Opinion – Atila Iamarino: China and the end of Covid zero

For anyone wary of China’s official numbers, with just over 5,000 Covid deaths out of a population of nearly 1.4 billion people, the coming months will show just how realistic they are. With the relaxation of the Covid zero policy, we will see the potential of the disease manifesting itself in the country.

It’s difficult to assess the impact of each isolation measure that countries adopted in 2020. We know that the most effective measures to stop the transmission of the virus were the ban on small agglomerations and the closure of commerce and schools. Others, such as the closure of airports and the cancellation of concerts and major events, did not have a clear benefit, either because they did not work or because many had already changed their behavior even without decrees.

The most effective strategy, as judged by a panel of experts from the World Health Organization, was to act early and forcefully. Australia, China, New Zealand, Vietnam and other countries that coordinated closures, testing and quarantines in time to stop the virus managed to avert the worst of the pandemic. On top of that, they are still among the countries with the best economic performance in the period.

But, one by one, these countries reopened as vaccines appeared, the population got tired and new variants pierced the barriers. Only China continued to control the situation with virtually no cases until the second half of 2022.

To someone looking in from the outside, the Chinese seemed to live in another world, moving around as if there was no Covid, while the rest of the world saw a massacre. But behind this “normal” life, there was a massive program of millions of tests, monitoring, border control and lockdowns that hit cities with more than 10 million inhabitants. Control measures that shocked more than the practice of administering morphine instead of oxygen to free up beds, which was adopted in Sweden.

They clash in part because, for many, we were “alone” facing the biggest pandemic of the century, while China is facing yet another of many new diseases with the potential to be lethal to humans.

With such a populous country, the world’s largest pig farm and second largest poultry farm, and a unique combination of wild animals with very concerning respiratory viruses, China is a melting pot of potential new human viruses.

H3N8, H10N3, H7N4, H7N9… China regularly records new cases of various types of pathogenic avian influenza in humans, to name a worrying group.

The reason we don’t hear about these and other viruses is because so far the cases have all been contained and these diseases have not established themselves among us. Covid is one of several new diseases that the country is trying to contain, hence its forceful action.

But there is a limit to what people tolerate. New, more transmissible variants have so challenged China’s containment capacity and led to the confinement of so many people that the protests have caused the country to drop Covid-zero measures.

With the relaxation, we can expect for the next one a compact of what other countries have gone through: ICUs filling up, factories closing and many deaths.

Despite the volume of doses applied, the bulk of vaccination in the country was done with vaccines that had been inactivated for many months. And less than half of those over 80 took the third dose. A combination that leaves many seniors vulnerable.

The adoption of containment measures is a collective process, with many solutions and without a clear answer, but with great consequences. The Chinese already saw what they had to lose with the zero Covid policy, now they will see what they were avoiding.