Unsurprisingly, Covid is now surging in China in the aftermath of the government’s reversal of its unsustainable zero-Covid policy. Given China’s lack of herd immunity and the prevalence of highly transmissible Omicron variants, this is hardly surprising. Unfortunately, there is a paucity of information on the extent of the spread, strikingly reminiscent of what happened during the original outbreak in Wuhan in early 2020.
Back then, of course, there was no playback for a lethal novel coronavirus. While there was understandable confusion as to the requisite public health protocols, China made a bad situation worse. While Chinese health officials were relatively quick to disclose the genetic sequencing of the virus, there was literally no transparency on the circumstances of the outbreak in December 2019. Live animal specimens were destroyed from the Huanan Seafood Wholesale Market in Wuhan, the most likely source of the zoonotic leap that triggered human-to-human transmission, and no information was provided on the subsequent rapid spread of SARS-CoV-2. Significantly, the Wuhan airspace remained open through 23 January 2020 as holiday travel picked up ahead of the 25 January Chinese New Year, facilitating the global spread of what was quickly to become known as Covid-19.
Fast forward three years and some glaringly similar signs are evident in China today. Official testing has been all but suspended, leading to the absence of any reliable data on spread. While the fatality rate is far lower with the current Omicron strain of Covid than was the case with the Wuhan (alpha) strain three years ago, high transmissibility means that nationwide exposure after the abandonment of zero-Covid policy dwarfs that of the initial outbreak. Moreover, there is a notable gap in China’s sharing of Covid genetic sequencing data; press reports indicate that China has only shared sequencing of 0.04% of its total cases over the course of the pandemic, more than 100 times less than the sequencing rate shared by the United States (as reported by GISAID, a global platform for Covid data).
There is another an eerie comparison of the current spread relative to that of three years ago. The current outbreak in China is largely concentrated in urban areas. Following China’s abandonment of its zero-Covid policy, domestic travel bans are being lifted; this comes only a couple of weeks ahead of the upcoming 22 January 2023 Chinese New Year, just before millions of travelers are likely to return to their home villages for the first time in three years. Unlike the Wuhan outbreak that spread rapidly through international air travel, China’s more immediate risks reflect the potential of a growing surge of urban-to-rural transmissibility. With China’s rural healthcare system far below the quality of urban care, the coming shift in the geographic dispersion of Covid could be far more problematic than official Chinese spin might lead you to believe.
Mindful of these largely undocumented risks of surging Chinese Covid spread, the United States and other Western nations are taking no chances with a replay of the Wuhan spread scenario of three years ago and have imposed stringent testing requirements effective immediately on all returning travelers from the PRC, Hong Kong, and Macau. Predictably, the Chinese are indignant at this response, accusing the West of a biased response that “lack(s) scientific basis.”
Scientific would hardly be the word I would use to describe the chaos that has since ensued after the abandonment of zero-Covid. Like the circumstances of three years, the Chinese have an uncanny knack of getting in their own way. Transparency would go a long way in relieving the world’s anxiety over what is going on in a post-Zero-Covid China. But transparency has never been China’s strength is coping with bad news. As I head back to Hong Kong in three days — my first trip since the Covid outbreak — I must confess to having a personal stake in this matter as well.
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