COVID in China on the rise

A massive omicron-fuelled outbreak of Covid cases is sweeping across China. Alongside Hong Kong, Shanghai has seen a big upswing in cases leading to over 25 million people returning to lockdown and businesses closing. But unlike the UK, where there are hundreds of thousands of cases per week, China has seen just a few thousand in total. The difference is that China continues to pursue a zero covid policy. Speaking with public health specialist Sian Griffiths, who was also involved in the original SARS outbreak in Hong Kong, James Tytko began by asking why the Chinese and UK approaches to managing Covid are still world’s apart…

Siân - That's to do with the choices of governments as to what strategy they're choosing in the UK and in many other countries. We're adopting a 'live with COVID' approach, which will allow cases of COVID in the community and will rely on vaccination to control the disease. In China and in Hong Kong, it's a zero COVID approach. That essentially relies on identifying cases, isolating them, isolating contacts, and dropping the transmission of infection so that you don't have infection in the community. It's just two sides of a coin.

James - Do you think that this is a viable strategy for China moving forward?

Siân - If you look at Hong Kong, as an example, Hong Kong has a population of 7 million people and has currently got an outbreak of Omicron. They didn't concentrate on vaccination, they concentrated on the 'zero COVID' approach of limiting the numbers of people coming into the country and controlling the numbers of disease. Unfortunately, once you have a very transmissible variant, such as the Omicron variant that's around at the current time, and an unvaccinated population, particularly the elderly, particularly those in care homes, you get a sudden surge in pressure on the health system and unfortunately in deaths.

James - Am I right in saying that recently Hong Kong, although they've been following China's lead for much of the pandemic in trying to stick to a zero COVID policy, haven't they recently started to reflect on their approach a bit more and ease some restrictions?

Siân - Hong Kong is changing its approach to COVID. Although officially it's still sticking with a dynamic zero COVID policy. That's what Carrie Lam, the chief executive said only yesterday. At the same time, they are starting to allow more flights in, because the economic impact on trade and by not allowing people into the country, by putting people who do go in even returning Hong Kongers who would have to go into quarantine at one stage for three weeks, that was just having such a harmful effect on the economy. If we look across to Shanghai, they had tried to be more liberal in the way that they were going to restrict and contain the population and then put in mass testing. However the costs are said to be in the billions for this exercise that they're going through at the current time.

James - And do you think that slightly more flexible, perhaps a more Western approach we're starting to see in Hong Kong might be a precursor for policy in China, perhaps?

西安——看来,这是一个政治决定of course they do have some important political meetings coming up and reading around this subject, it would appear that the general feeling is that they'll stick with zero COVID until after those political meetings. Unfortunately, they are seeing more outbreaks across China, most of the major cities and living with COVID policy allows you to carry on with your normal business. The zero COVID policy means that you have to stop people going to work, stop the transport systems, you test everybody, and that's a hugely difficult and challenging thing to do and has an impact on the economy. They are thinking of loosening up, but I doubt that it's going to be an official change yet.

James - And I know you've talked about the economic impact. Was there any other knock on effects that might have for us here?

Siân - For us in the UK, it does impact cultural relationships. It impacts on social relationships. There are families who aren't able to get back together again. There are people leaving Hong Kong because they just can't tolerate the restrictions on their lifestyle because of the approach to COVID. Ultimately zero COVID is going to be almost impossible for China. We've seen the organism mutate, mutate, mutate, and every time we get a successful mutation, we get an increased number of cases. The difficulty for China will be whether the vaccines they're using, that are home grown vaccines, how effective are they as you get these continual mutations? It's going to be very hard to really cope with this. China does have high vaccination rates, although not at high in the over 80s, so there is a risk of that particular group who are more vulnerable to hospital admission being affected.