Roving Periscope: No Zero Covid policy may now overwhelm China with infections!

Virendra Pandit

New Delhi: After three years of stringent Zero Covid policy, China’s rapid abandonment of mass testing, lockdowns, and centralized quarantine may overwhelm the world’s most populous country with fresh waves of infections, ahead of the Chinese New Lunar Year on January 22, 2023, when millions of holidaying people traditionally migrate within the country.

The media reported on Friday that China faces this gigantic task after the quick scale-down of the Covid control policy which may potentially surge exponentially and cause the death of up to two million.

Although China has abruptly called off the Zero Covid policy to quell widespread protests against it, the government has not yet put in place the required mitigation measures needed to deal with the resulting explosion in cases, which could total 5.6 million a day at the peak, according to some estimates.

Unlike the phased outbreaks in the US and Europe over months and years, China might witness a huge number of infections engulfing the country all at once in a population that until now has largely avoided exposure to the virus. Other countries, which slowly opened up, have learned to live with the virus because of effective vaccination and the evolution of immunity to many of the virus variants.

The Chinese have neither been adequately vaccinated—they see their vaccines as substandard!—nor have they learned to live with the virus. Their sudden exposure might cause something the world has not seen during the pandemic, the reports said.

Worried experts in various disciplines paint a picture of impending chaos, with absenteeism paralyzing factories, serious disease overwhelming hospitals, and outbreaks forcing residents to hide in their homes. Between 1.3 million and 2.1 million people may die, based on Hong Kong’s earlier experience with the omicron variant, according to an estimate by London-based research firm Airfinity, the media reported.

“It will be all over the country almost at the same time, but first in urban areas and then in rural because of the crowding,” said Ali Mokdad, a professor at the Institute of Health Metrics and Evaluation and chief strategy officer for population health at the University of Washington. “It will be one month from now when we see very high numbers of cases, and mortality will come two weeks later. It will never come back down to where it is now.”

That grim projection would put the peak for infections close to the start of the Lunar New Year, the most important holiday of the year in China. Before Covid-19, the weeklong break was the biggest internal mass migration event in the world as factory workers returned to their hometowns and villages for annual visits. Chilling winter will also supercharge the virus’s spread as people spend more time inside.

These formidable challenges will force nursing homes to battle to protect their vulnerable, schools will close for extended periods as waves of infection hit, and businesses won’t have enough workers as illness takes hold. China’s reliance on less potent home-grown vaccines means multiple shots are essential, while a dearth of circulating viruses allowed people–mostly the elderly–to skip immunization until now.

“I don’t think anything looks good for China right now,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Its 1.4 billion people are at increased risk of contracting this virus for the first time, and these first infections surely pose the risk of serious disease, including hospitalizations and deaths.”

A saving grace to China, however, is the dominance of the Omicron strain, which is highly infectious but milder than its previous avatars.

“At this stage, the virus is totally different; being infected isn’t that serious,” said Xiaolin Wei, chair of global health policy at the University of Toronto’s School of Public Health. “Right now, the death rate is very low.”

An analysis from economists at Barclays suggests China’s fatality rate from an omicron wave would be 4 in 1,000 people, or 0.4 percent, among the unvaccinated. For the fully vaccinated, it could be two in 10,000, or 0.02%, they estimated.

Although it abandoned stringent measures, China is also preparing for the worst-case scenario. It will allow the infected people to go to their desired hospitals rather than the designated ones and will set up special wards for pregnant women, patients battling comorbidities, and high-risk groups with health conditions.

The National Health Commission is mobilizing community medical centers across China as “gatekeepers”, to provide the first point of care to those with mild diseases so they could self-medicate and recover at home. The government would also add more hospital beds, something other countries did in 2020 itself.

But some health experts and economists say the government won’t try to rush its exit from Covid Zero, which means moving past the virus could take time.

Epidemiologist Eric Feigl-Ding said the remaining restrictions could help slow the spread of infections, while people are also more likely to wear masks and stay home.