China has gone from a “zero Covid” strategy to… no plan. At the beginning of December, faced with the increase in contamination and the thousands of demonstrators in the streets and universities of the country demanding the end of sanitary measures with brandished white sheets and “Xi Jinping resignation”, the party-state suddenly decided to open the valves. Exit confinements in quarantine centers, the abundance of mandatory PCR tests or the barricades blocking the streets… For the first time in almost three years, China is giving slack to the “invisible enemy”. Result: Covid cases are exploding in the country.
If the official data are not reliable (5,241 deaths from the virus in China since the start of the pandemic, an extremely low figure compared to other less populated countries), the testimonies in the press or on the social networks of hospitals saturated and crematoriums running at full capacity are multiplying. Half a million people are infected with the coronavirus every day in the Chinese city of Qingdao alone, a municipal health official has reported.
“Some information is to be taken with precaution, but it is expected that there will be significant health repercussions. It is difficult to form an idea based on the information that is communicated but the WHO has confirmed that China has seen its dikes of the zero Covid strategy give way under the pressure of the virus, analysis for L’Express Prof. Antoine Flahault, epidemiologist at the University of Geneva. According to this expert, it is probably the BF.7 variant, derived from Omicron BA.5, a very transmissible variant, escaping the immunity acquired by vaccines on transmission (not on the severe forms), which made the “untenable” situation vis-à-vis a zero Covid strategy.
On Tuesday, December 20, the authorities even decided to change the methodology for counting Covid deaths. Only people who died directly from respiratory failure linked to Covid-19 will now be counted in the statistics, contrary to the international standard which prevails and counts as death from Covid any person who died with the virus.
The vaccination in question
According to calculations by researchers at the University of Hong Kong, the peak of the epidemic has already been reached in Beijing. “The wave seems quite similar to that which we experienced in Europe in January with the arrival of Omicron and is perhaps of greater magnitude since the population is devoid of any immunity, further deciphers Professor Antoine Flahault. The only big difference is that Europe had very well vaccinated its elderly people and those at risk of severe form, which is not the case for the Chinese population. If Sinopharm Sinovac vaccines have been evaluated in a much less transparent way than Western vaccines, the Hong Kong teams were able to estimate, thanks to their population, half vaccinated by Sinopharm Sinovac and the other half by messenger RNA vaccines, that three doses of Chinese vaccines were needed to be properly protected against serious forms. However, to date, 60% of Chinese over the age of 70 have not received their three doses of vaccine.
“By transposing the model of Hong Kong which experienced a very large epidemic in March, the researchers predict one to two million deaths in mainland China. [en 2023, NDLR], explains the epidemiologist. But we must not forget that Hong Kong is a very developed city with very advanced health infrastructures unlike China where there are very large disparities between the big cities and the countryside. The potential death toll could therefore turn out to be even higher.
“We are very surprised by the situation. Initially, it was extremely strict and now the Chinese population travels a lot for family or professional reasons, especially between cities, spreading the virus in the country, says virologist Hervé Fleury, professor emeritus at the University of Bordeaux and the CNRS. They did not follow the example of Australia which succeeded in its zero Covid policy by relaxing discipline on confinements after having vaccinated almost all of their population.
Why was the Chinese population at risk not up to date with their vaccines? Experts are skeptical. Elements of the answer may be to be found in the population’s mistrust of the government or in the low perception of the risk represented by the virus due to the absence of large deadly waves since 2020. Or is it because of the Zero Covid policy which has greatly reduced viral circulation in the country? Still, this strategy is now turning against the population, which does not benefit from strong collective immunity. A finding to be qualified in certain rural regions in the North and West of China, where it is likely that the control of the epidemic was much less effective.
Consequences on Europe
The whole world now has its eyes riveted on China, the opacity of the regime making it particularly difficult to anticipate the evolution of the pandemic. On Thursday, the head of American diplomacy Antony Blinken thus called on the country to share its information on this new wave, again offering to provide vaccines. For its part, India, worried, has decided to take control measures at its borders with antigen and PCR tests. “If we want to at least anticipate things, it would be good to test travelers returning from China, believes Professor Antoine Flahault. Europe would be more quickly aware of the rise of this or that sub-variant by sequencing downstream of the positive PCRs.”
According to experts, the propagation of the Chinese wave would not change much in the situation in Europe since an uninterrupted succession of waves has already been hitting the continent since the beginning of 2022. In addition, the BF.7 variant is already present on the territory. However, it is necessary to monitor the arrival of potential new variants, like those already produced by outbreaks in India or South Africa. “The new variants arrive in populations that have already been immunized, they try to evade the antibodies. However, in China, as a good part of the population is not immune, we may not have any bad surprises, tempers the virologist Hervé Fleury. But to find out, you have to do sequencing.”
In addition to the disease, this new wave in China could also have a logistical impact on the old continent, causing shortages of drugs, tests and masks or possible new inflation. According to the Financial Times, ten Chinese companies producing ibuprofen and Covid tests have confirmed in recent days that all their production will be for the government rather than their private customers. “It’s a hopeless situation, but it’s every man for himself,” an official from the eastern city of Nanjing, where four producers of rapid Covid-19 test kits have told the British newspaper. been asked to declare their production to the government and give priority to local customers. “We waited so long for the lifting of Covid controls, but it came so suddenly that local governments, health systems and supply companies were not ready,” he added.
In 2020, 50% of the world’s paracetamol production came from China. A potential shortage would be particularly unwelcome as France faces a triple epidemic of bronchiolitis, influenza and Covid-19.