Advertisement
Advertisement
Coronavirus China
Get more with myNEWS
A personalised news feed of stories that matter to you
Learn more
People wearing face masks walk along a pedestrian shopping street in Beijing on July 2, 2022. Photo: AP Photo

Coronavirus: new variants raise questions about sustainability of China’s zero-Covid policy

  • Experts urge Beijing to focus on reducing deaths and hospitalisations by vaccinating the elderly
  • Local authorities pressured to achieve both zero-Covid and growth, but emergence of new Omicron spin-offs like the BA2.75 is worsening uncertainties
Whether China can maintain its zero-Covid policy and track down every single infection in the community is being questioned after infections caused by a more infectious strain of Covid-19’s Omicron variant, known as BA. 5, were reported in Xian, Tianjin and Beijing last week.

Two sublineages of Omicron – BA.4 and BA.5 – have quickly become the dominant strains in many countries, including the United States, Britain and Australia.

Scientists say the two subvariants, which are close relatives, are offshoots of the highly transmissible Omicron BA.2, with additional mutations in the spike protein that make them the most infectious Covid-19 lineages so far.

New Omicron strains better at dodging protection from vaccines: study

However, their status as the most infectious Covid-19 variants may only hold true for a while, as they now face the challenge of yet another Omicron spin-off, called the BA2.75 and nicknamed “Centaurus” by the science community.

The World Health Organization is closely monitoring the new subvariant, which first emerged in India in late June, but said it was still too early to tell if it could outcompete BA.4 or BA.5 or if it caused more severe sickness.

The speedy emergence of sublineages one after the other is not a surprise, as RNA (ribonucleic acid) viruses like Sars-CoV-2 – the coronavirus that causes Covid-19 – evolve quickly. But that also means China, which continues to hold on to a zero-Covid policy, will constantly have to catch up with ever-increasingly transmissible variants, with the race becoming ever more difficult.

On Friday, Chinese officials said the task of preventing local transmissions of BA.4 and BA.5 caused by imported cases and contaminated goods was “complex and grave”.

They vowed to step up measures such as putting people working in customs and at ports in closed loops, disinfecting imported goods, and quarantining people arriving from overseas, even though such travellers now only need to spend seven days in quarantine in government facilities, down from 14, with an additional three days at home.

02:01

Tens of millions under lockdown in China following outbreak of Covid BA.5 subvariant

Tens of millions under lockdown in China following outbreak of Covid BA.5 subvariant

Analysts say China’s zero-Covid policy is not only unsustainable, but also unnecessary, given the two sublineages have not caused a major surge in hospitalisations and deaths in other countries, and they have called for Beijing to focus on reducing deaths and hospitalisations by vaccinating the elderly.

Hopes rose briefly last week that the authorities might eventually shift to relying on vaccinations instead of mass PCR tests as the mainstay of their defence against the new subvariants after Beijing became, on Wednesday, the first mainland city to require vaccine proof to enter public venues.

However, the capital flip-flopped the next day and rescinded the mandate – a clear sign it would be sticking to the current approach of maintaining zero cases in the community through PCR tests and large-scale quarantine.

‘Completely at a loss’: anxious wait for Beijing residents with foreign vaccines

“Mass vaccination has never been a key instrument for achieving zero-Covid in China, partly because of the inherent tensions between the two: zero-Covid does not tolerate any infection, but even the best vaccines today cannot guarantee 100 per cent protection against infection,” said Huang Yanzhong, a senior fellow for global health at the Council on Foreign Relations in the United States.

“Beijing’s vaccine mandate, if sustained and expanded nationwide, would lead to a shift to a mitigation-based approach that focuses instead on protecting and prioritising the at-risk population. The decision to rescind the mandate so quickly suggests that China is not ready to pivot from zero-Covid any time soon.”

Xian, where local transmission of BA.5 was reported, announced seven-day bans on dining at restaurants and large gatherings last week, and closed schools and many public facilities to discourage movement by its 12.9 million people.

The authorities tried to avoid a citywide lockdown, like the two-month one in Shanghai that sparked food shortages and chaos. But Xian’s announcement of the week-long containment measures triggered an exodus of university students and migrant workers and the government had to clarify that it was not locking down the city.

The movements of people in Xian are still greatly restricted, with those in high-risk areas, where positive cases have been found, ordered to stay at home and people in low-risk areas told not to leave their district.

Stickers for residents who complete nucleic acid tests for Covid-19 in Xian. Photo: AFP

But unlike the lockdown in Shanghai, the city government stressed that supermarkets and food stores remained open. The approach was similar to that of Beijing in late April, where the government tried to maintain food supplies after a panic-buying spree while restricting people’s movements by sealing off specific buildings, streets or districts.

BA.5 has yet to cause a major outbreak in Beijing or Xian. On Friday, there was one symptomatic case and eight asymptomatic cases reported in Xian. No new local cases were reported in Beijing.

As of Monday, there were no local cases of BA2.75, which the WHO said was already circulating in 10 countries in Asia, Europe and North America, as well as Australia.

However, analysts said the existing approach was unsustainable as the virus was becoming more infectious, and also unnecessary because there was no proof that BA.4 or BA.5 could cause more severe disease.

“To achieve zero-Covid is no longer necessary,” said Jin Dongyan, a virologist at the University of Hong Kong. “It’s no longer achievable.”

Earlier this year, BA.4 and BA.5 caused cases to surge in countries including South Africa and Portugal. But there was no significant rise in hospitalisations and deaths and the virus remained much milder than the earlier Delta variant.

01:45

New Covid-19 subvariants can reinfect Omicron-recovered patients, early studies find

New Covid-19 subvariants can reinfect Omicron-recovered patients, early studies find

French health authorities said their clinical data showed that while the symptoms of BA.4 and BA 5 might last longer, there was no major increase in hospitalisation.

“BA.4/BA.5 cases also reported a longer duration of clinical signs. The rate of hospitalisation was not significantly higher for BA.4 and BA.5 compared to BA.1 and the majority of hospitalised cases had risk factors,” they said in a report.

Since BA2.75 is relatively new to the scene, scientists are still monitoring if it causes more severe disease.

Jin said many infections were breakthrough cases in those who were previously vaccinated or infected, and their symptoms were usually milder.

Huang said that even if China managed to eradicate all community-level transmissions in a city, “the victory can be short-lived” as the infections could easily flare up again after the authorities managed to suppress a local outbreak.

BA. 4 and BA. 5: what we know about the new Omicron subvariants

Although China is avoiding a repeat of a Shanghai-style lockdown, residents have been left facing a series of uncertainties. They have no idea when their residential complex or neighbourhood will be designated as high-risk and they have to remain confined to their homes.

Such uncertainties would deal a blow to the country’s economic recovery, Huang warned.

While Shanghai managed to suppress a major outbreak of BA.2 after two months of lockdown, it has reported a surge of cases in the past week, though the number of new local cases remains relatively low.

President Xi Jinping said late last month that China was willing to bear economic risks to stick to its zero-Covid policies.

But the central government is putting immense pressure on local authorities to achieve both zero-Covid and economic growth. They have also been told not to use medical insurance funds to finance PCR tests. All these dilemmas affect the sustainability of the policy.

“It is becoming even more difficult to implement this strategy,” Huang said. “The local authorities were held accountable for implementing that strategy but they have dwindling resources.”

Uncertainty dulls prospects for China trade, spending rebound: analysts

It remains to be seen whether BA.4/5 will eventually force China to shift away from its zero-Covid policy, but Huang said even if that was the case, the change would be subtle and gradual.

China announced on Friday that over 80 per cent of those older than 60 have received two shots of vaccine, with some 60 per cent having received three.

“The right thing to do is to beef up vaccination and to achieve three injections for all elderly,” Jin said. “They should set that as the next goal. And they should do this quickly. Within weeks.”

China mostly relies on inactivated vaccines produced by Sinopharm and Sinovac, which are less effective in fending off the new variants, even though they could still reduce the severity of cases.

But the country would eventually need more effective vaccines, said Chen Xi, associate professor of health policy and economics at the Yale School of Public Health.

“Sooner or later China will have to introduce more efficacious vaccines,” he pointed out.

38