China has abandoned zero-Covid. What happens now?

China is opening up rapidly after years of its “zero-Covid” policy, with strict lockdowns, mandatory testing and extensive travel restrictions. But the major policy shift could lead to further complications in China as people resume international travel, and geopolitically as a patchwork of countries impose restrictions on Chinese air travellers.

The United States, United Kingdom, Italy, India, Israel, Spain, Canada, South Korea and France are all implementing some form of restrictions on air travel from China; this usually means that a passenger boarding in China and heading to one of these countries cannot board without testing negative or, in the case of Spain, without being vaccinated. But policies surrounding infectious diseases are difficult to craft without accurate data on the number of cases, hospitalizations and deaths, which China has failed to collect and disseminate since the rollback of zero-Covid in end December.

It is far too early to say exactly what effect the change in policy will have; although China appears to be currently experiencing a major surge of infections, this has not translated into major infections outside the country. But since Chinese air travelers haven’t gone through multiple waves of the variants, they could be more vulnerable to infections.

Moreover, there is no great scientific evidence to support travel restrictions; “We have seen time and time again with this pandemic that a patchwork response, whether nationally or globally, does little to contain the disease,” said Saskia Popescu, assistant professor in the biodefense program at from George Mason’s Schar School of Policy and Government. University, told Vox via email. “Furthermore, travel bans and testing requirements are not as effective because they overlook the porous nature of borders, the realities of disease transmission, and are reactive rather than preventative.”

China rolls back Xi Jinping’s zero-Covid policy, cases rise

Chinese President Xi Jinping rolled back restrictions on his signing policy after widespread protests began against strict lockdowns and mandatory testing in November. Although Xi’s government announced a 20-point plan to ease those restrictions earlier this month, the protests, some of which called for Xi’s resignation, appear to have accelerated the dismantling of Xi’s policies.

Drastic closures, including in Shanghai, at the FoxConn iPhone factory in Zhengzhou and in Urumqi, Xinjiang, have reportedly left people without access to food, and many in Xinjiang believe the zero-Covid measures there, which banned people from leaving their apartments, prevented rescuers from helping people locked in their homes when a fire broke out in an apartment building in Urumqi.

In the month that followed, the set of policies that Xi once said would ‘put people and their lives above all else first’ quickly unraveled, leaving a significant rise in cases in its wake. and a strained healthcare system.

“I think we should be worried about what’s happening in China – for the Chinese people,” Andrew Pollard, chairman of Britain’s Joint Committee on Vaccination and Immunization, told BBC News Hour on Saturday. “In the country, there is a large amount of Covid spreading at the moment, the omicron variant is there, and it is spreading extremely well between people. And they haven’t had waves of Covid before… so we expect huge numbers of infections to occur.

Officially, China has recorded just over 5,000 deaths from Covid-19 since the start of the pandemic, which Pollard admitted was possible if that number only counts people who have died from the disease without any other underlying conditions. underlying. But the numbers are likely much higher, he said, if those cases are included, and they’re likely to rise as the disease spreads, especially among older people who are less likely to be vaccinated.

Already, reports out of China point to a hospital system under strain due to rising Covid-19 cases, as well as crematoriums and funeral homes under the weight of the death toll.

Stopping zero-Covid was, as Victor Shih, a China policy expert at the UC San Diego School of Global Policy and Strategy, told The New Yorker’s Isaac Chotiner, likely a complex decision driven by economic and social issues. at the national level as well as general discontent and protest. But Xi will have to deal with the fallout of his decisions – both the draconian lockdowns he has employed and announced for three years, and the likely wave of Covid-19 infections and deaths that will follow China’s reopening. This fallout, Shih said, will likely mean more protests of the type seen in November, and most likely increased skepticism about China’s economic and governance models, both at home and abroad. outside of China.

“Some serious damage is being done to public trust,” John Delury, a China expert at Yonsei University in Seoul, told the Financial Times. “We may not see the immediate effects of this. But this enters into the public calculation of the competence of their government. This is the worst possible start to Xi’s third term.”

The world is better equipped to deal with Covid-19, but there are still many unknowns

The end of covid-Zero also means the end of national disease surveillance. As Yang Zhang, professor of sociology and Chinese politics at American University tweeted in December regarding the tracking of Chinese Covid-19 cases“I don’t think the Chinese state had the capacity to collect, model and evaluate provincial/municipal infection data on a daily basis. [sic] over the past month. After the sudden opening, it’s a daunting job (for any state). They simply gave up.

Without adequate information on vaccine effectiveness, infections, hospitalizations and deaths, it is difficult to model how the disease might spread and to develop sensible policies regarding disease mitigation – hence the current patchwork of air travel restrictions.

“We are flying blind with no more information, but this is also an issue we face in the United States as the CDC has changed community transmission level thresholds, testing centers have been closed and home tests are not reported,” Popescu said. “At the end of the day, that should be a lesson in that we can’t really deal with an epidemic or a pandemic if the data is incomplete somewhere.”

Just like at the start of the pandemic, countries disagree on how they will deal with potential new cases arriving by air; three years later, Popescu said, countries that impose restrictions are not necessarily choosing effective restrictions. “Even [in the beginning of the pandemic] a travel ban was not supported by science and frankly proved ineffective in terms of control. The best travel restrictions can do with a disease of this magnitude is give governments time to prepare for its spread.

Italy, which has implemented a testing restriction for air travelers from China, has encouraged other European Union countries to do the same; France and Spain have also put restrictions in place, but the EU as a whole has so far refused to do so. In a place like Europe where overland travel between countries is fairly painless, “testing passengers from one country is not effective in containing disease (the horse is basically out of the stable),” said Popescu. Also, she said, ‘testing is reactive’, not proactive, she said – Italy implemented its testing mandate after cases were detected in flights arriving in Milan on December 26.

A positive sign from Italy’s testing program is that there don’t appear to be any new variants from China – meaning that, as far as researchers can tell, Covid-infected travelers from China don’t show no greater risk to, say, the United States. population than an American citizen infected with Covid-19.

The risks may be higher for Chinese travelers, who may be introduced to an unknown variant during their travels, or may not be vaccinated, although around 91% of the population is fully vaccinated, according to the New York Times.

Although the world is better equipped to deal with Covid-19 than in 2020, the patchwork of restrictions in response to China’s reopening still shows major flaws in the world’s ability to deal with the pandemic in a united and consistent, said Popescu. Covid-19 is likely to be endemic for years to come; incidents like China’s reopening and the potential for new disease variants and waves “should serve as a reminder of the importance of global health, vaccine equity, and partnerships in proactive public health interventions.”

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