Ending China’s extreme COVID policy could cause a health disaster

Almost three years after a pandemic that killed more than 6.6 million people worldwide, the official death toll in mainland China stands at 5,233, a surprisingly low figure for the world’s most populous country.

While most countries long ago stopped trying to eliminate the coronavirus and instead decided to live with it, China has gone to extreme lengths to prevent it from spreading. It has been tracking citizens, mandating regular testing, shutting down workers in factories, and shutting down entire cities under a plan that has come to be known as “Zero COVID.”

Now, as the economy rapidly declines and demonstrators take to the streets in unprecedented defiance of the authoritarian government, the country’s leaders face enormous pressure to ease those restrictions. increase.

But there is a big problem they have to deal with. Zero COVID has turned China into a coronavirus crater.

With outbreaks tightly controlled and vaccination coverage lagging, people may have little natural immunity. If rules are relaxed too much, experts fear the country of 1.4 billion will experience a major public health emergency that threatens its ability to care for the sick. .

“Without a coordinated and coherent plan, the number of cases will only increase rapidly and the healthcare system will quickly become overwhelmed,” he said. Yang Jung Hwang, Senior Fellow of Global Health at the Council on Foreign Relations and an expert in China’s public health. “It would defeat the very purpose of China’s pandemic response.”

To get an idea of ​​what that looks like, consider the following. Hong Kong in FebruaryAt that time, a highly contagious variant of Omicron breached the city’s zero COVID defenses and swept through the dense metropolis.

Although 72% of the population had been vaccinated against COVID-19, vaccination coverage among vulnerable older people was much lower. When the outbreak began, less than 45% of people over the age of 70 had been vaccinated, and among nursing home residents, less than 20%.

Within weeks, a large convention center was transformed into a makeshift hospital treating elderly COVID-19 patients. Wait times for ambulances lasted up to two days. The morgue ran out of coffins as the daily death toll surged from zero to nearly his 300. seem to be of low risk than its predecessor.

Public anger and frustration aside, many citizens fear a similar scenario could play out on the mainland.

“Society is very divided,” he said. Shi Chen, a health policy expert at the Yale School of Public Health. “They are worried about lockdown measures being too strict, but they are also worried about the government easing everything.”

When the novel coronavirus first emerged in Wuhan in late 2019, Chinese authorities were slow to recognize the threat. It was conducted. This meant canceling international flights, blocking highways, and confining entire city populations to their homes.

Within months, life returned to normal in China as countries such as the United States, South Africa and Brazil struggled to keep the death toll down.

President Xi Jinping said his best achievementThey say it’s proof that China’s governance is superior to that of the West.For a long time it seemed that he was right, Michael OsterholmDirector of the Center for Infectious Disease Research and Policy, University of Minnesota.

“Then came Omicron,” said Osterholm. “The previous variant was like a serious forest fire. It was difficult, but we were able to contain it. Omicrons are like the wind. They can deflect it. But , they can’t stop it.”

Chinese officials have certainly tried.

Authorities need daily or near-daily coronavirus tests to quickly identify infections. Single-digit case numbers are prolonging lockdowns. As of Nov. 22, 95 of China’s top 100 economic output cities have implemented COVID restrictions as new cases hit record levels, according to Beijing-based research firm Gavekal Dragonomics. .

Under the strictest lockdowns, citizens are struggling to supply enough food and medicine. These measures are also holding back the economy, closing businesses, disrupting factories and curbing consumer spending.

The government continues to tout low death tolls in countries that don’t include Hong Kong. Official tallies are subject to debate, but experts agree that China’s COVID-19 death rate remains one of the lowest in the world.

But its success has done little to quell the growing anger. For many, the cost of such unwavering policies is embodied by events such as the bus accident in the southern province of Guizhou. killed 27 people A person who had been transferred to a quarantine facility with zero COVID. Or the fact that anxious residents of Sichuan were forbidden to leave their apartment buildings. earthquake At least 93 people have died.Or the death of his three-year-old boy in Gansu died of carbon monoxide poisoning After medical workers enforcing lockdown prevented her father from calling an ambulance.

the last straw is Apartment fire kills 10 people Last week, Urumqi, the capital of the Xinjiang Uighur Autonomous Region, was under lockdown for more than three months. Angered citizens believed zero COVID controls prevented residents from fleeing and prevented firefighters from reaching the burning building in a timely manner.

Over the weekend, a mourning rally for Urumqi’s victims turned into mass demonstrations across the country, with many participants complaining about China’s zero COVID policy, Communist Party and President Xi.

Protesters hold up blank papers and chant slogans during a march in Beijing on November 27, 2022.

(Ng Hung Guan/Associated Press)

The government acted quickly, but suppress a protestthere are signs that public dissent is pressuring party leaders to come up with a COVID-zero exit plan.

It’s unclear exactly what that entails, but officials reiterated on Tuesday one major priority: boosting vaccination coverage among the elderly.As of mid-November, 90% of Chinese people are fully vaccinated, but according to the National Center for Disease Control and Prevention, only 66% of the population over the age of 80 is fully vaccinated, and despite widespread vaccination, Despite this, only 40% received the booster. Available.

As the elderly are most vulnerable to severe illness from COVID, it is imperative to boost their immunity.of Singapore, For example, 99% of pandemic deaths occur in people over the age of 60. Englandthat age group accounted for 92% of the deaths.

Vaccine skepticism has been widespread among older people across China since vaccination was first introduced, he said. Winnie Yip,director china health partnership at Harvard TH Chang School of Public Health. She takes it to the fact that her two domestically produced first-of-its-kind COVID-19 vaccines are only available to adults under her 60s.

“The general perception that the government gave people was, ‘We’re not sure about vaccines yet, so older people shouldn’t be vaccinated,'” Yip said. “Older people generally feel that they should not be at risk from vaccines because they are older.”

Nor can China count on its citizens having many immunities from past infections. The country conducts frequent coronavirus tests and uses a mobile health code that records travel history and close contacts to help identify asymptomatic cases before the virus spreads too far.

As a result, the health system could be overwhelmed with patients needing hospital beds if China’s strict zero COVID restrictions are lifted. According to research estimates and official comments, the country has about 4 intensive care beds per 100,000 population. According to the Kaiser Family Foundation, this equates to his ICU at 27 beds per 100,000 US population.

Even with a little leeway under the current circumstances, things can quickly spiral out of control.in the meantime Omicron-fueled outbreak in Shanghai In the spring, a trial of more lenient regulations flooded hospitals and nursing homes, putting the city of 25 million on lockdown for two months. Residents trapped in their homes complained of declining food and medical supplies, were forced to spend weeks in quarantine facilities, and sometimes had their parents separated from their children.

Workers set up a makeshift COVID-19 hospital with about 40,000 beds in Shanghai’s National Exhibition and Convention Center in April 2022.

(VCG via Getty Images)

“Cities are in a bit of a dilemma right now because they want to use a more flexible hand, but that doesn’t work,” he said. Ben Cowlingan epidemiologist at the University of Hong Kong.

Until China increases vaccination coverage among the elderly, improves vaccine and treatment efficacy, and strengthens medical resources, it cannot afford to relax its commitment to COVID-zero.

Andy Cheng, lead COVID analyst at Trivium China, a Beijing-based consulting firm, said: “If they had one of those three things, the risk calculation would be very different.

But so far China lacks all three.

Yang reported from Taipei and Healy from Fairfield, Connecticut. David Shen of The Times Taipei Bureau contributed to this report.