Deaths in Hong Kong’s worst ever COVID-19 outbreak are forecast to spiral, with experts predicting a wave of fatalities among the city’s under-inoculated and vaccine-hesitant elderly population.

Only 43% of seniors who are 80 or over have received even one dose, according to government data. While that is up from 22% in early January, it still isn’t enough to protect the segment of the population most at risk, according to Karen Grepin, an associate professor in the school of public health at the University of Hong Kong. Elderly patients have already made up the majority of the 311 deaths in this outbreak so far.

"Even doubling of a small number is still a small number,” Grepin said. "There are still unvaccinated people in nursing homes and that is just a ticking time bomb.”