Facing uncertainties, sticking to zero-COVID policy remains China’s best strategy: epidemiologists

The world has been fighting the COVID-19 pandemic for two years, and the initial fear of the unknown virus has now morphed into yearning for a return to normalcy. That is why The Lancet paper indicating that the end of the pandemic is near picked up steam and got scientists into a heated debate about the possibility of China ending the epidemic this year.

Yet the end of the pandemic seems an unlikely scenario when the more contagious coronavirus variant Omicron has driven cases in the US and Europe and other countries to historic highs. While other parts of the world look toward the end of the pandemic, renowned Chinese epidemiologists suggested the country "wait and see." As many uncertainties still lurk on the road to reopening, such as damage from the new variant, the possibility of other new variants, and the country's medical capacity to handle a possible wave, scientists believe sticking to the current dynamic zero-COVID policy remains China's best option.

It's a gamble we cannot afford to lose, they said.

"By March 2022, a large proportion of the world will have been infected with the Omicron variant," wrote Christopher Murray, director of the Seattle-based Institute for Health Metrics and Evaluation (IHME), in The Lancet on January 19.

"After the Omicron wave, COVID-19 will return but the pandemic will not," he said in the January 19 article, suggesting it will become another recurrent disease that health systems and societies will have to manage.

This comment, which coincides with WHO Director-General Tedros Adhanom Ghebreyesus' previous remarks that 2022 will be the last year of the COVID-19 pandemic, brings a ray of light into the darkness that has muffled the world for two years. Part of the optimism came from people's perception of Omicron, a more contagious but milder variant. Brazilian President Jair Bolsonaro even called it a "welcome" variant, Reuters reported on January 12.

In the face of Omicron, our focus must be on reducing transmissions and increasing vaccine coverage, Tarik Jasarevic, WHO spokesperson, told the Global Times in an email on Monday. He noted that while Omicron causes less severe illness than Delta does, it remains a dangerous virus, particularly for the unvaccinated.

The goal by mid-2022 must be for every country to vaccinate 70 percent of its population. "We can end the acute phase of the pandemic if we vaccinate populations, starting with those most at risk," Jasarevic said.

Chen Xi, an assistant professor of public health at Yale University, told the Global Times that he agrees with the forecast made by the Lancet. He predicted that the pandemic could end in March but with a necessary premise that there's no new variant.

"As the virus has become much contagious, it has become less lethal. But we can't exclude the possibility that it further mutates and escapes from the immunity system," Chen said. He contended that as long as the new and powerful variant does not occur, the death rate and the hospitalization rate caused by the current variant will reach the level of a flu, which shows that the global pandemic will enter the next stage, an endemic or seasonal outbreak.

However, such a "victory" will be achieved at a huge price, Chen said, as in the next six to eight weeks, countries in Europe and also the US will see surging infections, which will force the building of herd immunity. But in some parts of the world like in Africa, outbreaks will continue.

'Wait and see'

Scientists from China, one of the few countries still sticking to a zero-COVID policy, tend to be more discreet.

"If other countries reopen, that's their choice on the basis of their own situation, which we respect, whether it's a reckless or courageous move," Zeng Guang, former chief epidemiologist of China's Centers for Disease Control and Prevention (CDC), told the Global Times.

He said we need to "wait and see" on whether the pandemic will end in March, as the conclusion made by the Lancet article can only be taken as a reference with many unknown risks still existing.

Echoing Zeng, Wu Zunyou, a CDC chief expert, said at a Sunday seminar that the Omicron variant is "more contagious" because it can infect people even if they have been vaccinated and the variant's mortality rate is higher than influenza.

Chen Xi pointed out that comparing the psychological enduring capacity to the overall medical capacity, China still sees a huge gap with the US. In America, the number of nurses per 1,000 people is about seven times higher than in China, he told the Global Times. "In a developing country like China, a sudden lifting of strict measures will cause huge pressure on the medical system," he said.

Zhuang Shilihe, a Guangzhou-based immunologist, also noted that if China sees a large number of Omicron infections, there's a possibility that deaths will occur in the most vulnerable groups of our society, not only COVID-19 cases, but also those with underlying diseases who would be denied medical access because of overwhelmed medical resources.

Xi'an, a metropolis with a population of 12 million, faced criticism when it failed to deal with patients while it was battling China's worst outbreak since Wuhan since end of last year. One of the cases involved a pregnant woman who lost her baby due to delayed treatment.

Chinese Vice Premier Sun Chunlan said on January 7 that she felt heartbroken as she saw loopholes in the current anti-epidemic work in Xi'an in the lack of timely treatment of some local patients.

"If something like this has happened in a big city with a relatively developed medical system, you can imagine what the situation will be in the rural areas in China," said Zhuang.

Cannot afford to lose

China is now battling flare-ups in many places, including its capital Beijing, with Spring Festival travel and the Winter Olympics rush less than two weeks away. The Chinese capital began mass testing on its residents on Sunday.

Many Western media seized the chance and again snarled at China's zero-COVID policy as "unsustainable."

The International Monetary Fund managing director Kristalina Georgieva said Friday that China's zero-COVID policy is increasingly looking like a "burden," which is impinging economic recovery both domestically and for the world.

Experts dismissed the impact of zero-COVID policy on the economy, saying that China's strategy helps its society get back to normal, return population mobility, and stimulate consumption at a minimum cost, so that they won't be caught in a long period.

China is one of the countries that emerged strongest during pandemic onslaught, registered an 8.1 percent growth last year.

Lashing out at Western countries' irresponsibility, Zeng said that as China still adheres to its dynamic zero-tolerance policy, the level of infections in China has always been low while the US and some European countries are engulfed in surging infections amid the Delta and Omicron rampage.

Liang Wannian, a former National Health Commission official and head of a panel of experts advising the government on its coronavirus strategy, also said on Saturday that China's existing measures had effectively minimized the spread of COVID-19 and contained outbreaks within one to two rounds of the longest incubation periods, thus still the "best choice available" as Omicron looks set to dominate.

Experts said that most infections in China are triggered by imported cases. It is only safe for the country to loosen COVID-19 policies when viral spread outside China abates, or a "deadly blow" measure against the virus, such as effective vaccines, come in handy. "It's a gamble we cannot afford to lose," said Zhuang.

Falling in line in a chilly morning in Beijing for two hours for the nucleic test, 65-year-old Beijing resident surnamed Huang told the Global Times on Monday that she said COVID-19 policies should be "the stricter, the better." "People at my age are hit hardest by the virus… I am not going anywhere unless Beijing is virus-free. Nobody wants to be contracted, because being healthy is more important than anything else."