID-19, including those suffering from cancer. The shortage of medical care for these patients stems from the all-out campaign of the Chinese health authorities to contain COVID-19 with drastic lockdown measures at significant social and economic cost. The suspension of care occurs in spite of the mobilization of extra equipment and manpower to Hubei province and its capital Wuhan, and building of makeshift healthcare camps to monitor and care for the 67,794 (as at 15 March 2020) confirmed cases infected with coronavirus, and others suspected to have been infected [3].

     The problematic consequences of China’s COVID-19 strategy, which has been adopted to varying degrees by many countries, upon the broader healthcare system are beginning to emerge. Many hospitals in Hubei have been designated for and converted to the exclusive care of COVID-19 patients, with previous treatment plans for other patients being postponed or suspended. Additionally, due to fears of COVID-19 cross-infection, hospital wards have not been permitted to admit cancer patients and operating theatres have had to be closed. Chemotherapy has been suspended indefinitely. Clinical trials have been similarly affected: participants have been unable to return for follow-up; data collection are no longer timely; many protocols have been violated. Notwithstanding effective measures coping with the needs of cancer patients during the pandemic reportedly adopted by a hospital in Beijing, the nation’s capital [5], there is much evidence pointing to a systemic coming crisis in cancer treatment in the world’s most populous country, whose magnitude cannot be easily quantified.

     People in China with other diseases, even life-threatening ones, are struggling to even get diagnosed, let alone treated. The exclusive public health focus on COVID-19 at the expense of even special classes of patients implies that the health system in Hubei, if not elsewhere, is in all likelihood being strained to the breaking point in delivering the usual care while coping with the pandemic, and will remain so for quite some time. Delays in the delivery of oncological care could yield long-lasting, devastating effects at both individual and population levels. Lessons may be learned from the recent history of the Chinese special administrative region of Hong Kong. The former British dependency was one of the jurisdictions most heavily afflicted by the severe acute respiratory syndrome (SARS) outbreak of 2003, suffering almost 40% of the global death toll [5]. The Hong Kong Cancer Registry recorded a dip in crude cancer incidence to 20,763 during 2003 (the only year to break the uptrend) and a significant rebound the next year [6]. It may have been that the anxiety prevailing in the general public about seeking medical attention caused delayed diagnosis, or the administrative burdens inflicted by the epidemic hampered normal registration processes and then the non-registered cases were carried over to the next year. Note that this happened even though no radical cuts were made to cancer treatment in Hong Kong, as there have been in Hubei this time. When resources become as heavily skewed toward COVID-19 patients as they have in Hubei and elsewhere, the cancer patients currently ignored will face delays in diagnosis and treatment, which will adversely affect oncological outcomes. This very same challenge to healthcare service will be faced by other countries heavily afflicted by the virus such as USA, Italy, Spain, and France as the epicentres of COVID-19 has now shifted to Europe and the Americas.

     The Chinese government, as with governments elsewhere, should therefore take steps to prepare for a massive resurgence of cancer patients hitting the healthcare system once the COVID-19 pandemic has been contained. It is understandable that the authorities are under pressure to accord top priority to this containment, especially given the media furore and public anxiety. But it is both ethically and pragmatically dubious that this should be done to the detriment of all other patients. Considerations of justice and of equable resource allocation must not be neglected in national preparedness for cancer incidence [7]. The urgency to reassign priorities so as to give due weight to the needs of cancer patients and ontological research is acute even from a law and policy perspective. China’s landmark Basic Healthcare and Health Promotion Law, which codifies a decade of healthcare reforms and is set to enter into force on 1 June 2020, will for the first time guarantee to the Chinese people a positive “right to health”, which will in turn obligate the State to enhance citizens’ ability to live a “full life cycle” (Article 4), echoing the promises of Article 12 of the International Covenant on Economic, Social and Cultural Rights, signed and ratified by most countries of the world.

"The Paradox of Information Control in China" (Clement Chen Profiled in HKU's The Bulletin)

"The Paradox of Information Control in China"

The Bulletin

Published in May 2020

Chinese law allows access to information on the one hand but restricts it on the other, which has a troubling impact on everything from virus outbreak controls to the country’s new social credit system.

The COVID-19 coronavirus outbreak that started in Wuhan this past winter triggered deep questions about the flow of information in Mainland China, as officials played down the threat until it became too big to ignore. To those who experienced SARS in 2003, the situation was depressingly familiar. 

     Dr Clement Chen Yongxi of the Faculty of Law was an MPhil student during SARS. In 2002, he had witnessed the drafting of a new freedom of information regulation for Guangzhou – the first of its kind in China – and he was dismayed that it failed to make the municipal government more transparent about the SARS outbreak. 

     The situation prompted his research interest in the gap between law on paper and law in action, and to observe: “What happened with SARS is closely related to what is happening now.” 

     As in Guangzhou, the central government had ostensibly improved freedom of information with the 2007 introduction of the Regulation on Open Government Information (ROGI) which, ironically, was partly motivated by SARS and other cover-ups. But this failed to ensure prompt reporting about COVID-19. Whistleblowing doctors in Wuhan felt compelled to go to social media about the threat rather than official channels such as news agencies, and they were summoned and disciplined by the police for their efforts. 

     So why haven’t the lessons been learned? Dr Chen’s research over the past 12 years sheds light on the flaws – and progress – of information control on the Mainland.

No right to monitor government 

Dr Chen said the ROGI was initially considered a positive step because for the first time in Chinese history, citizens had the right to demand information from their government. But two critical defects have limited its impact. One is that it conflicts with other laws which restrict disclosure of information and prevail over ROGI. The other is that it contains a wide scope of exemptions, including disallowing the disclosure of information that ‘endangers social stability’, which is not defined. This gives government agencies wide discretion to interpret things as they see fit. 

     The judicial response to the government’s denial of access to information has been cautious. Courts examine closely the motive of the applicant, but subject agency claims to various degrees of scrutiny. As a result, they support information requests relating to the applicant’s personal interests, such as their property rights, but refrain from enforcing ‘watchdog requests’ concerning government accountability or the common good. 

     “Some judges have even claimed that the right to information under ROGI does not amount to the right of monitoring the government. This is a bit ironic because the nature of freedom of information laws almost around the world is as an instrument to support democracy and allow citizens to monitor government operations,” he said. “This partly explains why, after 17 years, ROGI doesn’t prevent a public emergency similar to SARS from being covered up.”  Click here to read the full text. 

Daisy Cheung & Eric Ip on a Public Mental Health Ethics Perspective on the Covid-19 Lockdowns (Journal of Medical Ethics blog)

"What are the obligations of the state? A public mental health ethics perspective on the Covid-19 lockdowns"

Daisy Cheung & Eric Ip

Journal of Medical Ethics blog

Published in May 2020

The Covid-19 crisis has led to the unprecedented and widespread use of lockdown measures all over the world. With such drastic measures being imposed so widely and on such short notice, the concern is that the Covid-19 precedent, which has allowed the suspension of a wide range of human rights in a desperate attempt to curb the spread of the pandemic, is a dangerous one. Insufficient thought is being given to the effects of policies being put in place. In particular, the effects of these measures on the right to mental health are being overlooked, next to the harm done to the freedoms of movement, residence, assembly, and association.

     What is the right to mental health? Legal obligations aside, it can scarcely be disputed that governments have an obligation to advance the common good and public interest, including to eliminate grave and preventable risks not only to the physical health but also the mental health of their people. There are two important reasons for this. First, without a minimally tolerable level of mental health, citizens will be unable to meaningfully exercise civil and political rights like the freedom of speech and the right to vote. This means that the unwillingness of governments to fulfill basic mental health needs will directly impede democracy-enabling rights. Secondly, neglecting the right to mental health will in one way or another lead to neglecting the right to physical health. There is a broad consensus that mental disorders are risk factors for communicable as well as non-communicable diseases, as well as being contributory factors to accidental as well as non-accidental injuries.

     How might this right to mental health be violated by the state? What we are concerned about, in a paper we are currently developing, is the failure to take necessary and appropriate steps to protect public mental health during an emergency. In the context of Covid-19 lockdowns, the primary concern is that in implementing an ill-planned, drastic response to the emergency, the response itself may result in harms to public mental health. While we cannot be sure of the precise psychological effects of the lockdowns, past studies of quarantines provide us with useful insight into the types of effects that lockdowns may have on mental health. For example, in a review of such studies, it was found that most of these reported a series of adverse psychological effects, the impact of which was wide-ranging, substantial and in some cases, long-lasting.

     Apart from the increased mental health risk to all citizens subjected to lockdown measures, however, the more troubling aspect is perhaps the disproportionate effect that the violation of the right to mental health will have on vulnerable and disadvantaged populations. Low-income families, for example, are often confined to very small spaces for lengthy periods at a time. The psychological risks of living within tight spaces would likely be gravely exacerbated if one has no choice but to remain in that small space, often with family members, for most of the day, with no end in sight. For these families, school closures may also mean that their children are no longer receiving the school meals that they heavily depend on, likely a source of anxiety for parents and children alike. Those with pre-existing mental disorders are also particularly vulnerable in these circumstances. Fear of hospitals and clinics will likely affect the willingness to access timely mental healthcare. Individuals with mental disorders will not be able to engage in many of the usual recommendations for maintaining good mental health, such as socialisation, which will then detrimentally impact their mental state.

     There are many other similarly vulnerable and disadvantaged groups. Lockdowns have kept those with abusive family members confined in the same living space as their abusers. The elderly and the disabled may be more likely to suffer difficulties procuring essential supplies such as groceries and masks, in particular during panic-buying, due to issues with mobility. Single parents are left with very few alternatives when faced with the closure of childcare facilities and schools while continuing to work from home. These predicaments are all likely to leave these groups with a range of adverse psychological reactions: fear, anxiety, anger and frustration... Click here to view the full text.