Friday, February 3, 2023
HomeHealthAs officials ease restrictions, China faces new pandemic risks

As officials ease restrictions, China faces new pandemic risks

As country after country has been hit by outbreaks this year, China has held back the coronavirus, buying valuable time to prepare for the inevitable: a variant of the virus so volatile and contagious that China, too, will struggle to contain it.

But instead of laying the groundwork for that scenario, China has stepped up its commitment to Covid zero by rolling out sudden lockdowns and contact tracing.

Meanwhile, daily vaccinations have fallen to record lows. Intensive care beds remained in short supply, even as workers built testing booths and isolation rooms. Research on homemade mRNA vaccines has not kept pace with the rapidly mutating virus.

Now the costs of such an approach are piling up, putting China in a predicament from which there appears to be no easy way out, the scientists said in an interview.

Even as the number of new Covid cases hit an all-time high, residents took to the streets to protest the lockdowns that have brought daily life to a halt in many cities. Alarmed officials began easing restrictions.

Researchers fear China could run into trouble trying to reopen the country and ease the strain on its economy without risking a flood of deaths. Such a catastrophic surge could pose a significant threat to the political leadership.

“We often pretend that China has a choice in terms of Covid zero versus openness,” said Dr. Siddharth Sridhar, a virologist at the University of Hong Kong. “There was never a choice. The simple fact is that China is not ready for a wave of this magnitude.”

Nothing slows down China’s preparations more than the difficulty in vaccinating the elderly. Two-thirds of people aged 80 and over are vaccinated, but only 40 percent received a booster dose, a critical shortcoming because Chinese-made vaccines provide weaker protection than Pfizer-BioNTech and Moderna vaccines.

AT study during the Omicron surge in Hong Kong, two doses of China’s main domestic vaccine Sinovac was only 58 percent effective against severe Covid or death in people aged 80 and over. In contrast, two doses of Pfizer-BioNTech were 87% effective in the same group. An early research in Brazil similarly, two doses of Sinovac were found to be only 61 percent effective in preventing death from Covid.

These results reinforced the impression among scientists that the Chinese vaccines, which rely on killed viruses to elicit an immune response, are in fact a three-dose rather than a two-dose vaccine.

The situation is complicated by the fact that the last major vaccination in China was in the spring, with an interval of eight months or more since the last dose for many recipients.

This can undermine their immune defenses. BUT studying in Malaysia found that while the Pfizer-BioNTech vaccine induced relatively robust protection against ICU admissions after three to five months, the effectiveness of the Sinovac vaccine against ICU admissions fell to 29 percent from 56 percent over the same period.

According to Dr. Paul Hunter, an infectious disease specialist at the University of East Anglia in England, Chinese vaccines play relatively well with other mRNA-free Covid shots. But reopening the country so long after the last vaccination campaign could be detrimental.

“I think this is more of an issue than the quality of Chinese vaccines,” said Dr. Hunter.

The gaps in vaccination of China’s elderly population are all the more evident given that the country as a whole has achieved relatively high coverage rates. Nearly 90 percent of the population received the primary vaccine series, usually consisting of two doses of Sinovac or Sinopharm, another Chinese-made vaccine.

This discrepancy is partly the result of an outdated theory that as long as younger and more active Chinese are immunized, the country will be able to establish a sort of herd immunity and protect the elderly, said Andy Chen, a Shanghai-based analyst at consulting firm Trivium. .

According to Mr. Chen, older people in China often avoid health risks, so the possibility of even minor side effects from a vaccine might seem threatening to many. China’s reluctance to release data on the efficacy and side effects of its vaccines has created a vacuum in which these concerns have flourished, other experts said. Misinformation about side effects has circulated on Chinese social media.

And while health officials encourage older people with chronic illnesses to get vaccinated, vaccinators are often reluctant to do so without access to the medical history of more vulnerable recipients.

The “zero Covid” strategy has only made the vaccination campaign more difficult. By limiting the spread of the infection, it has saved lives, but it has also undermined the sense of urgency for many older people to get vaccinated.

The emphasis on taking throat swabs instead of administering vaccinations has drawn additional attention during the vaccination campaign. Since the spring surge, China has set up tens of thousands of test beds in cities like Shanghai and Beijing and built huge facilities to isolate millions of people. The level of vaccination remained at the same level.

“The healthcare system is always understaffed,” said Xi Chen, assistant professor of public health at Yale University. “People were telling me at the time that they needed to focus on mass testing.”

This week, China said it would resume efforts to vaccinate its elderly citizens, announcing measures to use mobile vaccination stations, administer vaccinations in nursing homes and bypass the most vulnerable populations, the country’s National Health Administration said in a statement. commission.

But some experts, such as Yanzhong Huang, a global health specialist and senior fellow at the Council on Foreign Relations, expressed skepticism that the move was more than empty talk.

“It’s about impacting the current approach,” he said. “But this approach fundamentally no longer makes any sense from a public health policy standpoint.”

The authorities did not provide a detailed plan for new efforts and did not begin to require mandatory vaccination. As powerful as the country’s leadership is, experts say, forcing older people to get vaccinated is seen as a potential abuse of power, risking a public backlash.

“From the point of view of a local government official, if even one person dies from the side effects of vaccines, that’s blood on your hands,” said Mr. Chen, an analyst at Trivium. “Recovering from that is very difficult.”

If the number of cases continues to rise, gaps in vaccination coverage could put more pressure on hospitals, which may also have to contend with the winter cold and flu season. China has fewer intensive care beds per capita than many other Asian countries.

The country once battled a shortage of doctors and nurses, especially in rural areas, by moving medical workers from one province to another when the virus broke out. A nationwide flood of Omicron infections would make this impossible.

BUT study from Shanghai Fudan University in May warned of a “tsunami” of Covid cases and an estimated 1.6 million deaths if China abandoned its “zero Covid” policy. Since then, China has acquired more antiviral treatment options. But the capacity of its hospitals is limited enough that the sudden lifting of “zero Covid” restrictions would still trigger a health crisis, said Ben Cowling, a professor of epidemiology at the University of Hong Kong.

Given the inevitability that each time China reopens, the number of cases will rise, Yang Yang, assistant professor of biostatistics at the University of Florida, said efforts to “prepare the medical system” were a priority. He added that there are already some signs that management is shifting its focus from building quarantine facilities to strengthening its top hospitals.

China’s floundering retreat from the emergency phase of the pandemic contrasts with the withdrawal of countries such as New Zealand and Taiwan. There, the lockdowns gave respite while the population was vaccinated; when the measures were lifted, the death rate rose sharply, but to levels much lower than in countries such as the United States.

China’s strategy so far has also limited Covid deaths, the scientists say, but has not charted a way out of the restrictions.

“Restrictions and lockdowns can help buy time for critical public health and life-saving measures, but they are not in and of themselves an exit strategy,” said Jeremy Farrar, director of Wellcome, a global health fund.

China, which has rejected Pfizer and Moderna vaccines, appears to be pinning its hopes on local mRNA alternatives. Government scientists are conducting head-to-head testing of more than a dozen new vaccine candidates, including some doses of mRNA, experts say.

Public data is sparse, but Indonesia recently authorized mRNA inoculation in China, and some vaccine makers appear to be getting close to getting approval from Chinese officials.

“It might take a few shots to get the mRNA vaccine right, but early evidence suggests it’s headed in the right direction,” said James Bellash, a medical sciences expert at RTW Investments in New York.

China’s top leadership has signaled recognition that its overall approach to fighting the virus is causing more and more economic and social losses, and has called for action to correct what was a “one-size-fits-all” approach. Several cities have eased some of their toughest restrictions in recent days following a wave of mass protests.

But there still seems to be some debate about whether waiving Covid restrictions is the right approach. In the northeastern city of Jinzhou, in China’s Liaoning province, officials said they had already begun to ease some measures but were still holding back from abandoning the “zero Covid” strategy.

“We don’t have to give up our protection when we can reach zero avoiding large-scale infections,” officials said.

David Pearson made a report.



Please enter your comment!
Please enter your name here

Most Popular

Recent Comments