In early 2020, news of the emerging COVID-19 outbreak in Wuhan caused concern in Hong Kong, a densely populated region with a history of battling infectious diseases. This coincided with a period of significant political unrest and social division following months of large-scale anti-government protests. The proximity of Wuhan and the collective memory of the 2003 SARS epidemic shaped Hong Kong's initial response. The Hong Kong government activated its anti-epidemic plans, and the public readily adopted preventative measures such as mask-wearing and social distancing, reflecting their experiences with SARS. Despite these early efforts, COVID-19 still spread, prompting a detailed examination of Hong Kong’s response strategy. Hong Kong’s relatively low number of cases and deaths during 2020, achieved without full lockdowns, is analyzed. The study explores the interplay between the government's policies (including travel restrictions, testing, quarantines, and mask mandates), public acceptance, and the role of the science advisory system in shaping Hong Kong’s response.

The paper draws upon the literature of crisis management, defining a crisis as an urgent threat requiring swift decision-making under pressure and uncertainty. It uses 't Hart's crisis typology (situational and institutional crises) to frame the pandemic response. The authors also utilize the crisis management cycle (preparation, response, recovery, prevention) to analyze Hong Kong's actions. The literature on policy learning and policy windows is incorporated to understand how crises can foster policy change. The research acknowledges the crucial role of scientific evidence in pandemic policymaking, highlighting the need for expert advice in areas beyond the capabilities of politicians and policymakers.

This research employs a descriptive, in-depth case study approach with comparative analysis of the SARS and COVID-19 pandemics within the Hong Kong political context. It aims to identify parallels and contrasts in policy responses, science advisory mechanisms, and communication strategies. The study draws on a range of publicly available data sources, including policy documents, government statistics, media accounts, and academic literature. For SARS, the researchers analyzed self-published government brochures and documents to understand advisory structures and operational processes. For COVID-19, the analysis focused on documents from a dedicated government website, press conferences, and social media updates. The methodology involves tracing the government's policy responses and changes in scientific advisory mechanisms over time for both outbreaks.

The study reveals significant differences in Hong Kong's science advisory mechanisms between the SARS and COVID-19 responses. During SARS, the advisory structure was primarily hospital-centric, focused on immediate medical needs and treatment due to the high severity and rapid onset of the virus. The Hospital Authority (HA) Working Group on SARS played a central role. In contrast, the COVID-19 response saw a more multifaceted and multi-agency approach, involving the Center for Health Protection (CHP) and various government workgroups. The initial response to COVID-19 was faster than to SARS, reflecting lessons learned from the earlier crisis. However, the COVID-19 response also incorporated a broader range of expertise, extending beyond public health and medicine to include social and economic considerations. The study also highlighted the crucial role played by informally appointed expert advisors, who effectively communicated with the public and played an important role in shaping public opinion, particularly during periods of low public trust in the government. While the formal scientific advisory committees provided important guidance, their formal documents and meetings were not publicly accessible or transparent. The study found that the government’s response was heavily influenced by the political context of low public trust. Public acceptance was crucial for successful policy implementation, and widespread vaccine hesitancy and low participation in universal testing demonstrated the limitations of top-down approaches when public trust was eroded. The paper also identifies the benefits of technological advancements and cross-border collaborations.

The findings underscore the indispensable role of robust science advisory structures and experienced scientific experts in managing health crises. However, the research also demonstrates the limitations of relying solely on formal structures, especially in politically charged environments. The success of pandemic response hinges not only on sound scientific advice but also on public trust, effective communication, and a capacity to adapt policies to the evolving epidemiological situation. Hong Kong’s experience illustrates the interplay of scientific expertise, political context, and public acceptance in shaping pandemic policy. The study highlights the need for flexible and multidisciplinary advisory mechanisms capable of addressing not just medical but also social and economic dimensions of public health crises. The research contributes to a greater understanding of science advice in crisis management, revealing the complexity of incorporating this advice into policy-making, and highlights the necessity of building and maintaining public trust.

Hong Kong's COVID-19 response, informed by SARS experience, demonstrated the importance of robust science advisory structures and expert knowledge in managing health crises. The study highlights the need for transparent, multidisciplinary advisory mechanisms that adapt to the specifics of each pandemic. Future research should focus on enhancing transparency, understanding the dynamics of science advice within decision-making processes, and addressing the challenges of maintaining public trust in both government and scientific expertise during public health emergencies. Further research is crucial to understanding how to best bridge the gap between scientific advice, policy decisions, and public acceptance, particularly in politically sensitive contexts.

The study's reliance on publicly available data limits its ability to delve into the internal decision-making processes of government and advisory committees. Lack of access to internal communications may have limited the depth of analysis regarding the influence of scientific advice on policy decisions. The focus on the year 2020 limits the insights into the long-term impacts of COVID-19 and the evolution of the science advisory mechanisms beyond the initial response phase. Further research involving interviews with key decision-makers and experts could provide deeper insights into the process of science advice and its impact on policy decisions.