As the Chinese authorities relax ‘zero Covid’ restrictions in the face of social unrest, health experts fear that a wave of Covid infections could spread rapidly.
Official figures for Covid infections in China seem to be wildly underestimated, with social media circulating photos and videos of crowded fever clinics and people lining up outside of hospitals, while China’s National Health Commission (NHC) reports no new COVID-related deaths on Wednesday 21st December, and only 3,101 new confirmed cases nationwide in a population of 1.4b.
The previous day, the NHC reported just seven deaths over the first two days of recording all COVID deaths.
At a press conference held Tuesday by the Joint Prevention and Control Mechanism of the State Council of China, the director of the infectious diseases department of Peking University First Hospital, Wang Guiqiang, clarified the criteria China uses for recording a death as caused by COVID.
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“Deaths caused by pneumonia and respiratory failure caused by the coronavirus are classified as deaths caused by COVID infection, while deaths caused by other diseases and basic diseases, such as cardiovascular and cerebrovascular diseases, myocardial infarction, etc., are not classified as deaths from COVID-19,” he said. “From clinical practice, [and] in the current study, the main cause of death after infection with the omicron strain is the underlying disease.”
Global health wave
But Devi Sridhar, chair of global public health at the University of Edinburgh, wrote in The Guardian; “Experts following the situation estimate that 60% of the Chinese population (accounting for 10% of the world’s population) will be infected in the next 90 days.”
Experts estimate that China’s method of compiling the Covid death toll is likely to be underestimating by at least 75% compared to international standards, leading to fears that a Covid wave could be going unreported.
“The vast majority of COVID-related deaths are due to underlying diseases,” said Twu Shiing-jer, former minister of Taiwan’s Department of Health and chairman of the Development Center for Biotechnology in Taipei. “According to a study that was done in New York in 2020, in general, only about 0.7% of COVID-related deaths were purely due to infection without other causes.”
According to the World Health Organisation, many countries use excess mortality statistics as a more accurate measure of COVID deaths. This is the difference in the total number of deaths in a crisis compared to those expected under normal conditions, while the Institute for Health Metrics and Evaluation (IHME), an independent global health research centre at the University of Washington, projected a worldwide toll of 7,727,905 deaths by April 1, 2023, using officially reported COVID cases. Tracking total deaths, which are the estimated number of deaths attributable to COVID, including unreported deaths, the study projects a global death toll of 18,572,492 by April 1, 2023.
Experts believe that China is certainly not prepared for the wave of infections which will inevitably follow its relaxation of zero Covid restrictions. While the official tally of cases is falling, that is probably because people are being tested less often. As winter conditions favour transmission of the Omicron variant, it could be that infections will spread particularly quickly in China.
While China’s ‘zero Covid’ policy caused worldwide disruption to production chains, an epidemic in the country could have even more wide-reaching consequences. With the authorities’ policy apparently to ‘burn through’ the epidemic as quickly as possible, short-term disruption could be immense. America’s chief medical advisor Dr Anthony Fauci is urging Beijing to accept the use of Western Covid vaccines based on messenger RAN technology, which are more effective than the home-grown Chinese vaccines. He says that a wave of infections would hit China’s population of over-60s, of which there are around 85m, particularly hard. He is also concerned about the virus’ ability to mutate in such a large population as a Covid wave spreads.
“There’s no doubt that China is in for a bad couple of months,” says James Wood, an infectious-disease modeller at the University of New South Wales in Sydney, Australia, quoted in Nature. But Xi Chen, an economist at Yale University in New Haven, Connecticut, who studies China’s public-health system, says “It is never too late to flatten the curve”, suggesting that says giving most of the population a fourth vaccine dose, combined with a high level of adherence to masking and reimposition of temporary restrictions on social interactions when death rates surge, could reduce the rate of infection and ease the burden on hospitals.
In the UK, Covid-19 infections continued to increase in England, and increased in Wales and Scotland, in the week ending 5th December 2022. In Northern Ireland, the trend was uncertain in the week ending 3rd December 2022.
The estimated percentage of people living in private households (those not in care homes or other communal establishments) testing positive for COVID-19 was:
2.01% in England (1 in 50 people)
1.84% in Wales (1 in 55 people)
2.11% in Northern Ireland (1 in 45 people)
1.91% in Scotland (1 in 50 people)
An estimated 2.2 million people in private households in the UK (3.4% of the population) were experiencing self-reported long COVID as of 6th November 2022.
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