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The potential public health implications of China easing COVID-19 restrictions

The potential public health implications of China easing COVID-19 restrictions
In recent days, Chinese authorities have loosened some COVID-19 protocols in cities including Guangzhou and Chengdu. (File photo: AFP/Noel Celis)

SHANGHAI: China has started taking steps to ease its zero-COVID policy, fuelling a mix of relief and worry as the public waits to see the health consequences, and impact on the medical system, of a full-blown exit.

Researchers have analysed how many deaths the country could see if it pivots to a full reopening, with most pointing to the country's relatively low vaccination rates and lack of herd immunity as some of its most vulnerable spots.

As of Sunday (Dec 4), China reported 5,235 COVID-related deaths and 340,483 cases with symptoms.

Here are some of the estimates:


Zhou Jiatong, head of the Center for Disease Control in southwestern Guangxi region, said last month in a paper published by the Shanghai Journal of Preventive Medicine that mainland China faces more than 2 million deaths if it loosened COVID-19 curbs in the same way Hong Kong did this year.

Infections could rise to more than 233 million, his forecast showed.


In May, scientists in China and the United States estimated that China risks just over 1.5 million COVID-19 deaths if it drops its tough zero-COVID policy without any safeguards such as ramping up vaccination and access to treatments, according to research published in Nature Medicine.

They forecast that peak demand for intensive care would be more than 15 times capacity, causing roughly 1.5 million deaths, based on worldwide data gathered about the variant's severity.

However, the researchers, the lead authors among whom were from Fudan University in China, said the death toll could be reduced sharply if there was a focus on vaccination.


China could see 1.3 million to 2.1 million people die if it lifts its zero-COVID policy due to low vaccination and booster rates as well as a lack of hybrid immunity, British scientific information and analytics company Airfinity said last Monday.

The company said it modelled its data on Hong Kong's BA.1 wave in February, which occurred after the city eased restrictions after two years.


In November, huge protests against the severe COVID-19 restrictions in China erupted in numerous cities, in the biggest show of opposition to the ruling Communist party in decades.

The World Health Organization's emergencies director Dr Michael Ryan said last Friday that using imported messenger RNA vaccines, like those made by BioNTech-Pfizer and Moderna, would be a “solid option” for China to boost its immunisation coverage.

China's homegrown vaccines have proven to be less effective and scientists say any protection they provided is likely to have faded with the emergence of the Omicron variant.

The decision of which vaccines to use “are choices that sovereign governments need to make based on the best benefit to their population", Ryan said.

He said future strategies should balance “the control of the virus with the lives, the livelihoods and well-being and human rights of the people in China".

China has been developing its own version of an mRNA vaccine and has yet to authorise either of the shots made by Western companies.

Unlike in many Western countries, vaccination rates among China's elderly are lagging; only 66 per cent of people over 80 have got one shot, while 40 per cent have received a booster, according to China's National Health Commission.

By comparison, 93 per cent of Americans 65 and over have received a full course of vaccine and another 2 per cent have at least one dose, according to the Centers for Disease Control and Prevention.

Without significantly raising China's vaccination rate quickly, releasing its COVID-19 restrictions could produce a surge of hospitalisations and deaths that could overwhelm the health system.

In recent days, Chinese authorities have loosened some COVID-19 protocols in cities including Guangzhou and Chengdu, easing testing requirements and controls on movement.

Still, many of the rules that brought people into the streets of Shanghai, Beijing and at least six other cities remain in force.

The announcements easing restrictions didn’t mention last month's protests of the human cost of anti-virus measures that confine millions of people to their homes.

But the timing and publicity suggested Chinese President Xi Jinping's government was trying to mollify public anger.

Source: Reuters/AP/jo


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