China learns a virus lesson the hard way
China wages an intense battle to curb the newly-emerged SARS-CoV-2 virus, as reports reaching media say millions of people infected by the dreaded virus
China prides itself in being an example to the less developed nations by its spectacular economic growth since the 1980s, thanks to innovation, hard work and leaders who put country first without enriching themselves. While our leaders have spectacularly succeeded in dragging down millions into poverty, Chinese leaders have reduced poverty levels spectacularly.
But all this came at a price. Draconic laws such as the one child per family policy (only recently ended) were imposed to control population growth, and such policies were possible only because of Beijing’s autocratic rule muzzling many personal freedoms.
The zero-COVID policy which followed the pandemic was another such draconian set of rules, but citizens had no option but to obey. At the start of the pandemic, citizen journalists who reported the truth were incarcerated, social media reporting blocked, and people cowed into silence.
This iron-fisted rule seemed to work till this year, when China began to face new outbreaks of new COVID variants while the pandemic was receding elsewhere and most countries were returning to near normalcy.
It should be a sobering lesson to everyone, especially to China’s leaders who believe that nature can be shaped and controlled as rigidly as people. Citizens who step out of line can be arrested, jailed or worse, but weapons and police powers are helpless against germs, viruses and infections.
China’s new generation isn’t quite ready to follow every whim and caprice of their leaders, as mass protests by youth across China showed after the new COVID outbreaks. That Chinese leader, instead of resorting to a massive Hong Kong-style crackdown on protesters, took the defensive step of cancelling the Zero COVID policy shows a clear shift in the leadership-masses equation which has been the norm in China for decades.
It’s a tacit acknowledgement by Beijing that everyone’s support is needed if China is to get out of this mess. Instead of defeating COVID, the new line is about co-existing with it, a policy which the rest of the world adapted long ago. But China did so only after mass protests, a troubled economy and an embarrassing inability to control the latest COVID variants made it crystal clear that its Zero COVID policy has failed.
Chinese leader, instead of resorting to a massive Hong Kong-style crackdown on protesters, took the defensive step of cancelling the Zero COVID policy shows a clear shift in the leadership
But scientists abroad are now worried that Beijing isn’t collecting and sharing enough data about the new situation.
According to evolutionary biologist Edward Holmes of the University of Sydney, “SARS-CoV-2 has an open goal in front of it: a population with very low levels of standing immunity.”
But how the epidemic is unfolding is a mystery because the country has practically stopped collecting basic epidemiological data.
Models that predicted a massive wave of infection and death if China ended zero COVID policy appear to have been correct. Press reports and social media posts have shown intensive care units stretched beyond capacity, with crowds of patients in wheelchairs and on gurneys in hallways. Doctors and nurses are reportedly working while sick. Crematoriums are overwhelmed. But China’s official COVID-19 death toll is widely considered laughably low. And some scientists worry a genomic monitoring plan unveiled last month doesn’t have the power to detect new SARS-CoV-2 variants arising as the virus works its way through one-fifth of the world population.
Earlier in the pandemic China’s daily counts of COVID-19 cases and deaths, based partly on its exhaustive testing programmes, were generally believed to be accurate. Now, they seem to be doctored. Patients with mild symptoms are not encouraged to get tested, let alone those who are asymptomatic. People testing positive at home are not told to report their results.
The China Centre for Disease Control and Prevention (China CDC) put the number of confirmed cases the last week of December 2022 at more than 35,000—a fraction of the official number in the United States. But leaked notes from an internal meeting suggest a very different reality: The agency was told that almost 250 million people in China—roughly 18% of the population—may have caught COVID-19 in the first 20 days of December. Some experts said the number is implausibly large, but Yanzhong Huang, a global health specialist at the Council on Foreign Relations, a US think tank, says it’s “not unreasonable,” given credible reports that 80% of Beijing residents have been infected by now.
According to Huang, China’s reporting had long been inconsistent regarding the death toll, with some regions reporting all fatalities in which SARS-CoV-2 was a factor, as most countries do, and others excluding people who died from other conditions, such as heart attacks, even if they had COVID-19. In early December, China’s government decided the narrower definition should be used nationwide.
Even then, the official count is astonishingly low: just eight deaths for the entire last week of December 2022. According to Louise Blair, who tracks China’s COVID-19 outbreak for Airfinity, a London-based health analytics firm, these figures are not consistent with media reports and what is being seen on social media.
More likely, an estimated 9000 people were dying of COVID-19–related causes every day in late December. Also missing are data on case fatality rates, the average number of new infections stemming from each case, and hospital and intensive care admissions. “These are critical data that would help health authorities get a handle on the surge and further the world’s understanding of the pandemic,” says Xi Chen, a public health scientist at the Yale School of Public Health.
A major worry is that the wave will breed a new and even more troublesome SARS-CoV-2 variant. “It’s possible that something might be emerging, because there is such a big population in China,” says George Gao, who in July 2022 stepped down as head of China CDC but is now helping track circulating variants. But he told Science, “There are no novel mutants—yet.” At a Dec. 20 press briefing, Xu Wenbo, head of the National Institute for Viral Disease Control and Prevention, explained that the BA.5.2 and BF.7 Omicron subvariants, which are now causing most infections globally, are also dominant in China. BQ.1 and XBB, which have recently been spreading in Europe and North America, have turned up in limited numbers in several provinces.
In addition to China CDC, research groups at more than 30 hospitals and universities are also tracking SARS-CoV-2 variants, says a Chinese epidemiologist who asked not to be identified. These groups “will report immediately if a dangerous variant emerges,” the source says.
Still, the lack of reliable data is already undermining faith in China’s handling of the outbreak. A dozen countries, including the United States and France, have announced they will require pre- or post-flight tests on air travellers from China. But, according to some experts, that is unlikely to keep new variants out. The goal should be to convince the Chinese to be more forthcoming about what’s happening on the ground—and for that, they say that quiet diplomacy may work better than travel restrictions.