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Why is China stubbornly sticking to zero COVID despite the chaos?

‘They just painted themselves into hard-to-get-out corners,’ says expert

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Even for governments accustomed to doing what they want with little regard for the will of the public, China’s zero COVID policy may seem puzzling.

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Stringent measures to contain signs of viral infection continue to add to public unhappiness.

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That backlash has exploded in recent days, with Chinese citizens taking to the streets in the gravest anti-government protests since the student occupation of Tiananmen Square in 1989.

So why is President Xi Jinping so stubbornly adhering to zero COVID?

Medical experts and China watchers say the answer lies in the marriage of ideology and virology. The effects of the Communist Party’s increasingly nationalist tendencies and the fear that alternatives will be just as painful and more embarrassing.

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Ending zero COVID is assumed to result in a tsunami of coronavirus illnesses, hospitalizations and deaths, thanks to declining vaccinations, poor vaccines, and the lack of natural immunity that widespread infection creates.

This will force the government to make an enviable choice. Should you open the floodgates and try to ride out the deluge, or should you keep your finger on the embankment for as long as possible?

“They’ve drawn themselves into a corner that’s hard to get out of,” says Dr. Paul Hunter, a professor of medicine at the University of East Anglia in the UK. “No matter what you do, at some point you’re going to get a pretty frightening surge of infections.”

China faces “huge challenges,” reiterated Yi Chun Lo, deputy director of Taiwan’s Center for Disease Control.

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If they open up there will be huge waves of infection among their population

Yi Chun Lo, deputy director of the Taiwan Center for Disease Control, said:

“If they open up, if they don’t stick to a zero COVID strategy, there will be a huge wave of infections among their population and it’s a highly populated country,” he told the National Post and others. told the international media .journalist last month.

But it’s not just the health implications of the end of restrictions that Beijing is concerned about, argues a prominent Chinese observer.

After being heavily criticized by the World Health Organization for its handling of the 2003 SARS outbreak, China has tried not to be “humiliated” again, said Guy, who served as Canada’s ambassador to Beijing from 2012 to 2016. Mr Saint-Jacques said.

For starters, China promoted Dr Tedros Ghebreyesus of Ethiopia to Director-General of the World Health Organization. Saint-Jacques said this was because he assumed that Ghebreyesus was susceptible given the aid Beijing provided his country.

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In fact, the WHO has been widely criticized for its sympathetic approach to China, failing to point it out when it withholds key information, even though it generously praises its efforts to contain the virus.

And when COVID-19 first appeared in Wuhan, despite local attempts to cover it up, Xi said, including in a speech he gave at the party’s 20th National Congress recently, that China has taken up has repeatedly boasted that it handled the pandemic better than its rivals. America.

“He supports the (coronavirus-free) policy,” said Saint-Jacques, pointing to the growing power around the president. “It’s very difficult to come to him now and say, ‘Your Excellency, this is having a huge impact on the economy and we have to change our approach.'”

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But at its core, zero COVID is still a public health issue. And China’s dilemma with this strategy stems largely from how the virus spreads, the tools mankind has developed to stop it, and how those tools are used.

Hunter says a recent Canadian-led study points to the optimal approach.

Papers by researchers from the University of Toronto, UBC University, Johns Hopkins University, Oxford University, and others analyzed past research and found that vaccination is effective in preventing serious illness and death, and that it is possible to catch the virus. is more effective, and a combination of immunizations and infections—something called hybrid immunity—provides the most durable protection against severe COVID illness.

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That means controls like lockdowns and mask mandates were paramount before the population was widely vaccinated, says Hunter.

Subsequent easing of restrictions among particularly susceptible subspecies of Omicron led to widespread infection in many countries, but also provided the benefits of hybrid immunity, he said. The protection of vaccination has lowered the risk of contracting COVID-19.

Canada, for example, achieved high levels of immunity through the use of effective vaccines, which spread to about 60% of the population during the Omicron period, said Dr. Prabhat Jha, executive director of the Center for Global Health Research at the University of Toronto. says. St. Michael’s Hospital.

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In China, a relatively large number of people, 89% of the population, are fully vaccinated. But even after that, we maintained zero COVID, quarantined vast numbers of people at home and government facilities for a small number of cases, conducted mass testing, closed businesses, and put quarantined workers to sleep in factories. I was.

Infection — and the added value of innate immunity — was curtailed sharply, all the while making the initial dose less effective.

“What China has done has undermined the benefits of the vaccination program,” said Hunter.

But that’s not the only problem.

Beijing has focused its vaccination efforts on adults of working age, a decision Hunter calls a “mistake.” As a result, older Chinese residents, the types most likely to clog hospital ICUs or die from COVID, have relatively low vaccination rates. Only about half of these people were fully vaccinated.

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The government promised this week to increase vaccination rates among the elderly, but loosening restrictions now would come at a high cost, experts say.

“China could prove to be the leading cause of the global COVID-19 death toll in 2022, possibly exceeding one million,” Jha said. “The virus is apolitical and spreads where the barrier to immunity is low.”

Then there’s the vaccine itself.

The most potent have proven to be cutting edge mRNA shots like Pfizer and Moderna and adenovirus vaccines like those made by AstraZeneca. The former injects people with a piece of genetic material that prompts their cells to make the virus’ trademark spike protein, causing the body to produce antibodies against it. The latter uses a harmless virus to deliver some of the SARS-CoV-2 genetic material and also trigger an immune response.

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China had access to an mRNA vaccine developed by Germany’s BioNTech in partnership with Pfizer, but never approved its use. Instead, it contains an inactivated (killed) version of the virus. It relies mainly on products manufactured by domestic companies Sinovac and Sinopharm, which use old technology. And it’s been proven to be less effective.

These vaccine decisions were undoubtedly driven by nationalism, suggests Saint-Jacques.

“Now in China, ideology drives everything.”

Meanwhile, a flood of seriously ill COVID patients could overwhelm the country’s hospitals.China has only about four intensive care units per 100,000 population, compared with 13 in Canada and 34 in Germany. There is none.

Beijing has hinted in recent days that it will ease some of its restrictions. But how to finish off Xi and his colleagues once and for all?

They may be waiting for higher vaccination rates, the emergence of a less virulent new coronavirus, or increased medical resources to handle the fallout, said Taiwan’s Lo. .

“Their healthcare facilities or capabilities need to be transformed before they face such challenges,” he said. “I think they need to rethink their departure from the zero-coronavirus strategy.”



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Why is China stubbornly sticking to zero COVID despite the chaos?

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