H5N1

China says peak COVID-19 infections exceeded 7 million daily, deaths more than 4,000 daily

Via CNA: China says peak COVID-19 infections exceeded 7 million daily, deaths more than 4,000 daily.

HONG KONG: China's daily new COVID-19 infections hit a peak of more than 7 million per day around Dec 22, while deaths reached a daily peak of more than 4,000 on Jan. 4, the country's Centre for Disease Control and Prevention said on Wednesday (Jan 25).  

The figures, published on the centre's website, come after a prominent government scientist said over the weekend that 80 per cent of China's 1.4 billion population have already been infected, making the possibility of a big COVID-19 rebound over the next two or three months remote. 

"Around Dec 22, 2022, the number of infected people and the number of fever outpatient consultations reached a peak," it said, with the number of new infections "exceeding 7 million per day and the number of daily fever outpatient consultations peaking at 2.867 million".

China has passed the peak of COVID-19 patients in fever clinics, emergency rooms and with critical conditions, a National Health Commission official said last week.  

Nearly 60,000 people with COVID-19 had died in hospital as of Jan 12, roughly a month after China abruptly dismantled its strict zero-COVID policy, according to government data.  

But some experts said that figure probably vastly undercounts the full impact, as it excludes those who die at home and because many doctors have said they are discouraged from citing COVID as a cause of death.

North Korea locks down capital city over 'respiratory illness'

Via Reuters: North Korea locks down capital city over 'respiratory illness' - report.

SEOUL, Jan 25 (Reuters) - Authorities in the North Korean capital Pyongyang have ordered a five-day lockdown due to rising cases of an unspecified respiratory illness, Seoul-based NK News reported on Wednesday, citing a government notice.  

The notice did not mention COVID-19, but said that residents in the city are required to stay in their homes through the end of Sunday and must submit to temperature checks multiple times each day, according to NK News, which monitors North Korea. 

On Tuesday, the website reported that Pyongyang residents were appeared to be stocking up on goods in anticipation of stricter measures. It is unclear if other areas of the country have imposed new lockdowns. 

North Korea acknowledged its first COVID-19 outbreak last year, but by August had declared victory over the virus.  

The secretive country never confirmed how many people caught COVID, apparently because it lacks the means to conduct widespread testing.

Lauterbach warns of incurable immune deficiency caused by Corona

Via Early Bulletins News: Lauterbach warns of incurable immune deficiency caused by Corona. Excerpt:

Anyone infected with Corona is at increased risk of developing an incurable immune deficiency. According to Health Minister Lauterbach, this is shown by various studies that are currently being investigated further. As a result, the risk of chronic diseases such as dementia increases.  

According to Federal Health Minister Karl Lauterbach, one person’s multiple coronavirus infections can seriously affect the immune system. Lauterbach in the Düsseldorf newspaper Reinisch Post said: “It is alarming to see people with multiple Covid-19 infections. Those affected are coping with an immune deficiency that can no longer be cured. Research has shown very clearly that many people are. 

“This can be a risk factor for the development of chronic diseases, from cardiovascular problems to dementia,” the minister emphasized. “As I said, this is still not certain and is being intensively researched. I am discussing it with experts according to research. It shows that if you have a system, it’s preferable to avoid further Covid infections,” said Lauterbach.  

Speaking to the newspaper, the minister also announced major initiatives for people with long Covid. “For example, a hotline will be set up in my ministry in a timely manner, which is intended to act as a point of contact for people looking for information on Long Covid,” he said. said. He also wants to fund 100 million euros of so-called health care research in the future to improve the situation for those suffering from Long Covid.  

“We assume that an appropriate proportion of people who become ill after corona infection suffer from long-lasting Covid symptoms. In that case, it represents a major blow of fate, and if the number of sick people continues to rise, the labor market will deteriorate,” the minister explained.

China records almost 60,000 Covid-related deaths after abrupt shift in policy

Via the South China Morning Post: China records almost 60,000 Covid-related deaths after abrupt shift in policy. I wish I could believe it. Excerpt:

China said on Saturday it had recorded almost 60,000 Covid-related deaths between December 8 and January 12, and the current wave has already peaked.   

It is the first time China has released a death toll since its abrupt pivot away from the zero-Covid policy last month.  

Jiao Yahui, director of the National Health Commission’s medical affairs department, said medical institutes had recorded 5,503 deaths as a result of respiratory failure triggered by Covid infection and 54,435 deaths of people infected with Covid-19 but with underlying conditions, such as cancer or cardiovascular diseases.  

The average age of those who died was 80.3, and 90 per cent of fatalities were aged 65 or over.  

Jiao also said the current wave of cases had peaked. “The number of fever clinic visitors is generally on a downward trend after peaking, both in cities and rural areas,” she added.  

Jiao said the number of emergency patients was also declining and the ratio of patients who had tested positive for Covid-19 was steadily falling as well.  

Jiao said there had been 128,000 patients with severe Covid-19 on January 5, but the number had dropped to 105,000 by January 12.  

The use rate for intensive care hospital beds was 75.3 per cent, she added.  

Among the critically ill Covid-19 patients on January 12, there were 97,000 patients with severe underlying conditions, accounting for 92.8 per cent. The remainder, some 7,357 people, had Covid only.

‘It’s insane’: China’s doctors struggle to cope amid COVID surge

Via Sixth Tone: ‘It’s Insane’: China’s Doctors Struggle to Cope Amid COVID Surge. Excerpt:

Just weeks after China ended its “zero-COVID” policy, Dr. Xu Zuping and her outpatient department find themselves confronting an unprecedented crisis.  

The team in Shanghai is treating up to 600 patients a day — almost 20% more than the same period last year, Xu estimates. And they’re having to do so with four out of six doctors infected with COVID-19.  

“I’ve worked at this hospital for over 30 years, but I’ve never seen the emergency room as busy as it is now,” says Xu, who spoke with Sixth Tone using a pseudonym to protect her privacy. “Ambulances keep arriving with people in a critical condition. When I treat my patients, I constantly worry about whether there are enough seats in the infusion center.” 

Hospitals all over China are struggling to cope as a wave of COVID-19 infections rips through the population. Doctors describe shocking levels of overcrowding, shortages of key supplies, and medical teams weakened by mass infections.  

China abruptly dismantled its strict “zero-COVID” system in early December, and since then the virus has spread at breakneck speed. It’s unclear how many people have been infected, but local authorities estimate that case numbers in Shanghai alone have surpassed 10 million.

A surge in hospitalizations soon followed. According to China’s health commission, around 8% of COVID-19 patients in China developed pneumonia in 2022. Though this appears to be a relatively low ratio, it translates into a huge number of people with lung infections due to China’s vast population.   

By the end of December, Xu’s department was already receiving record numbers of patients. The team is based at one of two major hospitals in Chongming — an island on the northeastern tip of Shanghai, where the Yangtze River bleeds into the East China Sea.  

Most of the patients are in their 80s and 90s, and the vast majority have pneumonia, Xu says. The hospital’s emergency room has been completely overrun.  

“Given the crisis at the emergency room, we can no longer transfer patients for hospitalization,” she says. “The few remaining beds in the inpatient department are reserved for patients from the emergency room.”

The dire aftermath of China’s untenable “Zero COVID” policy

In The New Yorker, Druv Khullar writes: The Dire Aftermath of China’s Untenable “Zero COVID” Policy. Excerpt:

In “How to Lie with Statistics,” a best-selling book from 1954, the journalist (and tobacco apologist) Darrell Huff details common techniques for manipulating people’s understanding of reality, among them truncating the y-axis of a graph. A trend line starts in a chart’s midsection and moseys up and to the right—a gradual rise over time. But if you hack off empty space at the bottom and zoom in on the action, the line takes off like a rocket. The axis transforms the narrative.  

Throughout the pandemic, we have truncated not the y-axis but the x-axis: stopping time to pass judgment on a nation’s performance instead of waiting to consider the broad sweep of the covid-19 years. Cut the graph at the summer of 2020 and the United States is a catastrophic outlier, a beacon of pandemic mismanagement. Let it roll a few more months and European countries botch their reopening, unleashing a wave of deaths. Press play again and India is engulfed in a viral inferno that threatens not only its own citizens but, because it stopped exporting vaccines for half a year, millions of lives around the world.  

Last month, China, after suppressing the virus for three years through its often draconian “zero covid” policy—recording just five thousand covid deaths in a population of 1.4 billion—abruptly abandoned that approach and is now consumed by an enormous viral surge. The country that was home to the first coronavirus outbreak may now experience its worst. The axis transforms the narrative.  

In the past month in China, hospitals, pharmacies, and funeral homes have been overwhelmed, but the scale of the misery is anyone’s guess. The country no longer tallies asymptomatic infections or reliably reports covid deaths—employing not the distortion of statistics but their omission. According to minutes from a meeting of the National Health Commission, however, a quarter of a billion people are thought to have contracted the virus in the first three weeks of December; an estimated thirty-seven million were infected on a single day.  

Experts expect the initial surge to peak in the cities later this month, but a second, possibly more punishing wave could tear through rural areas in February or March, after millions of people trek home for the Lunar New Year. Projections of the eventual fallout vary, but some models anticipate that one to two million people will die of covid in the coming months.

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.