In an effort to maintain zero locally transmitted Covid-19 cases, Hong Kong has imposed one of the world's toughest quarantine regimes, confining most arrivals from overseas to a hotel room for as long as three weeks.
The strategy is working but has drawn backlash from business groups in the city that say the economic cost is too high and risks the city's status as one of the world's top financial centers. Residents, too, have complained that they are unable to go on trips, visit sick relatives abroad or bring their children back from overseas schools and colleges.
A decision this month to allow Hollywood star Nicole Kidman to skip quarantine after she arrived from Australia to film an Amazon Prime drama series fueled local anger. Officials said the show was an economic boost for the city.
Many travelers around that time had to cancel trips to or from the city or suffer the cost and time of a hotel stay -- if they could find a room -- after the government increased restrictions for arrivals from 15 countries including the U.S., France and Switzerland.
Jessica Cutrera, an American asset manager based in Hong Kong, said many business people in the city feel isolated, especially as the U.S. and Europe have opened up.
Nobody expected to travel last year, she said, but "Now our competitors or other service providers are able to travel. They are seeing their clients; that puts us at a disadvantage."
The quarantine measures have vexed the international financial community, already unsettled by more than two years of political turmoil, including antigovernment protests in 2019 and China's implementation of a national-security law last year.
In an open letter to Carrie Lam, Hong Kong's chief executive, the European Chamber of Commerce said the rules could lead many in the international community to question "if they want to remain indefinitely trapped in Hong Kong when the rest of the world is moving on."
Those concerns could pose a threat to Hong Kong's status as an international business center, the letter said.
A government spokesperson said authorities had apologized for the most recent disruption but that "everything we are doing is to protect Hong Kong from another major outbreak, particularly at a time when the Delta variant is spreading quickly around the world."
Since the pandemic began, the city of 7.5 million has had about 12,000 confirmed cases and about 200 deaths. It has recorded two locally transmitted infections in the past four weeks.
Defending the decision to grant Ms. Kidman an exemption, the government said the actress's work was "conducive to maintaining the necessary operation and development of Hong Kong's economy."
Ms. Kidman and her representative couldn't be reached for comment.
An experiment earlier in the summer to allow shorter quarantine periods for fully vaccinated travelers entering Hong Kong who underwent blood tests to check that they had sufficient antibody levels was short-lived.
Officials scrapped it after one person, who contracted the virus inside a quarantine hotel, tested positive 14 days after arriving back in Hong Kong, after she had been allowed back into the community.
Such rapid rule changes have irked travelers. Days after Ms. Kidman arrived, local officials threw into disarray plans of thousands of people overseas to return by classifying 15 countries as high risk, adding them to a list that already included the U.K., Brazil and India.
Residents overseas raced to find three-week stays in designated quarantine hotels, with some unable to secure rooms until mid- to late October. Nonresidents and unvaccinated Hong Kongers from high-risk places were barred.
The new measures have taken a financial and emotional toll on Ankur Bordia, who owns a jewelry business in Hong Kong, and his wife, Priyanka Bordia.
The couple, traveling with two toddlers and two domestic helpers, have been stuck in India for months because it is on the high-risk list and their Indian vaccination records aren't recognized by Hong Kong authorities.
Like many families, they planned a workaround: a three-week "washout" journey to the lower-risk Maldives and Dubai, before flying on to Hong Kong. After the government moved the United Arab Emirates to the high-risk list last week, the family is back at square one.
Mrs. Bordia, who estimated that plans had cost the family of six about $25,000, is planning a three-week stay in Doha, Qatar; or Cairo.
"Every single moment there is this fear: What if a sudden policy change is announced?" she said.
Tara Joseph, president of the American Chamber of Commerce in Hong Kong, which represents U.S. businesses in the city, said she had been inundated with stories of business people caught out by the new restrictions, some who are stuck abroad and others concerned by the cost of staying in a hotel for three weeks.
A few have decided to leave the city as a result, she said.
"It's decision makers -- senior executives -- who are getting stuck, and this doesn't provide a good image for Hong Kong," Ms. Joseph said.
Some senior executives can apply for an exemption depending on where they are traveling from, but such cases are few.
Mark Tucker, chairman of London-based HSBC, served his three-week quarantine during a recent visit to the city.
Allan Zeman, a real-estate developer and government adviser, said he agreed with the policies even though they are painful.
The government's priority is to open its borders with mainland China, which has adopted zero tolerance for the virus and plays a big role in Hong Kong's economy, he said.
Low case counts have enabled local businesses to reopen and let Hong Kong residents live almost normal lives, aside from being unable to travel, Mr. Zeman said.
After operating under severe restrictions during earlier waves of infections, local businesses, shops and restaurants can operate more freely, with social-distancing rules relaxed because of near-zero local cases.
But some worry there is no end in sight for strict quarantine -- 47.8% of the population has had both shots of a Covid-19 vaccine, despite plentiful supply since April.
By contrast, Singapore, rivaling Hong Kong as the region's business hub, has more than 75% of its population fully vaccinated and has shifted away from its zero-Covid-19 plan, taking steps to cautiously loosen border restrictions.
Yuen Kwok-yung, an infectious-disease professor on an expert panel that advises the Hong Kong government, co-wrote a commentary published on August 25 arguing that herd immunity has become unachievable as the virus mutates and renders vaccines less effective.
Hong Kong should maintain its zero-Covid-19 strategy until its population has been vaccinated and is ready to explore ways of coexisting with the virus, his team wrote.
Other medical experts argue that three weeks is misguided.
"I think there is clear evidence that quarantine longer than 14 days is unnecessary," said Ben Cowling, a professor at the University of Hong Kong's School of Public Health.
"If anything, a 21-day quarantine actually increases the risk," he said, pointing to cases in New Zealand that resulted from infections inside quarantine hotels or among workers at entry ports.
Ms. Cutrera, the asset manager, said business leaders aren't trying to be critical of the government but would welcome the opportunity to work with officials on policies that support industry and are backed by scientific evidence, such as allowing home quarantine and shortening the period from 21 days.
Working with family offices internationally that often cover complex and sensitive areas, she said, made it important that her team be able to spend time with clients.
While her team had switched easily to Zoom relationships with longtime U.S. colleagues, it became more difficult after her company recently merged with another American business.
"When you've got a new relationship, new team members and growing business, you really cannot replicate that in-person time," Ms. Cutrera said.
