#17,136
While any numbers we get out of China must be taken with a very large grain of salt - as their government tightly controls the release of any `negative news' - the trends depicted in the above chart are probably reasonably representative of the relative intensity and spread of COVID on the Mainland.
Aside from the initial outbreak in Wuhan nearly 3 years ago, and a noticeable spike after a more transmissible Omicron wave arrived 12 months ago, China's Zero-COVID policy has - until recently - kept COVID largely under control.
But that level of control has come at great cost; to their economy, the government's image, and to the hundreds of millions of people forced to live under draconian lockdown and forced quarantine rules.
While successful in the short-term, China's endgame with this virus is difficult to fathom. The SARS-CoV-2 virus shows no signs of going away, and despite the roll out of a vaccine in 2020, the vast majority of China's population has likely gained (or retained) very little immunity to COVID over the past 3 years.
Two weeks ago, in China: Beijing Relaxes Some Zero-COVID Regulations Even As Cases Continue To Rise, daily cases were reported by China to be running about 10,000 a day. Today, China's National Health Commission reports more than 40,000 cases (symptomatic & asymptomatic) for the 1st time.
While it is anyone's guess what the true size of China's outbreak really is, the fact that they are admitting to a quadrupling of cases in 2 weeks is telling.
The newer Omicron variants (BQ.1.1, XBB, etc.) are many times more transmissible than the original Wuhan strain, and are highly evasive of any previously acquired immunity, allowing them to spread even under China's rigorous Zero-COVID policies.
Reports of rare mass protests across China (see here, here, and here) are simultaneously being suppressed by China's government, and championed by social media and the Western press, making it difficult to gauge how much of an impact they may actually have.
What is more evident is that China is at a crossroads with COVID, with very few palatable options.
With more than a billion people with little or no immunity - if they relax their Zero-COVID policies they risk a tsunami of cases - which would further undermine their economy, overwhelm their healthcare services, and potentially destabilize the region by threatening the power of President Xi Jinping and the Communist Party.
But even if they keep their COVID policies largely intact, they appear to be rapidly losing ground to the virus, meaning that any decision to maintain Zero-COVID could well become moot in the weeks ahead.
Another concern is that no one really knows what could happen if multiple Omicron variants are allowed to spread rapidly across hundreds of millions of immunologically naive Chinese. Initially hospitalization would soar and deaths would rise, but other possibilities include:
- New, potentially more dangerous Omicron recombinants may emerge, which could revitalize the pandemic both in China, and around the globe. It is even possible that we could see another major antigenic leap in the virus, such as we saw with Omicron a year ago.
- Many rural Chinese live in close proximity to farm animals, which could provide additional routes for SARS-CoV-2 to spillover into other species, again with unpredictable results (see WHO/FAO/OIE Joint Statement On Monitoring SARS-CoV-2 In Wildlife & Preventing Formation of Reservoirs).
- At the very least, China's economy, and by extension - much of the world's supply chain - could suffer for months to come should a major epidemic shut down manufacturing.
- It is fair to say that the political, societal, and economic impacts - both in China and around the world - from any of these events could be enormous.
Given the speed of COVID's spread in China right now, that seems increasingly unlikely.
