After extraordinary mass protests against zero-Covid, the Chinese government has taken its most decisive step to yet to abandon the punitive program.
On Wednesday, officials declared the end of mandatory centralized quarantine, allowing persons with moderate Covid to isolate themselves at home, as well as restrictions on lockdowns, fewer Covid test result checks, and unrestricted travel around the nation. It occurred as cities began to relax municipal limits.
Even as China takes a road away from zero-Covid, it must manage several impending hazards.
The greatest obstacle is preventing the inevitable increase in infections from leading to a large death toll.
James Crabtree, executive director of the International Institute for Strategic Studies in Singapore, stated, “China’s biggest risk now is lifting Covid restrictions without a broadly vaccinated populace.
“China will try to reopen in a targeted manner, shielding individuals who have not yet been vaccinated, but other nations have not been able to accomplish this thus far and have generally observed that reopening leads to a wave of cases.”
This is particularly worrisome for China considering the poor Covid immunity among its senior population and its continued reliance on less effective indigenous vaccinations.
When other countries, such as South Korea and Singapore, opened up, their populations were well-vaccinated and got foreign vaccines from Pfizer, Moderna, and AstraZeneca, but they were unable to avoid an increase in infections.
Authorities in China report that just 69% of individuals over 60 and 40% of those over 80 have received a booster shot.
Given this group’s persistent mistrust of vaccines, accelerating their vaccinations will continue to be difficult.
“Many elderly suffer from underlying ailments. They estimate that vaccination will not be safe. Prof. Liang Wannian, director of China’s Covid expert council, previously told that it is safe.
On Wednesday, the Chinese government announced plans for temporary and mobile vaccination clinics and asked local governments to utilize “incentives to motivate the elderly to be vaccinated.”
According to reports, they intend to raise the immunity of the majority of senior citizens by the end of January, before the Chinese New Year, when large numbers of people would move throughout the country.
In the interim, China’s still-vulnerable senior population faces a wave of severe Covid cases, which might result in many deaths if hospitals become overwhelmed. This is precisely what happened when the Omicron wave struck Hong Kong earlier this year.
Possibly, as a result, China’s mainland has resorted to home quarantine for mild and asymptomatic cases. This past week, the Global Times, a state-run news site, cited a similar move by Singapore as an example worthy of imitation since it would free up resources and hospital beds for more serious patients.
However, this objective may be difficult to achieve.
People with moderate Covid could seek treatment from the country’s extensive network of community clinics and telemedicine providers, making it possible for Singapore to effectively transition to home quarantine.
During the epidemic, China’s healthcare infrastructure suffered from a decrease in investment, resulting in its current state of disrepair. Donald Low, an expert in public policy at the Hong Kong University of Science and Technology, remarked that in many areas, people continue to rely on hospitals for even the most basic care.
“In China, community-based care is scarce in comparison to hospital-based care. It’s difficult to follow Singapore’s example on that… Prof. Low stated that China had two years to construct this infrastructure but failed to do so.
The timing of the measure relaxation also poses a hurdle.
Dr. Siddharth Sridhar, a clinical virologist at the University of Hong Kong, expressed concern that China is opening its borders during the winter when the virus is more likely to spread swiftly.
What could China do then?
Dr. Sridhar warned that if the reopening is rushed, the scenario will be “exponentially worse” than what occurred in Hong Kong earlier this year.
“Hong Kong is simply 7.5 million people. Infrastructure for public healthcare that is adequate. Deep pockets. It is not applicable in many locations in China.”
Based on US and European data from the first six months of the Omicron outbreak, a recent Bloomberg analysis determined that a similar full reopening in China would result in 5.8 million individuals being admitted to intensive care. This would completely overwhelm China’s hospital system, which has less than four intensive care unit beds per 100,000 individuals.
Dr. Sridhar noted that the Chinese government might transfer resources from containment to a door-to-door immunization drive, improve infrastructure for critical care such as ensuring oxygen supplies, and teach as many people as possible in basic critical care.
Experts assert that it must also substantially increase its public health communications to alleviate public fears of the virus and provide clear guidance on what to do if a person tests positive for Covid.
During Hong Kong’s Omicron wave, weak and ambiguous government directions led to hospitals being overwhelmed with cases as a result of widespread hysteria, even though residents were permitted to isolate themselves at home.
Prof. Low stated that Chinese authorities could develop a plan to live with Covid, similar to Singapore. He stated that the government must be forthright with its citizens about the inevitability of Covid becoming endemic and something they must learn to live with.
People have a zero-risk bias, which the government must combat by stating that the Covid danger will always exist.
Dr. Sridhar stated that vigilance will be required concurrently. “Right now, it would be a grave error to assert that Omicron is harmless and that we are fine. However, this is exactly what we are doing, therefore it’s time to open up.
“You are inviting tragedy upon yourself by doing so.”
