Is China's 'Zero COVID' Policy Coming to an End?

[russ_watters]

TL;DR Summary

China appears to be ending its "Zero COVID" strategy and cases are exploding.

It looks like backlash against China's ZERO COVID policy is finally causing its end. The upside is they succeeded in delaying mass infection until (presumably) everyone was vaccinated. The downside is now they're getting the organic mass infections they'd been largely able to prevent until now.

China is reporting rapidly falling case counts because, since the pandemic is over, they aren't mass-testing anymore. Officially the pandemic is over for them like it is for everyone else, but in reality it is largely just beginning. However, because it is China we're likely never going to know how many people died from COVID in the past 3 years, how many will die in the current surge nor how many lives "Zero COVID" saved. Early unvaccinated fatality rates were on the order of 1-2%. Vaccination and improved healthcare/anti-viral drugs likely reduces that by a factor of 10 or better. There's 1.4 billion people in China and eventually everyone's going to get it (and most of them soon), so....?

Empty streets, deserted shopping centers, and residents staying away from one another are the new normal in Beijing – but not because the city, like many Chinese ones before it, is under a “zero-Covid” lockdown.

This time, it’s because Beijing has been hit with a significant, and spreading, outbreak – a first for the Chinese capital since the beginning of the pandemic, a week after leaders eased the country’s restrictive Covid policy.

https://www.cnn.com/2022/12/14/chin...easing-streets-impact-intl-hnk-mic/index.html

 

[berkeman]

Yeah, I didn't realize that China was not using mRNA vaccines for Covid until I saw the article below a couple days ago. What a waste of lives, IMO.

https://www.cnn.com/2022/12/12/opinions/drew-weissman-rna-therapeutics-vaccines-goldynia/index.html

Across the globe, however, life has looked very different. China has resisted the use of Western mRNA vaccines, instead relying on its zero-Covid policy of strict lockdowns and Covid controls to try to keep the virus from spreading within its borders. This policy recently sparked unprecedented demonstrations among Chinese citizens and, as a result, on Wednesday, the Chinese government released extensive revisions to its restrictive, and ultimately unsuccessful, zero-Covid policy.

The easing of China’s policy may be heralded as a victory, but it’s one that could come with a steep cost. As of late November, 90% of China’s population had completed two doses of a Covid-19 vaccine, while only about 66% of people over 80 had received two doses, according to Chinese officials. What’s more, the vaccines available to Chinese citizens use an inactivated SARS-CoV-2 virus, and pale in comparison to their mRNA counterparts that are approved in the US, says Weissman.

But now, it seems, China is recognizing the promise of mRNA vaccines; it’s reportedly close to having one, made in its own country, approved for use. If that approval comes soon, it could deliver the nation from its pandemic turmoil.

 

[atyy]

Yeah, I didn't realize that China was not using mRNA vaccines for Covid until I saw the article below a couple days ago. What a waste of lives, IMO.

https://www.cnn.com/2022/12/12/opinions/drew-weissman-rna-therapeutics-vaccines-goldynia/index.html

China's vaccines are fine. For the elderly, an extra dose is needed compared to mRNA vaccines (which could also be beneficial in younger ages), but the effectiveness is decent enough.

See Table 3 of McMenamin et al, Vaccine effectiveness of one, two, and three doses of BNT162b2 and CoronaVac against COVID-19 in Hong Kong https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286709/

Similar results (slightly worse in VE, but still acceptable provided enough doses are given) were obtained by Tan et al, Comparative effectiveness of 3 or 4 doses of mRNA and inactivated whole-virus vaccines against COVID-19 infection, hospitalization and severe outcomes among elderly in Singapore, https://www.sciencedirect.com/science/article/pii/S2666606522002693

David Owen has an interesting evaluation of the situation in China: https://www.otandp.com/blog/what-ne...the-covid-response-in-hong-kong-and-singapore

 

[phinds]

The upside is they succeeded in delaying mass infection until (presumably) everyone was vaccinated.

But they didn't. The most vulnerable population, people over 80, are only about 65% partially vaccinated (2 doses) and only about 25% have had all 3 doses needed for a reasonable chance at immunity. They have set themselves up for massive deaths among their most elderly population segment.

I've read about this in several places. Here's one (CNBC):

https://www.cnbc.com/2022/11/29/chi...iors-has-climbed-over-the-last-two-weeks.html

As of Monday, 65.8% of people over age 80 had completed the primary series of Covid vaccination, an official told reporters. Still, just about 40% of that group had received a booster shot as of Nov. 11, according to prior disclosures.

That article is two weeks old but that stats will not have changed much since then.

 

[atyy]

But they didn't. The most vulnerable population, people over 80, are only about 65% partially vaccinated (2 doses) and only about 25% have had all 3 doses needed for a reasonable chance at immunity. They have set themselves up for massive deaths among their most elderly population segment.

I've read about this in several places. Here's one (CNBC):

https://www.cnbc.com/2022/11/29/chi...iors-has-climbed-over-the-last-two-weeks.htmlThat article is two weeks old but that stats will not have changed much since then.

Yes, they need to get their elderly as maximally vaccinated as possible. The problem isn't non-mRNA vaccines. The Chinese scientists have known that improving elderly vaccination is key: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2022.173. They are ramping up vaccinations now, hopefully that goes well.

 

[phinds]

They are ramping up vaccinations now, hopefully that goes well.

Problematic since apparently there is a serious resistance among the elderly to getting vaccinated. Some of the articles I read mentioned it but I can't remember what they said the reason was.

 

[atyy]

Problematic since apparently there is a serious resistance among the elderly to getting vaccinated. Some of the articles I read mentioned it but I can't remember what they said the reason was.

I'm not sure what the problem is in China, but I suspect it's like what we had in Singapore (where in my view we opened up too early, before we had a high enough elderly vax rate), where I've heard of seniors who didn't know the importance of vaccination, for reasons that include having never remembered being vaccinated in their lives! Anyway, in Singapore the government recognized its error, and worked hard with community groups at outreach and door-to-door campaigns, which eventually got our elderly coverage >95%.

 

[russ_watters]

But they didn't. The most vulnerable population, people over 80, are only about 65% partially vaccinated (2 doses) and only about 25% have had all 3 doses needed for a reasonable chance at immunity. They have set themselves up for massive deaths among their most elderly population segment.

I've read about this in several places. Here's one (CNBC):

https://www.cnbc.com/2022/11/29/chi...iors-has-climbed-over-the-last-two-weeks.html

Whoops, I had no idea and the article I read didn't mention it. I just assumed that in China that there was no such thing as a voluntary vaccination program and everyone would have already been vaccinated. What the heck have they been doing for 2 years? Did they really believe "Zero COVID" would drive the virus extinct or that they could keep the policy for a decade? Their situation is much worse than I realized and has major implications for the rest of the world.

In the US by comparison our overall vaccination rates aren't very impressive but in the 65+ age group we're at 93% "full" (2 doses mRNA). The overall booster rate is pretty low though and I don't see a breakdown by age.

 

[Rive]

What the heck have they been doing for 2 years?

Yeah, quite confusing. They made it through the first year of the pandemic quite well, and then this

 

[phinds]

What they have been doing is fooling themselves that their lockdown policy was going to solve the problem and a vigorous vaccination program, particularly among the elderly, would have been unpopular (not sure WHAT they thought the lockdown policy would be) and unnecessary. Xi made up his mind that that's what would work and foolishness flowed down from the top. Now they are going to pay the price, Xi having given in to the massive unpopularity of the lockdown.

Problem is that there is a high likelihood that there will be a big spillover from their problem to the rest of the world. I'm not thinking about virus spread so much as further economic disruption, which the world seriously does not need right now.

 

[phinds]

from todays "The World In Brief" from The Economist:

A hospital in Shanghai reportedly told staff that it expects half of the city’s 25m people to become infected with covid-19 by the end of December. The virus has been sweeping through China since the government moved away from its “zero-covid” policy following widespread protests. Local authorities have reported only 390,000 cases or so, a figure many think is an underestimate.

That would be 12,000,000+ cases in one month in one (huge) city. Hard to believe (and it IS only an estimate). China is not going to do well in the coming months.

The Economist estimates that as many as 1,500,000 people will die in China from Covid by mid-March. Again, just an estimate, but it doesn't sound good.

 

[phinds]

CNN reports that crematoriums and funeral homes are totally swamped throughout China but the government is reporting only a small number of new deaths.

https://www.cnn.com/videos/world/2022/12/23/china-covid-deaths-crematoriums-ebof-wang-dnt-vpx.cnn

 

[Rive]

The Economist estimates that as many as 1,500,000 people will die in China from Covid by mid-March

I know that their early vaccines were nothing to brag about, but these numbers suggests an awful low vaccination efficiency...

 

[pinball1970]

Yeah, quite confusing. They made it through the first year of the pandemic quite well, and then this

China had a real lockdown whereas we (Royal we, most of the west) did not.

We also allowed flights in to the UK just before Delta hit July 2021.

We had a staggered easing of lock down before that from May to July 2021.
By the time Omicron hit at the end of 2021 we were out of lockdown for five months double/triple vaccinated getting Covid. 220,000 cases in one day at the peak December 2021.
I do not have the exact number but the percentage of the UK that were double vaccinated AND had tested positive for Covid were reporting very high.

Lockdown in China meant lockdown from communications I had with colleagues in January/February 2020.
So that will mean relatively low cases from the get go. The numbers were rising all over the planet except China who flat lined from April if the published numbers were robust. From discussion on pf regarding immunity what would the best place to be in as a country?
Ideally triple vaccinated then being infected with an Omicron variant?

Obviously not because getting sick is a good idea but because everyone will get it eventually. (Part of a pf thread on Covid from a tweet from a geneticist. Possibly from @atyy or @Ygggdrasil )
Also Omicron was more upper rather than lower respiratory so less deaths (one reason)
In terms of pf I have not posted a reference but all of the numbers are from UKHSA technical reports from 2021 and worldometer.

Two and half years in the US, 1.1 million deaths, WITH vaccines. About 200,000 in the UK gives roughly 1 in 300 deaths for a vaccinated country where most have had Covid.
In a 1.3 billion population that ratio equates to about 4 million.
Omicron less severe so 1.5 million deaths does not look unrealistic.

 

[phinds]

37 million new cases in one day:
https://www.aljazeera.com/news/2022...riencing-37-million-daily-covid-19-infections

Nearly 37 million people in China may have been infected with COVID-19 on a single day this week, the Bloomberg news agency has reported, citing minutes from an internal meeting of the country’s National Health Commission held on Wednesday.

In all, the report which was published on Friday said about 18 percent of the country’s population – 248 million people – are likely to have contracted the virus in the first 20 days of December

 

[russ_watters]

I know that their early vaccines were nothing to brag about, but these numbers suggests an awful low vaccination efficiency...

China is big: 1.5 million people is 0.01% of the total population. Some combination of large population of unvaccinated (concentrated amongst the most vulnerable) and high infection rate can get you there fairly quickly, even if the vaccine only drops your risk of death by a factor of 10 say, (1% to 0.1%). Heck, even with everyone vaccinated you could expect something like that if most of the population gets infected, like it has elsewhere.

 

[Rive]

Ideally triple vaccinated then being infected with an Omicron variant?

I think yes, something like that. And then whet they actually did is:
- they gave time to the virus to drift away from the type used in the vaccine
- they let both the immunity from the vaccines and the awareness to wane
- then blew up the whole mess.

Two and half years in the US, 1.1 million deaths, WITH vaccines.

Yeah, but as far as I know that's for the whole period (which includes times without any vaccines too).
So with all the time they got with their zero covid thing they are kind of expected to do better?

China is big: 1.5 million people is 0.01% of the total population.

Sure, they are big, but that number is only for two and half months! Even with the speed it spreads (*) it's just the very beginning...

(*) ... BTW that speed also tells a story about the actual protection still present If those numbers are ~ right then I expect their next half year to be something really terrible

 

[pinball1970]

Yeah, but as far as I know that's for the whole period (which includes times without any vaccines too).

Yes and with variants like Alpha that at Christmas 2020 to Feb 2021 that killed a lot in the UK.
Hopefully in China, the Omicron variant that is very efficient at spreading but not as lethal.

 

[russ_watters]

Sure, they are big, but that number is only for two and half months! Even with the speed it spreads (*) it's just the very beginning...

Good point, that's awfully quick. Sounds like people think this is more holding back and them opening the floodgates after the dam is full than watching it rise. Here's an article (paywall, sorry) suggesting they are getting 37 million new infections a day:
https://www.reuters.com/business/he...omberg-news-2022-12-23/?utm_source=reddit.com

That's more infections than the US total population in a week and a half.

 

[phinds]

Here's an article (paywall, sorry) suggesting they are getting 37 million new infections a day:

See post #15, which includes a public article. Also, it's not "37 million new infections a day" it's one just one particular day. And it's an estimate.

 

[wukunlin]

Uh, almost everyone I know, including myself caught COVID recently. Most of us are in Southern China, my in-laws up north caught them too. The few remaining coworkers that still go to work are mostly coughing. Most people I know have got at least 2 sinovac jabs as well.

Stocks of Paracetamol and Ibuprofen are completely gone. Even herbal alternative stuff are either gone or gouged to ridiculous levels. Lozenges' prices went up by 3 times over night.

 

[phinds]

@wukunlin what's the hospital situation where you are?

 

[wukunlin]

@wukunlin what's the hospital situation where you are?

I haven't been able to see for myself tbh. Only heard the emergency and fever clinics are bursting. We are hearing sirens of ambulence a lot more frequently than usual.

 

[StevieTNZ]

The latest in China: https://edition.cnn.com/2022/12/25/asia/china-covid-cases-publishing-nhc-intl/index.html

 

[StevieTNZ]

The impact: https://www.stuff.co.nz/business/13...aces-for-supply-issues-as-covid19-grips-china

 

[WWGD]

Yeah, quite confusing. They made it through the first year of the pandemic quite well, and then this

Is it possible to know with any certainty what goes on in China? Are there agencies or journalists that openly challenge what the government says?

 

[Grelbr42]

Is it possible to know with any certainty what goes on in China? Are there agencies or journalists that openly challenge what the government says?

Not from within China. Not for long, anyway.

https://www.rfa.org/english/news/china/ccp-bridgeman-10142022161722.html

Nobody has heard from this guy since. Various people do things like posting cell phone vids with commentary. It never lasts. They either stop out of fear or they get caught and dealt with pretty quickly.

Lots of people attempt to do it from outside China, attempting to make do with reports from friends, etc. There is some ability to make some sense out of such reports. YMMV.

 

[pinball1970]

Not from within China. Not for long, anyway.

https://www.rfa.org/english/news/china/ccp-bridgeman-10142022161722.html

Nobody has heard from this guy since. Various people do things like posting cell phone vids with commentary. It never lasts. They either stop out of fear or they get caught and dealt with pretty quickly.

Lots of people attempt to do it from outside China, attempting to make do with reports from friends, etc. There is some ability to make some sense out of such reports. YMMV.

Politics not science.

 

[nsaspook]

https://www.japantimes.co.jp/news/2023/03/02/asia-pacific/hong-kong-mask-mandate-end/

Hong Kong removes mask mandate for residents and travelers​

Authorities in Hong Kong have enforced one of the longest — and strictest — mask mandates since COVID-19 emerged, making them compulsory in public places for more than 940 days. Anyone caught breaking the mandate faced on-the-spot fines of $5,000 Hong Kong dollars (around ¥87,000). At one point, residents were even told to wear masks while exercising outside.

But even after the mandate was lifted, the vast majority of people on the streets of Hong Kong continued to wear masks.

Looks like the 'End' is over.