Low Immunity, Vaccine Hesitancy, Govt Failure: What's Fuelling Covid-Spike In China?

After three years of following strict Covid-19 protocols in China, the country is seeing is the biggest wave of the pandemic with a sudden surge in Covid-19 cases. According to the recently released minutes from an internal meeting of China's National Health Commission, nearly 248 million people contracted the virus in the first 20 days of December this year. That is nearly 18 percent of the population. The sudden spike is being blamed on the unplanned lifting of the controversial and contested policies for Covid containment that had been in place in China for three years.

China’s Zero Covid policy was extremely restrictive and put several impositions in place, arguably at the cost of curtailing human liberties and rights. The strict rules of the policy which China forcibly enforced on its population since the start of the pandemic forced people to endure full-scale lockdowns even in cases of small outbreaks. The authorities also followed a policy of strict hospitalisation, sending even asymptomatic patients to Covid isolation wards. Several persons in China protested against the ‘quarantine camps’ which subjected many including patients, their know relatives and contacts or anyone even suspected of being exposed to Covid-19 to prolonged periods of isolation.

Sudden relaxation behind spike?

Following massive protests against the state’s alleged excesses, the Chinese authorities decided to lift Zero-COVID policy restrictions about two weeks ago. However, the sudden surge in cases following the relaxation in rules has brought forth questions about China’s preparedness to deal with a potential wave in wake of absent elf strict Covid-19 protocols it had so far followed. 

While the measures had been controversial and painful for many, those in support of the lockdown claim that the measures had helped keep the numbers in check.

At the onset of the relaxation, while Chinese social media was filled with posts by relieved citizens, many shared concerns over the potential risk to senior citizens and the possibility of medical systems collapsing in case of a sudden surge. 

Now, China appears to be on the brink of a potentially crippling Covid-19 wave, resulting in a million deaths due the virus in the coming year. Morgues and hospitals are already reportedly overwhelmed due to a surge in infections after China eased Covid testing requirements.  A Washington-based non-profit organisation RAND Corporation’s Jennifer Bouey was quoted by medical news platform New Scientist as stating that the sudden surge was a direct result of the sudden relaxation of rules. 

China was not the only country to impose strict lockdowns. However, most countries were able to transition into the post-lockdown period unlike China. While Xi Jinping's government was quick to impose the Zero-COVID restrictions to contain the virus outbreak that started in 2019 in Wuhan and was zealous in its imposition, experts argue that the government failed to prepare for the phase following the lockdown. 

Effect on pharmaceutical industry 

The strict Covid-19 curbs deeply impacted China’s pharmaceutical availability. Despite being one of the biggest pharmaceutical manufacturers of the world, the nation is facing critical pharma shortages due to its failure to stockpile. The country’s supply chain network has also not recovered from the damage caused by Zero-COVID restrictions.

Chinese President Xi Jinping’s push for traditional Chinese medicine, as per a report in Foreign Policy,  may have has also resulted in the poor treatment of Covid-19. While several homegrown studies and research show high success rates for alternative Chinese treatments for Covid-19, international research does not promote TCM as a reliable source to fight Covid-19. 

A new variant 

Among the 500 Covid-19 variants currently in circulation in China, the current surge is being led by the dominant  BF.7 strain, a sub-variant of Omicron that surfaced hand has been around for over a year. BF.7 or BA.5.2.1.7 has evolved from the previously reported BA.5 sub-variant. Earlier in the year, several cases of BF.7 infections were reported in the United States and the United Kingdom. It has been reported in India as well. As per reports, the variant is highly transmissible. 

However, virologists argue that there is no hard scientific evidence to support the theory that one Covid variant was behind the surge in China as there was no way to ensure if other strains were not infecting residents. 

Lack of hybrid Immunity

Virologist Dr Ekta Gupta told The Indian Express that due to the strict lockdown in China, many Chinese residents remain without natural immunity that persons gets after being naturally infected by Covid-19. 

“…Natural infection provides a wider and longer immunity against Covid-19,” she said, adding that in India, since natural infection rates were higher, a higher number of people enjoy hybrid immunity from natural infections. Indians also have a high level of vaccination. 

Lower vaccination rates

Due to the strict Covid-19 measures, NPR reported in December that vaccine hesitancy remained high in China. While the Chinese government’s official data shows that 90 percent of its population unvaccinated, reports suggest that significant numbers of the senior citizens remain unvaccinated. 

As per a government announcement, about 30 percent of people in the age group of 60 above were not vaccinated or received a booster shot as on November 11. That includes 80 million people.

Vaccine hesitancy persists among the Chinese who reportedly trust foreign made vaccines that are banned in China in contrast with the homegrown Chinese shots available to them. Despite near-total control over all media and research, experts feel the Chinese government has not done a good job in dispelling Covid-19 myths including doubts of Covid-skeptics. Studies have also shown conflicting results about the Chinese vaccines’ effectiveness, especially for elderly receivers. 

Experts have opined that lifting the strict Covid-19 restrictions needs to be done with care and at the right pace so as not to overburden the medical infrastructure and many have been advocating vaccines as the only way forward. "The main way for China to exit Covid with the least damage is via vaccination and three doses of vaccination is a must," the BBC quoted Professor Ivan Hung at Hong Kong University in a previous report.