As Hong Kong sinks under its worst wave yet of the coronavirus, overwhelmed hospitals have left patients waiting on sidewalks. People have stood in testing lines that wind across parks and soccer fields. Cases are still growing exponentially, as officials opt for targeted lockdowns rather than a citywide one. Researchers have warned that by summer the latest wave could kill nearly 1,000 people — more than four times the number that have died of Covid in Hong Kong over the past two years.

The city’s flailing response has exposed a crucial weakness in its ability to handle the coronavirus. Unlike other places facing a surge of the Omicron variant, Hong Kong, a semiautonomous Chinese city, cannot choose to live with the virus; Beijing continues to demand local elimination. But the city, which retains certain freedoms unheard-of in the mainland, also cannot wield Beijing’s full authoritarian tool kit or nearly unlimited manpower to stamp out transmission at any cost.

Hong Kong’s leader, Carrie Lam, has struggled even to define the term that the government uses to describe its approach, “dynamic zero.”