With record covid cases, China scrambles to fill immunity gap


A coronavirus outbreak set to be the largest of the pandemic in China has exposed a critical flaw in Beijing’s “zero covid” strategy: a vast population with no natural immunity. After months with only occasional hotspots in the country, most of its 1.4 billion people have never been exposed to the virus.

Chinese authorities, which reported a record 31,656 infections on Thursday, are scrambling to protect the most vulnerable populations. They launched a more aggressive vaccination campaign to boost immunity, expanded hospital capacity and began restricting the movement of at-risk groups. The elderly, who have a particularly low vaccination rate, are a key target.

These efforts, which stop short of approving foreign vaccines, are an attempt to prevent the virus from overwhelming an ill-prepared healthcare system with a flood of very sick covid patients.

More intensive care beds and better vaccination coverage “should have started 2.5 years ago, but the focus on containment meant fewer resources spent on it,” said senior health researcher Yanzhong Huang. world at the Council on Foreign Relations.

Huang believes that even mRNA boosters, which have been shown to be more effective in fighting diseases of the latest omicron variants, would not now solve the fundamental problem with China’s goal of eliminating the infection rather than to alleviate the symptoms. Boosting immunity by allowing some degree of community transmission “is still not acceptable in China,” he said.

China’s epidemic containment strategy originally protected daily life and the economy while preventing serious illness and death. But this has become increasingly costly as increasingly stringent measures fail to keep up with more transmissible variants.

Earlier this month, the government announced what on paper appeared to be the most significant relaxation of controls yet, with shorter quarantine times and less testing requirements. Officials insist the 20-point “optimization” plan is not a prelude to accepting outbreaks.

But the effort to break cycles of disruptive lockdowns had a rocky start. Some cities have eased measures, while districts in others have ordered residents not to set foot outside their homes. The result: confusion, fear and anger.

Clashes erupted in a few places, mostly at a massive Foxconn factory in central China that makes half of the world’s iPhones. The scene there turned violent this week as thousands of workers protested the company’s failure to isolate those who tested positive and honor the terms of employment contracts.

The fight against epidemics is once again a priority. Shijiazhuang, a city of 11 million about 185 miles from the capital, on Monday suspended its reduced requirements for mass testing and announced five days of citywide testing.

The first deaths reported since May – although only one or two a day – have heightened concerns that hospitals are ill-prepared to deal with a rise in severe cases. Bloomberg Intelligence has estimated that fully easing coronavirus controls could leave 5.8 million Chinese in need of intensive care in a system with just four beds per 100,000 people.

At a press conference on Wednesday, Chinese health officials said more than 100 critical cases meant more hospital beds and treatment facilities were “much needed” given the health risks to people. elderly and people with pre-existing conditions. The spread of the infection was accelerating in several places, they added, with some provinces facing their worst outbreaks in three years.

Major cities like Beijing, Guangzhou and Chongqing have ordered residents of certain neighborhoods to stay at home. Shopping centers, museums and schools were again closed. Large conference centers are being converted into temporary quarantine centers, mirroring the approach taken in Wuhan at the start of the pandemic. Some of the strictest restrictions are on nursing homes, with 571 such establishments in Beijing implementing the strictest level of control measures and preventing all but essential exits and entries.

Opening up to a world now mostly living with the virus would cause a wave of deaths, officials fear. Chinese vaccines were initially limited to adults between the ages of 19 and 60, a policy that continues to impact vaccination rates today. Only 40% of Chinese people over 80 have received a booster shot, despite months of campaigning and giveaways to encourage adoption. (Among people over 60, two-thirds have received a booster.)

Since the start of the pandemic, China has relied solely on domestic vaccine manufacturers. It has approved nine locally developed options, more than any other country, with the oldest and most widely used vaccines coming from state-owned Sinopharm and private company Sinovac. Both received endorsement from the World Health Organization early last year after being shown to significantly reduce deaths and hospitalizations.

Sinopharm and Sinovac have distributed their products widely around the world as part of a Chinese push to become a leading provider of global public goods and to improve China’s image. Yet in late 2021, demand for Chinese vaccines began to dry up as production and distribution by Pfizer and Moderna increased.

China has still not approved any foreign vaccines or explained its decision to avoid what could be an effective way to close its immune gap. A visit by German Chancellor Olaf Scholz to Beijing in early November ended with an agreement for the Pfizer-BioNTech vaccine to be made available to foreigners living in China through the company’s Chinese partner, Shanghai Fosun Pharmaceutical.

BioNTech has a development and distribution agreement with Fosun that gives the Chinese company exclusive rights to supply the country. But Chinese regulators have repeatedly delayed signing the vaccine, despite it being available in Hong Kong, Macao and Taiwan.

When asked last week if the government would approve BioNTech for public use, the director of China’s Center for Disease Prevention and Control said authorities were working on a new vaccination plan that should be released soon.

Without access to the most effective mRNA candidates from Pfizer-BioNTech and Moderna, which have been updated to fight the omicron variant, the world’s most populous country remains dependent on vaccines developed using the original strain of the virus.

Some health experts say Beijing’s reluctance is hard to justify. “China should approve BioNTech and Moderna vaccines for the entire Chinese population as soon as possible,” said Jin Dong-yan, a virologist at the University of Hong Kong. “It’s ridiculous that they only allow foreigners in China to receive the BioNTech vaccine. It’s like they think the Chinese are inferior to foreigners.

China is instead trying to develop 10 of its own mRNA candidates. The one who is farthest is from the biotechnology group Abogen Biosciences and the state-run Academy of Military Medical Sciences. Indonesia approved it for emergency use in September, but it hasn’t received approval from Chinese regulators and may not get it until data from phase 3 clinical trials in Indonesia and Mexico will not be available. Trials are expected to end in May.

Other options in China include an inhalable vaccine developed by CanSino, which has been available in Beijing, Shanghai and Hangzhou since October. An antiviral drug developed in China, Azvudine, originally used for HIV patients, was approved to treat covid in July. Traditional Chinese medicines are widely used.

But new, more effective vaccines remain a top priority, and the country’s major pharmaceutical companies are poised to mass-produce them. CanSino is completing a production facility in Shanghai that will be able to manufacture 100 million doses a year – after receiving approval.

With record covid cases, China scrambles to fill immunity gap

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