HONG KONG (AP) - For two years, Hong Kong successfully insulated most of its residents from COVID-19 and often went months without a single locally spread case. Then the omicron variant showed up.

The fast-spreading mutation breached Hong Kong’s defenses and has been spreading rapidly through one of the world’s most densely populated places, overflowing hospitals and isolation wards and prompting measures to test the entire 7.4 million population and hastily build six isolation and treatment centers.

The surge shows what happens when COVID-19 strikes a population unprotected by immunity from previous infections, and has exposed a low vaccination rate among elderly citizens who are bearing the brunt of the crisis.

Only about 30% of Hong Kong residents over the age of 80 and around 58% of those in their 70s are fully vaccinated, lagging younger populations by a large margin. This is despite the fact that vaccines have been widely available in Hong Kong since early 2021.

The city has reported about 150 deaths in the past three days, many among the unvaccinated elderly.

Health authorities said that the vaccine reluctance among the elderly is an unfortunate side-effect of Hong Kong’s success in warding off the virus for months.

Many people thought that the risk of getting COVID-19 was virtually nil since there were no cases, and senior citizens were led to believe that the risk of vaccination was greater than not getting vaccinated, said Karen Grépin, a public health expert at the University of Hong Kong.