There are no funeral ceremonies for some of the hundreds of elderly Hong Kong residents dying every day of covid. Their bodies are instead sealed in plastic bags and then quickly cremated, freeing up space at the morgue for more arrivals.

Hong Kong — a wealthy financial center — now has the highest covid death rate in the developed world. More than 2,300 people have died since the start of the city’s most recent outbreak, compared with just 213 in the two years prior. Those dying are overwhelmingly elderly, unvaccinated residents, but they also include toddlers and children too young to be immunized.

The outbreak has been an embarrassment for the city’s government, which once prided itself on a “zero covid” policy that kept local infections down. The policy mirrors that of mainland China, where strict social distancing, mass testing, lockdowns and largely closed borders have been effective at preventing the coronavirus from overwhelming the hospital system.

But Hong Kong has been unable to match the mainland approach, lacking the resources to isolate everyone who tests positive or put the city under lockdown. The highly transmissible omicron variant crippled the city’s defenses, affecting the most vulnerable elderly population in particular. In January, less than 1 in 5 residents above the age of 80 had been fully vaccinated with two doses, and almost none had three.

That percentage has risen since then, but experts say it is still too little, too late, especially compared with Singapore, South Korea and Japan, where the elderly were a priority for vaccinations.

“It would have been better if [the elderly] were vaccinated in the past eight months, we could have avoided this huge problem now,” Yuen Kwok-yung, a professor at the department of microbiology at the University of Hong Kong and a government adviser on covid, told reporters earlier this month.

“Unfortunately, I think the elderly will pay a huge price” in this wave, he added.

The failure to vaccinate this group has now pushed hospitals, elderly care homes and morgues to a breaking point. Kwok Hoi-bong, chairman of the Funeral Business Association, said that public mortuary refrigerators are so overwhelmed that temporary ones had to be installed outside the facilities.

“The key is how to clear them as quickly,” Kwok said. “There are regrettably more and more bodies.”

Conundrums like these are new to Hong Kong and reminiscent of the early days of the pandemic in cities like New York and Italy’s Bergamo — which are now moving on and reopening to the world.

Hospital emergency rooms are also overflowing. One doctor at a public hospital’s emergency ward said in an interview that beds are now crammed close to fit them all in the space. Doctors can barely access the patients, with no way to walk around the beds.