A pandemic can make or break a government and its leader. New Zealand Prime Minister Jacinda Ardern won the October election by a landslide because of her “go hard, go early” approach in effectively eliminating the local spread of Covid-19 after a second lockdown.

In contrast, US President Donald Trump might have won his second term if not for his dismal Covid-19 performance. Brad Parscale, a campaign adviser, reportedly told him, “Sir, regardless, this [coronavirus] is coming. It’s the only thing that could take down your presidency.” And it did.

Hong Kong’s relatively impressive performance in the early phase of the pandemic was once thought to be a turning point for Chief Executive Carrie Lam Cheng Yuet-ngor, whose fate had been haunted by political unrest since mid-2019. At the end of the year, however, it appears she is trapped in a no-win battle against Covid-19.

Learning from the bitter lesson of the severe acute respiratory syndrome (Sars) outbreak in 2003, Hong Kong has displayed community-wide crisis awareness and speedy emergency response. Government efforts have improved, with better coordination of the public and private sectors.

Both the government and public health system are largely efficient, yet the administration has not received full credit for its arduous task. Crisis leadership has been hampered by low public trust, making it hard to enact more coercive and contentious measures.

Until June, in terms of infection and death rates, Hong Kong was near the top end of the international table. Since then, the city has slipped. The pandemic is now in its fourth wave with more untraceable local infections.

Lam once described Covid-19 as a three-way tug of war, having to balance public health, economic impact and social acceptance in devising response measures. This is a dilemma faced by all governments when fighting a ferocious pandemic.

Hong Kong is densely populated. While the potential public health risk is related to close human contact, restrictions over gatherings and movement are not easy to enforce, especially under the present distrustful climate. Compliance cannot be taken for granted.

There was an early debate overseas between strong suppression and a herd immunity approach. International experience has shown that the latter does not work and the cost is high.

Sweden is unique in resisting for a long time wearing masks or imposing a lockdown. Its death rate is now many times that of other Nordic countries. An independent inquiry blames the government for being unprepared to meet the pandemic, and Sweden’s king admits the country “has failed”. The US is also paying a huge price for the Trump administration’s lax approach and disrespect for science.

Hong Kong has not gone down that route. However, with the successive spikes in cases, the government’s effectiveness is being questioned. It has rejected universal mandatory testing in favour of voluntary testing, except for infected or suspected cases and vulnerable groups.

Unlike Sars, which only lasted several months, Covid-19 is asymptomatic and has been around for a year, yielding new variants and with no sign of subsiding. While vaccines are now available, population-wide vaccination will take at least another year.

As the pandemic goes on, community fatigue has crept in, leading to reduced alertness. The government must keep the public on side, avoiding elite bias or professional prejudice. People are concerned about the threat to their lives and livelihood.

Hong Kong cannot casually talk about a lockdown given its externally oriented economy that depends on worldwide connectivity. The economy has suffered enormously, with GDP for the full year expected to be down by more than 6 per cent.

The government has so far dedicated HK$311.5 billion (US$40.2 billion) to anti-pandemic support and relief. Another HK$6.4 billion is forthcoming, but its coffers are not unlimited. If the economy deteriorates further, the fiscal capacity to alleviate livelihood problems will weaken while unemployment shoots up and business closures and downsizing become more frequent.

Blanket lockdowns are costly and unsustainable. The government still aims to achieve zero cases while not shutting down so some social and economic life can continue, but is that possible?

Even if the mainland model cannot be replicated in terms of whole-country mobilisation, stringent lockdowns, locality confinement and mass testing, the argument for tightening quarantine, testing and local community control appears to be getting stronger.

One can look beyond the mainland for lessons. In April, Singapore imposed a “circuit breaker”, in effect a nationwide partial lockdown, with very restrictive measures until June to contain the local upsurge of Covid-19. Melbourne went into lockdown for 112 days from August to October when the state of Victoria became the epicentre of Australia’s second wave.

In Britain and other parts of Europe, lockdowns have been imposed amid a more serious second wave this winter. Even South Korea is considering its first lockdown in light of a rise in new infections. All along, it has been relying on aggressive testing and sophisticated tracking.

Only those closest to the front line can gauge the real challenges. The government, assisted by expert advisers, is still in the best position to size up the problems. That said, a prolonged crisis will not give it the requisite strength and support to face the pandemic.

Politics cuts both ways. The government cannot muster sufficient capacity to fight the coronavirus without the public on its side. Yet, should it fail to effectively contain the pandemic, public support will dwindle further. The dual threat of the pandemic and economic recession will induce more discontent in an already tense political environment.

The zigzagging between control and relaxation is disruptive, breeding more uncertainty. Unless the goal of zero cases is quickly achieved, even with great pain, there is little prospect of gradual economic recovery.

The economy should be a priority. Difficulties in the logistics of virus suppression cannot be underestimated, but they have to be tackled with bolder action. The public needs to be won over through continuous engagement with informed and honest discussion.

Severe, intrusive measures including mandatory testing and partial or local lockdowns, if ultimately unavoidable, are better implemented earlier rather than later to have a real impact. Once the opportunity is missed, the coronavirus will become uncontrollable, as we are seeing in the US and Britain.