Following widespread protests, the People’s Republic of China, a country of 1.4 billion people since December 7, began dismantling its “Zero-Covid” regime of lockdowns and testing that had largely kept the virus away for three years, at great economic and psychological costs. The easing coincided with a jump in Covid cases that experts say will likely gather pace through winter, with projections suggesting China could face more than a million deaths next year.
China’s Covid-19 policy was under serious criticism from the very beginning. There were stringent restrictions, testing and policies, quarantine and suppression of human rights in its Zero-Covid-19 policy. Now when China has taken a U-turn and liberalized its Covid policy related restriction, it is again under criticism.Many blame abrupt abandonment of Zero-Covid policy in the face of protests after years of enforcing harsh measures to stamp out the corona virus, as responsible for the present spike in infections. The decision to abruptly relax Covid restrictions has sent the health system of the country in disarray. “There is no transition time for the medical system to prepare for this,” said Zuofeng Zhang, professor of epidemiology at the University of California, Los Angeles. “If they could spend a small portion of resources (used) in Covid-19 testing and lockdown, China would be better off in this policy change.”
More than a dozen global health experts, epidemiologists, residents and political analysts interviewed by Reuters identified the failure to vaccinate the elderly and communicate an exit strategy to the public, as well as excessive focus on eliminating the virus, as causes of the strain on China’s medical infrastructure.
The present upsurge in Covid-19 in China has again brought the inadequate preparedness of China’s health infrastructure. At the public hospital in Shanghai, Nora, a 30-year-old doctor reported to Reuter’s that tension had spiraled since China relaxed its stringent Zero-Covid policy on December 7. “Patients quarrel with doctors to access drugs that are in short supply, like cough medicines and pain killers. Medics are overloaded; infected staff continues to work because of a scarcity of personnel.”
In Tianmen, a small city near Wuhan, infected patients were camped outside clinics as they received intravenous drips. In Hanchuan, in Hubei province, the same kind of crowding of infected patients was seen. In some cities there was a lack of clear guidance on what happens when someone gets infected. At a public hospital in Beijing, a senior doctor said all surgeries had been cancelled except in cases where the patient would probably die the next day. According to a report based on an interview of a local by Reuters, “Up to 80% of doctors in top hospitals in Beijing are infected with the virus but forced to keep working, “Beijing, funeral homes and crematoriums are struggling to meet demand.”
The nation’s overall fatalities since the pandemic began were revised to 5,241, but the figures are taken with disbelief as the definition of death caused by Covid-19 in China is very narrow. Amid doubts over China’s very low Covid death toll by global standards, the National Health Commission clarified that only people whose death is caused by pneumonia and respiratory failure after contracting the virus are classified as Covid deaths. As the outbreak grows, official data on severe cases and mortality rates are unlikely to reflect the situation, experts including Mike Ryan, WHO’s emergencies director, have said. The National Health Commission has reported only a handful of Covid-related deaths which was very low by global standards.
Meanwhile the Global Times, citing a leading Chinese respiratory expert, predicted a spike in severe cases in the capital over the coming weeks. Keeping in view the latest upsurge in Covid-19 infections, many countries in the world have expressed concerns and some of them have decided screening of Chinese travellers before they enter their territory. The United States indicated it stands ready to assist China with its outbreak, warning an uncontrolled spread which may have implications for global growth.
As the Covid-19 infection report provided by China is doubted, at least 12 countries have imposed mandatory testing of the Chinese travellers. While the UK and the US announced reintroduction of compulsory pre-flight Covid-19 testing, others such as Japan and Italy are requiring testing upon arrival and quarantine for those who test positive. On December 28, the Centers for Disease Control and Prevention announced that the US will require travellers arriving from China, Hong Kong and Macau to present a negative Covid-19 test taken no more than two days before their departure, effective from January 3. The UK and France said they required negative Covid-19 test taken no more than two days prior to departure effective since January 5. Spain, Australia, Canada, Japan, South Korea, Malaysia, Israel and India have also announced precautionary measures. One country, Morocco has even decided to ban entry to all travellers coming from China outright.
As of January 1, India announced that it will require travellers arriving from China and Hog Kong as well as Japan, South Korea, Singapore and Thailand to provide proof of a negative Covid-19 test no more than 72 hours prior to departure. The Indian government previously announced that it would also begin testing 2% of international arrivals for Covid-19 at random.
The new restrictions have not gone down well in Beijing and it has threatened retaliatory measures. Surprisingly, the EU called screening of travellers from China unjustified on December 29 and the European Centre for Disease Prevention and Control said the surge was “ not expected to impact” the EU due to relatively “higher level of vaccination and immunization.” However, the EU said that the EU could issue its recommendations even while leaving the countries free to make their own policies to prevent infection due to travellers from outside. It seems that EU has taken this stance in order to keep going the post pandemic global recovery without interruption and avert an L-shaped recovery after recession in Europe and other parts of the world.
While China’s official health estimates suggest there are 4000 cases of Covid per day, scientists’ estimate the number is more and close to 1 million. The US-based Institute of Health Metrics and Evaluation, part of the University of Washington, last week said it expects more than 1 million deaths through 2023 as a result of the abrupt lifting of China’s Covid restrictions.
The latest Omicron variables are likely to mutate to sub-variants. China is downplaying such a possibility. Although, some scientists believe that the pandemic is reaching its last phase in few months, several leading scientists and WHO advisors told Reuters it may be too early to declare the end of the global Covid pandemic emergency phase.
Daniel Lucey, a fellow at the Infectious Diseases Society of America and Professor at Dartmouth University said, “There will certainly be more Omicron sub-variants developing in China in the coming days, weeks and months… it could be more contagious, more deadly, or evade drugs, vaccines and detection from existing diagnostic.” She opined that the world must anticipate recognizing it early and taking rapid action.
In the recent days, Chinese officials issued many new rules: encouraging vaccinations, setting rules for protecting old age homes and other vulnerable sites, preparing villages to fight infections. A drive to vaccinate the elderly began three weeks ago. Reportedly, China has accelerated action to enhance vaccination coverage. According to PRC government data China’s overall vaccination rate is above 90% but the rate for adults who have had booster shots drops to 57.9%, and to 42.3% for people aged 80 and older. However, the full effects of ditching “Zero-Covid” remain highly uncertain given China’s patchy vaccine coverage, fragile health system and the lack of clarity about the real extent of infections as cases start to surge. Cities are ramping up efforts to expand intensive care units and build special.
China needs to work on its health infrastructure more than spending huge money on its global power mission through the BRI. According to the WHO, China’s health infrastructure is inadequate. China has about 2 physicians per 1,000 people, versus 4.3 in Germany and 5.8 in Britain. And it has 3.6 intensive-care beds per 100,000 people, compared with 34.7 in the United States, 29.2 in Germany and 12.5 in Italy. This shows China’s poor standing in health infrastructure.
China’s investment in medical resources such as hospital beds and the growth rate of medical staff slowed during the pandemic. While overall health spending inched up from 2019 to 2021, it dropped slightly as a share of GDP for the first time in more than six years, to 6.5% last year versus 7.1% in 2020 and 6.6% in 2019. It is unclear how much went to building quarantine facilities or providing tests, but analysts’ estimates gathered by Reuters in May put China’s planned Covid-related spending this year at around USD 52 billion. China really needs to be sincere, quick and collaborative while dealing with the Covid outburst and this requires transparency and sharing data. It also needs to benefit from other countries’ experience and vaccine resources. India is an outstanding case and praised by multilateral agencies for its Covid management.