• China is the last holdout for a zero-tolerance strategy, even as other nations brace for a ‘viral blizzard’ caused by Omicron
  • With Covid-19 set to become endemic, and vaccines yet to provide total protection, a long-term strategy is the need of the hour, say analysts

4 Jan 2022

Josephine Ma

China’s no-holds-barred approach should be able to keep the highly transmissible Omicron variant from exploding within its borders, but the country will still need a long-term strategy as Covid-19 looks set to become endemic, analysts have warned.

This comes as China battles the spread of the disease in Xian, the capital of northwestern Shaanxi province, with nearly 1,700 people sickened in two weeks in the country’s worst coronavirus outbreak since the start of the pandemic two years ago.

New symptomatic cases in Xian dropped below 100 on Sunday for the first time since December 24, but the price paid has been huge, with the city of 13 million locked down for almost two weeks, causing a public outcry over food and other shortages.

Senior officials in Xian dismissed from posts as city turns corner on Covid-19 outbreak

China is the world’s last holdout for the zero-tolerance approach to Covid-19, as most countries brace for a viral blizzard caused by the heavily mutated Omicron variant, and many of the rich nations bank on vaccinations and booster campaigns to reduce hospitalisation.

The United States had 2 million new cases in the past week, outpacing the previous record of 1.7 million cases from January 3-9 last year, USA Today reported. Omicron accounted for about 59 per cent of all new US cases in the week to December 25, according to the US Centres for Disease Control and Prevention.

Despite the surge in cases, countries like the US, United Kingdom, Spain, Ireland and Greece have shortened isolation periods for infected people so as to minimise the social and economic impact.

They are banking on the high vaccination rates and the milder symptoms caused by Omicron, though leading health specialists like Anthony Fauci, the top US infectious disease expert, have warned that hospitals might still be overwhelmed by the rocketing number of cases.

Although 85 per cent of the Chinese population have received at least two doses of vaccine, it has emerged that inactivated vaccines – most widely used in China – can hardly defend the population against the new variant, as laboratory tests revealed little to no neutralising activity.

Some initial studies in China have shown that the neutralising activities of Chinese inactivated vaccines were improved by a third shot.

But Huang Yanzhong, director of the Centre for Global Health Studies at Seton Hall University in New Jersey, said that even with the third shot, the neutralising antibody levels were still lower than those produced by mRNA vaccines.

 Volunteers deliver daily necessities in a neighbourhood in Xian. Photo: Xinhua
Volunteers deliver daily necessities in a neighbourhood in Xian. Photo: Xinhua

However, Huang said China still looked confident with its own Covid-19 playbook and any short-term public outcry would not sway existing policy.

“You basically have to implement a strategy to the extreme, relying on lockdown measures and experiencing multiple rounds of testing to figure out all the cases and isolate them,” he said.

The government would then declare victory when it had finally stubbed out the outbreak and shape the narrative to praise the heroic acts of the health care staff and the authorities, Huang said.

“Like what we have seen before, all those complaints, [and] dissatisfactions will evaporate.”

China has reported only a handful of Omicron cases so far, most of them imported. Tianjin reported the first imported case last month, followed by another in Guangzhou, and two more in Changsha, in central Hunan province.

A look back at lockdowns, vaccines and variants defining the Covid-19 pandemic in 2021

Despite the high transmissibility of Omicron, China’s stringent approach should be able to stop it from spreading in the country, David Heymann, a professor of infectious disease epidemiology at the London School of Hygiene & Tropical Medicine, said.

However, while that meets the short-term goal, he said the country would need a long-term strategy.

“In the short term, China has shown that they can do that [practise zero-tolerance] by mobilising many, many different forces to help them do the contact tracing and other activities. And they’ve done a good job in keeping the virus out and keeping their populations virus-free.”

“In the long term, I don’t know what the Chinese strategy is. And I would hope that they have a strategy as to what they plan to do as this virus [becomes] endemic.”

Huang at Seton Hall said the government had to calculate the long-term and short-term costs for maintaining its zero-case approach.

“We don’t know if the pandemic will last two or three more years and this is going to also make China isolated on the international stage,” he said.

In the short term, China will have to make sure there are no unpleasant surprises when it hosts the Winter Olympics next month, and the upcoming national congress has also been factored in as the country holds fast to its current Covid-19 strategy.

China could just be buying time in hopes of effective therapeutics and vaccines eventually being developed, Huang said.