H5N1

WHO says China releases COVID hospital data after reporting gap

Via Reuters: WHO Says China Releases COVID Hospital Data After Reporting Gap. China's National Health Commission, however, hasn't updated its COVID-10 reports since December 24. Excerpt:

GENEVA (Reuters) -The World Health Organization received data from China on new COVID-19 hospitalisations after a reporting gap, with figures on Thursday showing a nearly 50% increase in the week to Jan. 1.  

The U.N. health agency received no data from China in the weeks after Beijing lifted its zero-COVID policy in early December, prompting some health experts to question whether it might be hiding information on the extent of its outbreak. 

The WHO's latest report showed 22,416 new hospitalisations for mainland China in the week to Jan. 1 versus 15,161 the previous week. This was still below the all-time peak of nearly 29,000 admissions in early December.  

Over the same week, the report showed China had 218,019 new cases and 648 new deaths, although these figures typically include Hong Kong, Taiwan and Macau as well as mainland China. During the same period, the Chinese Center for Disease Control and Prevention reported nine deaths.  

The WHO did not release a report last week due to end of year holidays.  

On Wednesday, WHO officials gave their clearest criticism yet of China's recent handling of the pandemic, saying COVID-19 data is not giving an accurate picture of the situation and under-represents the number of hospitalisations and deaths.

China is flying blind as pandemic rages

Via Science: China is flying blind as pandemic rages. Excerpt:

Most scientists believe China’s decision to end its zero-COVID policy was long overdue. But now they have a new worry: that the country is collecting and sharing far too little data about the rough transition to a new coexistence with the virus.  

China abruptly dropped virtually all controls a month ago, after protests, a sagging economy, and the extreme transmissibility of the virus’ latest variants made clinging to zero COVID untenable. Now, “SARS-CoV-2 has an open goal in front of it: a population with very low levels of standing immunity,” says evolutionary biologist Edward Holmes of the University of Sydney. But how the epidemic is unfolding is a mystery because the country has practically stopped collecting basic epidemiological data.  

Models that predicted a massive wave of infection and death if China ended zero COVID appear to have been correct. Press reports and social media posts have shown intensive care units stretched beyond capacity, with crowds of patients in wheelchairs and on gurneys in hallways. Doctors and nurses are reportedly working while sick. Crematoriums are overwhelmed. 

But China’s official COVID-19 death toll is widely considered laughably low. And some scientists worry a genomic monitoring plan unveiled last month doesn’t have the power to detect new SARS-CoV-2 variants arising as the virus works its way through one-fifth of the world population.

Earlier in the pandemic China’s daily counts of COVID-19 cases and deaths, based partly on its exhaustive testing programs, were generally believed to be accurate. Now, they are anyone’s guess. Patients with mild symptoms are not encouraged to get tested, let alone those who are asymptomatic. People testing positive at home are not asked to report their results.  

The China Center for Disease Control and Prevention (China CDC) put the number of confirmed cases the last week of December 2022 at more than 35,000—a fraction of the official number in the United States. But leaked notes from an internal meeting suggest a very different reality: The agency was told that almost 250 million people in China—roughly 18% of the population—may have caught COVID-19 in the first 20 days of December. Some experts said the number is implausibly large, but Yanzhong Huang, a global health specialist at the Council on Foreign Relations, a U.S. think tank, says it’s “not unreasonable,” given credible reports that 80% of Beijing residents have been infected by now.  

As to the death toll, China’s reporting had long been inconsistent, Huang says, with some regions reporting all fatalities in which SARS-CoV-2 was a factor, as most countries do, and others excluding people who died from other conditions, such as heart attacks, even if they had COVID-19. In early December, China’s government decided the narrower definition should be used nationwide.  

Even then, the official count is astonishingly low: just eight deaths for the entire last week of December, which is “not matching media reports and what is being seen on social media,” says Louise Blair, who tracks China’s COVID-19 outbreak for Airfinity, a London-based health analytics firm that estimates about 9000 people were dying of COVID-19–related causes every day in late December.  

Also missing are data on case fatality rates, the average number of new infections stemming from each case, and hospital and intensive care admissions. “These are critical data” that would help health authorities get a handle on the surge and further the world’s understanding of the pandemic, says Xi Chen, a public health scientist at the Yale School of Public Health.

Up to 70% of Shanghai population infected with COVID-19: Top doctor

Via Channel NewsAsia: Up to 70% of Shanghai population infected with COVID-19: Top doctor. That means about 17.5 million people in Shanghai alone have COVID-19.

SHANGHAI: A senior doctor at one of Shanghai's top hospitals has said 70 per cent of the megacity's population may have been infected with COVID-19 during China's huge surge in cases, state media reported Tuesday (Jan 3).  

The steep rise in infections came after years of hardline restrictions were abruptly loosened last month with little warning or preparation, and quickly overwhelmed hospitals and crematoriums.  

Chen Erzhen, vice president at Ruijin Hospital and a member of Shanghai's COVID-19 expert advisory panel, estimated that the majority of the city's 25 million people may have been infected.  

"Now the spread of the epidemic in Shanghai is very wide, and it may have reached 70 per cent of the population, which is 20 to 30 times more than (in April and May)," he told Dajiangdong Studio, owned by the Communist Party mouthpiece People's Daily.  

Shanghai suffered a gruelling two-month lockdown from April, during which over 600,000 residents were infected and many were hauled to mass quarantine centres.  

But now, the Omicron variant is spreading rampantly across the city and experts predict infections there will peak in early 2023. In other major cities, including Beijing, Tianjin, Chongqing and Guangzhou, Chinese health officials have suggested that the wave has already peaked.  

In neighbouring Zhejiang province, disease control authorities said Tuesday that there had been one million new infections in recent days and that the province was entering a peak plateau for COVID-19.  

Chen added that his Shanghai hospital was seeing 1,600 emergency admissions daily - double the number prior to restrictions being lifted - with 80 per cent of them COVID-19 patients.  

"More than 100 ambulances arrive at the hospital every day," he was quoted as saying, adding that around half of emergency admissions were vulnerable people aged over 65.  

At Tongren Hospital in downtown Shanghai, AFP reporters saw patients receiving emergency medical attention outside the entrance of the overcrowded facility on Tuesday.  

The corridors overflowed with dozens of elderly patients lying on beds crammed together, hooked up to IV drips. Some patients wore oxygen masks attached to bedside canisters.

Impact of surge in China COVID-19 cases on epidemiological situation in EU/EEA

A news report from ECDC: Impact of surge in China COVID-19 cases on epidemiological situation in EU/EEA.

The number of COVID-19 cases has reached a record high in mainland China, peaking on 2 December 2022. In the past three weeks, incidence has fallen, likely also due to a lower number of tests being carried out, resulting in fewer infections being detected.  

ECDC, together with the EU/EEA Member States and the European Commission has increased its monitoring activities and will revise risk assessments and adjust actions if needed. ECDC is working closely with the World Health Organization (WHO)/Europe and WHO/Headquarters and is in regular contact with the Chinese Center for Disease Control and Prevention (China CDC) and major CDCs globally.  

ECDC continues to routinely monitor and report on emerging SARS-CoV-2 variant threats via its Strategic Analysis of Variants in Europe (SAVE) Working Group, where variants and epidemiological trends in countries neighbouring China as well as in the EU/EEA will continue to be evaluated.  

The number of COVID-19 cases has reached a record high in mainland China, peaking on 2 December 2022. In the past three weeks, incidence has fallen, likely also due to a lower number of tests being carried out, resulting in fewer infections being detected. There continues to be a lack of reliable data on COVID-19 cases, hospital admissions, deaths as well as Intensive Care Unit (ICU) capacity and occupancy in China.  

High levels of SARS-CoV-2 infections and increased pressure on healthcare services in China are expected in the coming weeks due to low population immunity and the relaxation of non-pharmaceutical interventions.  

China has started depositing SARS-CoV-2 sequences in GISAID EpiCoV[1] in higher numbers. From 1 to 30 December 2022, China has deposited 592 sequences, out of which 540 sequences were being deposited this week (from 25 December to 30 December 2022). As of 30 December 2022, of the total 592 sequences submitted from China, 437 had recent sample collection dates between 1 and 24 December 2022 in GISAID EpiCoV.  

These sequences mainly belonged to the lineages (including their sub-lineages) BA.5.2 (35%), BF.7 (24%), BQ.1 (18%), BA.2.75 (5%), XBB (4%), BA.2 (2%). In addition, from travel related cases, the variants BA.5.6, BA.4.6, BM.4.1.1 and BA.2.3.20 have also been detected to be circulating in China. No new variant has been detected.  

The variants circulating in China are already circulating in the EU, and as such are not challenging for the immune response of EU/EEA citizens. In addition, EU/EEA citizens have relatively high immunisation and vaccination levels.  

Given higher population immunity in the EU/EEA, as well as the prior emergence and subsequent replacement of variants currently circulating in China by other Omicron sub-lineages in the EU/EEA, a surge in cases in China is not expected to impact the COVID-19 epidemiological situation in the EU/EEA. This is based on the information available as of this week, and the ECDC assessment, as detailed in Communicable Diseases Threat Report of week 51, remains currently unchanged.

China’s President Xi battles to save face as Covid U-turn weakens his grip on power

Via The Guardian: China’s President Xi battles to save face as Covid U-turn weakens his grip on power. Excerpt and then a comment:

China’s leader Xi Jinping told his country it stands on “the right side of history” in a new year address on Saturday, but experts have warned that the president starts 2023 diminished by his chaotic U-turn on Covid strategy.  

He may struggle to deflect blame for the human and economic costs of zero-Covid’s failure, and control the national narrative, even if public signs of dissent are crushed.  

Officially, China has registered just over 5,200 deaths from Covid, but there is a yawning gap between the picture presented by the usually efficient communist propaganda apparatus and the reality reflected in social media posts and anecdotes from across China.  

Hospital emergency wards are overflowing with desperate patients. Medical supplies are running low, with pharmacies selling out of drugs ranging from anti-viral to basic painkillers. Police patrolled one Beijing crematorium where Reuters reported long queues of hearses last week.  

In his first public comments to the Chinese people on Covid since his government changed course three weeks ago, Xi used his speech on Saturday to claim the government and Chinese Communist party (CCP) had “put the people first and put life first all along”.  

For many in China, that phrase will ring hollow, particularly those fighting for medical care for loved ones newly struck down by the disease.  

Questions about why the country clung so long to zero-Covid, at such heavy cost, and did so little to prepare for opening up are likely to undermine Xi, even if the damage to his authority isn’t visible beyond the walls of the secretive leadership compounds.  

“The fact that the CCP’s posture towards the pandemic has now completely reversed after a popular uprising can only mar Xi Jinping’s carefully cultivated air of infallibility,” said Orville Schell, director of the centre on US-China relations at the Asia Society in New York.  

“Xi is virtually immune from public expressions of criticism within China,” he added. “But my Chinese friends are all shaking their heads in incredulity at the contrariness of Xi’s policies.”

Foreign analysts, scouring the internet and official pronouncements for clues, estimate there are already thousands of deaths a day, with more to come.  

A first wave in urban areas is expected to peak in January, but a second, bigger wave will race through rural areas – where health systems are even weaker – in February and peak in early March, according to British health analytics firm Airfinity.

In a recent Tyee article, I argued that COVID-19 is only one of China's looming problems; economic uncertainty and climate disasters, especially water security, are making matters even worse.