After three years of stringent restrictions including quarantines, lockdowns, enforced regular testing, all in pursuit of a “zero-COVID” policy, the Chinese Communist Party is forced to reconsider their entire approach to suppressing the infection. Although street protests have been suppressed, the Party recognizes the enmity towards prevailing COVID policy among the 1.4 billion population. Perhaps viewing the ongoing, televised World Football Cup competition in Qatar has brought home to citizens that China is out of step with the rest of the world.
China has relaxed certain restrictions, including evidence of recent negative testing to use public transport. Lifting of restrictions is uncoordinated, since according to reports, it is still necessary to demonstrate a recent negative test result to enter some public buildings and stores. Authorities are now allowing those testing positive to isolate at home instead of enforced removal to quarantine centers.
"Big Whites"enforce COVID restrictions |
The susceptibility of the population to COVID is the major barrier to effectively relaxing controls. China has relied on administration of their domestic CoronaVac inactivated vaccine. Although moderately effective in preventing severe clinical outcomes, the vaccine requires three doses and has a limited duration of protection compared to mRNA vaccines as used in the Americas and the E.U. Experience in Hong Kong demonstrated the superiority of the Pfizer-BioNTech mRNA vaccine but high levels of infection with severe clinical outcomes due to inadequate vaccination rates were recorded, especially among the elderly.
Epidemiologic models suggest an extensive outbreak of COVID should current restrictions be relaxed. Over a six-month period, it is predicted that there could be 112 million symptomatic cases, 2.7 million admissions to intensive care and 1.6 million fatalities. At peak demand, ICU cases would exceed capacity by a factor of 15. A late November study conducted by Airfinity predicted between 160 and 280 million cases and 1.3 to 2.1 million deaths over an 80-day period.
Officials in China blocked a 2021 joint venture initiative between BioNTech and the Fosun Pharmaceutical Company to manufacture mRNA vaccine. Recognizing the deficiencies of the CoronaVac inactivated product both in China and in nations where the product was either sold or donated, work on a domestic mRNA vaccine was initiated. This belated activity of reinventing the wheel will ensure that there will not be any local product available for distribution in the immediate future.
The China Monolith |
China has evidently painted itself into a corner by deploying an ineffective vaccine and maintaining extreme and impractical measures to achieve “zero COVID” Given that the economic impact of the restrictions are now evident in a declining GDP and that public dissatisfaction is growing, a reversal in policy is imminent. It is predicted that vaccination will be intensified in areas considered essential for economic activity and the Communist Party is now prepared to accept the inevitable avalanche of COVID cases. Naturally the Party will find scapegoats to be blamed for the debacle, saving the image of President Xi, now secure in a third term with hand-picked supporters.
Lest we indulge in Schadenfreude it should be remembered that the U.S. has recorded 1.1 million deaths and 99 million diagnosed cases in a population one quarter that of China since the commencement of the outbreak in 2020. At least 70 percent of losses were avoidable after introduction of the two mRNA vaccines in 2021. We are still loosing 300 to 400 of our fellow citizens each day, mainly among the elderly and those with predisposing conditions. The prevailing “it’s over” sentiment is exemplified by the 13 percent uptake of booster vaccines by those eligible. This ignores the reality of seasonal influenza and the rigors of approaching winter.
The attempts to control COVID in Sweden and China were both incorrect but the U.S. could avert inevitable losses through more extensive vaccination and commonsense disease prevention procedures.