General

China’s withdrawal from zero-Covid is not without risks.

December 8, 2022

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Chinese officials have taken their most dramatic action yet to end the punitive program following extraordinary public demonstrations against zero-Covid.

In addition to limiting lockdowns, reducing the number of times Covid test results would be checked, and enabling those with mild cases of Covid to isolate at home, officials announced the end of mandatory centralized quarantine on Wednesday. It happened after other cities started to loosen their own regulations.

China must avoid a number of potential hazards as it steers clear of zero-Covid.

The key difficulty is preventing mass fatalities from resulting from the expected increase in infections.

According to James Crabtree, executive director of the International Institute for Strategic Studies in Singapore, “China’s main concern currently is lifting Covid restrictions without having a widely vaccinated populace.”

“China will aim to reopen in a targeted way, shielding people who have not yet received the vaccine, but so far at least other nations have not been able to do this, and have generally found that re-opening leads to a surge of cases,” says the author.

Given the low level of Covid immunity among the elderly and the country’s continued reliance on ineffective domestic vaccinations, this is especially concerning for China.

Even though South Korea and Singapore had populations that had gotten foreign vaccinations from Pfizer, Moderna, and Astrazeneca before they opened up, they were unable to stop an increase in diseases.

According to recent data from the Chinese government, only 69% of people over 60 and 40% of people over 80 had received a booster shot.

Given their ongoing mistrust of vaccines, speeding up their vaccinations will continue to be difficult.

“Many elderly individuals have underlying illnesses. They believe vaccinations won’t be secure. However, it is safe,” Prof. Liang Wannian, the chair of China’s Covid expert council, previously told the BBC.

Chinese officials outlined plans for temporary and mobile vaccination clinics on Wednesday. They also advised local governments to employ “incentives to mobilize the enthusiasm of the elderly to get vaccinated.”

According to reports, they are aiming to increase the immunity of the majority of elderly people by the end of January, before Chinese New Year, when a large number of people would travel throughout the nation.

Meanwhile, China runs the possibility of experiencing a wave of severe COVID cases, which might cause many deaths if hospitals become overburdened due to the country’s still-vulnerable elderly population. When the Omicron wave hit Hong Kong earlier this year, this is exactly what happened.

For mild and asymptomatic cases, mainland China has now switched to home quarantine. A similar action taken by Singapore earlier this week was highlighted as one worth imitating by the state-run media outlet Global Times since it would free up resources and hospital beds for more serious cases.

But achieving this objective might be challenging.

Singapore’s robust healthcare system, which includes a variety of choices, could successfully transition to home quarantine since those with moderate Covid may use the nation’s extensive network of community clinics and telemedicine providers for treatment.

China’s healthcare system is still uneven and suffered from a drop in investment during the pandemic. According to Donald Low of the Hong Kong University of Science and Technology, a public policy specialist, many people still depend on hospitals for even the most basic medical care.

Compared to hospital-based care, community-based care is comparatively rare in China. It’s challenging to apply the Singapore model there. China had two years to construct that infrastructure, but they failed to do so, according to Prof. Low.

Another difficulty is the timing of the measures’ relaxation.

It is especially concerning, according to Dr. Siddharth Sridhar, a clinical virologist at the University of Hong Kong, that China is opening up in the dead of winter, when the virus is more likely to spread quickly.

So what options did China have?

Dr. Sridhar cautioned that it must proceed cautiously with its reopening to avoid experiencing a situation that is “exponentially worse” than what occurred in Hong Kong earlier this year.

“Only 7.5 million individuals call Hong Kong home. a functional public healthcare system. Big bankroll. Many regions of China are exempt from it.

According to a recent Bloomberg estimate using data from the first six months of the Omicron outbreak in the US and Europe, a similar full reopening in China would result in the admission of 5.8 million patients to intensive care. With less than four ICU beds per 100,000 people, China’s healthcare system would be completely overwhelmed.

Dr. Sridhar noted that the Chinese government may divert funds from containment to launch a door-to-door immunization drive, improve the infrastructure for critical care, such as by ensuring oxygen supplies, and train as many people as possible in fundamental critical care.

In order to ease public concerns about the virus and provide clear advice on what to do if someone tests positive for Covid, experts say it also needs to significantly strengthen its public health messaging.

Poor and ambiguous government orders during Hong Kong’s Omicron wave caused hospitals to overflow with cases as many people worried, even though they were permitted to isolate at home.

According to Prof. Low, Chinese authorities may outline a plan to coexist with Covid, much like Singapore did. It must also be open with its citizens about Covid being endemic and being a reality they must deal with, he continued.

People have a zero-risk mentality, thus the government needs to explain that the Covid risk will always exist.

Dr. Sridhar noted that prudence will be necessary at the same time. “At this point, saying Omicron is safe and we are fine would be a mistake. That is what we are doing, and it’s time to be open.

You’ll only be bringing calamity upon yourself if you do that.