Has the “zero Covid” strategy reached its limits in China? The country is facing a surge in contamination with another 3,393 new cases of Covid-19 recorded on Sunday March 13, according to official data, a record since the start of the pandemic in February 2020. Due to this epidemic peak across the country , the authorities have closed schools in Shanghai and confined several cities, while more than ten provinces are rushing to stem local outbreaks. In the northeast of the country, the city of Changchun, which has nine million inhabitants, has been confined since Friday. A partial lockdown was also imposed on Jilin City.
Despite a clear acknowledgment of the failure of the strategy adopted by the Chinese authorities in the face of the Omicron sub-variant, BA.2, Beijing does not seem to want to loosen the screws on health restrictions. However, according to Antoine Flahault, epidemiologist and director of the Geneva Institute of Health, Beijing will have no choice but to adapt it because “the unprecedented epidemic outbreak has made this strategy untenable”.
L’Express: What does the “zero Covid” strategy implemented in China actually consist of?
Professor Antoine Flahault: This is one of three strategies that can be implemented in the fight against a pandemic. Also called “elimination”, it does not tolerate the circulation of the virus at all. Adopted by China, New Zealand or even Australia concerning Covid-19, it can lead to the eradication of the virus, as happened with smallpox. Its main characteristic is the closing of borders and the tracing of any case of contamination, which makes it possible to trace all the chains of transmission.
Countries like Iceland, South Korea or Japan have adopted the strategy of “suppression”. Then there is the strategy we have chosen, that of “living with” which is called in English “mitigation”.
Is this strategy still effective today?
The “zero Covid” was particularly effective on the health level as well as on the economic and social level during the first phase of the epidemic. Thanks to the closure of the borders, all the cases identified came from outside the country. The outbreaks were quickly traced and controlled. This strategy resulted in few containments in China because the virus was not circulating, which also prevented many deaths, until the appearance of the Delta variant, then the Omicron variant.
With the appearance of the latter, and its cousin the BA.2, the Chinese authorities can no longer stem the phenomenon, as this sub-variant is more transmissible than the original strain, in addition to triggering a longer incubation period. short. The unprecedented epidemic outbreak has made the “zero Covid” strategy untenable, which is why Australia and New Zealand, which had made the same choice as China, have decided to stop it even if there is still a very low tolerance to the circulation of the virus.
And the confinements?
Containment is a way of reducing contact between people so a priori it is effective when it is applied strictly. But with variants and sub-variants that have very high transmissibility, it is very difficult to contain the epidemic despite this measure. In this case, disproportionate measures are needed in the face of a variant of the virus which, in the vast majority, does not trigger serious forms. This is the untenable aspect of the “zero Covid” strategy. We cannot afford to block people when hospitals are not saturated in a Western democracy. And the Chinese also might not understand such strong measures.
Are Chinese vaccines and their questionable effectiveness one of the reasons for this epidemic outbreak?
Despite a large proportion of people vaccinated in Hong Kong with the Sinopharm vaccine, the situation is untenable and mainland China fears the same scenario on its territory with overcrowded hospitals and many deaths. The effectiveness of Chinese vaccines has therefore been questioned but, while the inhabitants of South Korea are vaccinated with the same products as Westerners, the “zero Covid” strategy is in turn shattered in the country, which is facing a major wave of the BA.2 sub-variant, which circulates mainly in Asia.
This is because current vaccines, even with messenger RNA, are not effective in stemming the BA.1 and BA.2 wave. On the other hand, they protect against serious forms. And the Chinese have every reason to be a little scared because Chinese vaccines are less effective, even more so against BA.2.
Faced with this wave of contamination, can China change its strategy?
Beijing is very proud of this strategy showing the world that it has managed to have very few deaths compared to those recorded in Western countries. Nevertheless, everyone thinks that it will not be able to be maintained for very long. China will realize that it is not possible to maintain this policy and will surely coat the rhetoric so as not to lose face while choosing an appropriate form of “zero Covid” strategy.
I doubt they are going for the western strategy of “living with it” because, unlike New Zealand for example, the country does not have much to lose with the closing of the borders, the inhabitants have not shown their desire opening. On the other hand, they will certainly adopt a slightly more lax policy, such as that of “suppression”, already observed in Japan or South Korea, and which consists in taking drastic restrictions very early, without waiting for a saturation of hospital services. , unlike France or the United Kingdom, which took severe measures only as a last resort, very late.
Did the Olympics have an impact on the epidemic in China?
The Olympics had no impact on the introduction of the variant in the country, which was very careful in enclosing the athletes in a bubble. On the other hand, the large ports are still bustling with activity with a lot of exchanges and obvious risks of contamination, in addition to the fact that many people are asymptomatic. It is the air cargo and port crews who bring the virus.
Does this epidemic outbreak threaten the world?
I think the circulation of the BA.2 variant is a threat to Europe independently of China. But what could threaten the rest of the world, both health and economic, is a huge wave in China that would bring out new variants, as was the case in Brazil or India. Then if China, the workshop of the world, closes completely, there could be serious economic consequences.