The Decibel - Why the surge of COVID in China looks a lot like 2020

Episode Date: January 5, 2023

Since China abandoned its COVID-zero policies, the country has seen a dramatic outbreak of infections. But exactly how bad things are remains murky, as contradictory reports of cases and deaths emerge.But other countries are reacting nonetheless; Canada and others have put new travel restrictions on people arriving from China. There are fears that the rate of infection and the size of China’s population could make things dramatically worse. The Globe’s Asia Correspondent, James Griffiths, explains.Questions? Comments? Ideas? Email us at [e-mail]

We continue to ask China for more rapid, regular, reliable data on hospitalizations and deaths, as well as more comprehensive real-time viral sequencing. That was Dr. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization. He was asking China to share more information about its COVID-19 outbreak. This is because COVID cases in China are exploding after COVID zero policies were lifted in December. More and more countries have new restrictions on Chinese travelers and Canada's travel restrictions just kicked in today. If this all feels kind of familiar, it kind of is.

The Globe's Asia correspondent, James Griffiths, will give us a look at how things got so bad so quickly in China. I'm Maina Karaman-Welms, and this is The Decibel from The Globe and Mail. James, thank you so much for talking to me today. Great to be here. So I actually want to start off by reading back to you a short part of an article that you wrote about a month ago. Quote, the country's success, and we're talking about China, in staving off mass infection and death in the first years of the pandemic was long a major point of pride. Managing reopening will be as much a propaganda challenge as a medical one, end quote. So James, let's start with that medical challenge you talked about there. What are things like in Chinese cities right now? Bad, in a word. We don't know

exactly how bad because the numbers are very flawed, as we can discuss later. But we've got runs on medicine around the country, huge queues at pharmacies, fever clinics, we've seen backed up funeral parlours, and we've seen absolutely packed, overwhelmed hospitals, especially in rural parts of the country where the health system is not really up to scratch anyway. Almost everyone you know is sick or has been sick or, you know, is tested positive but is asymptomatic. You know, a lot of people, you know, will have relatives that are very sick or have died already. And, you know, people are, you know, experiencing things like there are lack of workers at restaurants or there are no delivery drivers or, you know, these things like if you need to go to hospital for a non-COVID reason, the hospital is full of people with the virus. I mean, really, the comparison is what much of the rest of the world had in these past two years, and especially in 2020. It really

looks like 2020 in lots of China at the moment. And what makes this all the more remarkable is that this is happening in a country that only a couple of months ago, a few weeks ago, had very little COVID and very strict controls. And now they have almost no controls and a lot of COVID. So we're talking drastic changes from just a few weeks ago, then. Yeah, it's honestly staggering. And it's been weeks now. And I still find it hard to comprehend what's happened. You know, this is a trend. This was happening. You know, this isn't something that they decided at the spur of the moment, though they may have decided to speed it up a lot towards the end of last year, you know, but there was a gradual easing off. We'd seen the spur of the moment, though they may have decided to speed it up a lot towards the end of last year, you know, but there was a gradual easing off. We'd seen the kind of propaganda messaging was starting to change around COVID. The toll the controls were having on the economy

were really starting to bite. And there was growing concern within the government about the, you know, the economic ramifications of zero COVID going forward. And so they were definitely going to, you know, ease this off in 2023. That was clear. We didn't expect it to happen in 2022. But then we had the protests in late November, spontaneous protests all over the country, showing the level of anger and frustration and just how much people were sick of zero COVID. And that may have sped things up, though I don't think we should overemphasize how much protests will have had an effect in China, because this is not a government that

responds well to protests or to public dissatisfaction. So, you know, they may have taken that not so much as a sign that they needed to do something, but as a sign that people would be amenable to the shift that they were already planning and sped that up. Let me ask you about current case numbers, James. What are the official COVID case numbers and deaths that are coming out of China? So the deaths as of this week are around 5,500 total for the entire pandemic, which is... That seems incredibly low. It does seem incredibly low. One model by Airfinity, which is a UK research firm and

does a lot of data crunching on COVID around the world, they estimate that by mid-January, we're looking at around half a million deaths more likely, and we're heading on for about 1.7 million deaths by the end of April. So this is thousands of deaths a day that we're looking at at the moment. And there is a lot of anecdotal data to suggest that that is happening. Surges of people using moratoriums and funeral homes, and also just people losing family members and talking about it. But it isn't being recorded by the government because at the start of this latest outbreak, as they reduced controls, they also changed how they categorize COVID fatalities. So as opposed to most countries where if you've

tested positive for COVID within a few weeks or even a month of dying, regardless of what you die from, that normally gets counted as a COVID fatality because COVID can be a comorbidity with a lot of other things. And it's ultimately the thing that's killed you even if you haven't died of respiratory failure, say. But in China, it's only if you die of respiratory failure and only after very recently testing positive on a nucleic acid test that you count as a COVID death. And that's just not a lot of people, especially if you're very sick by the time you get to hospital or you contracted it earlier and that led to organ failure and things like that. Yeah, so they've really narrowed the definition for what they're counting there in a way that

maybe doesn't represent the full picture. What about the number of cases that we're seeing in China, James? So while the government has changed how it officially categorizes deaths, it has also stopped at the central level counting cases. So it's left it to provincial health authorities to count cases in their areas of the country, which makes getting a total figure a lot harder. But again, this is something that feels and looks a lot like them trying to downplay the effects of this policy shift and downplay just how large this outbreak is. What are experts saying about how bad it might get?

So the high estimates we've seen for deaths is around 3 million. That hopefully won't happen. China is working very hard, admittedly, belatedly, and admittedly, after lifting controls, but they are working to try and get people vaccinated. The government's also invested in getting things like Paxlovid, which is the antiviral drug and things like that into hospitals, into treatment centers. They've converted some of the quarantine camps into treatment centers. They pumped some money into local communities. So hopefully that high estimate won't be hit. We're probably looking at over a million deaths, which is devastating. Again, this is a tragedy and it's awful to see this. But you know, again, we have to keep in context of 1.4 billion people, a million is is a relatively small percentage of that. And so that would be, you know, keeping this outbreak at a relatively

low level, even if it's still far more deaths than they would have had, had they waited to get vaccine coverage in place before they opened up. Yeah. What is the situation with vaccines there? Because we imagine, at least in Canada too, right, we have a significant degree of protection, at least from these vaccines. So what is the situation in China in terms of how vaccinated people are? So as of around mid-December, the overall vaccination rate for the country is in the high 90s. But when you factor in age groups, that drops off dramatically. So for the over 60s, the number of people who've had three jabs is something like 70%. For the over 80s, it drops even further. And you know, those are the

demographics that you're really concerned about. These are the people that really do need to be vaccinated, that in most other countries are the first to be vaccinated. But for some reason, in China, they've been among the last groups to be getting all their jabs. Yeah. And as you say, older people, of course, are more susceptible. And I think it's 40% of people over 80 are vaccinated. So not a huge number of people over 80 actually have that additional protection. No. And what's even more bizarre is that Beijing had had a very poignant object lesson in what would happen if you exposed an unvaccinated population to Omicron and to kind of the latest virus strains in Hong Kong, when in the middle of last year, Hong Kong's

virus protections essentially failed. And even though we had zero COVID here, the virus got in, it spread rapidly through the community. And we had similarly bad vaccination rates, especially among the elderly, and had horrific death rates among the worst death rates in the world per capita. And it just emphasises how strange it is that the government both didn't respond to the Hong Kong outbreak and the Hong Kong deaths with another push for vaccination on the mainland, but then even more so didn't push for vaccination before reopening. I guess let's just continue on with this thread, because a big part of this concern, too, is when the virus spreads so rapidly like it is in China, there's a lot of people there that are getting sick. This is the possibility that new variants

of concern can emerge. And right now, it seems like a subvariant of Omicron is spreading in China. But how concerned are officials that a new variant could emerge from all of this spread? Yeah, that's the biggest concern from a global perspective. Even if Omicron stays as it is and burns through China, that is a devastating thing from a Chinese perspective and from a human perspective, just on the toll it's going to take on people and the amount of deaths it's going to lead to. You know, what's scary about this is that you have a very large population that has not been exposed to COVID before. So again, we're going back to kind of 2020 when we did see the virus mutating more rapidly because it was being exposed to new populations. It goes into people,

it changes as it spreads. And we've got millions of people in China who have never been exposed. They really did control the outbreaks very, very well from 2020 and 2021 and well, for most of 2022. So all these people that have never been exposed before, they're now catching Omicron. Does it mutate? Does that mutation? We don't know. It could anything. It could make it milder. That would be great. It could make it more severe. It could make it more deadly. That's the major concern. We'll be back after this message. Okay, so we've talked about the medical side of things here. The other issue you identified with

China reopening was the propaganda challenge. So how have people within China reacted to this current outbreak? So people are kind of shell-shocked just at how fast things have happened. No one expected this to go this fast, both inside China or outside of China. Even when the shift started or when it was announced, it was so rapid. There was really no reason for this to be done so quickly, and especially at the worst time of year to do it from a medical perspective. This is winter when cases are already on the rise because of various factors, and right ahead of the Lunar New Year, the biggest travel period in the Chinese calendar. It was clear that if you lifted restrictions before

that, that you would have the virus spread all over the country as millions of people went on the move. So no one really expected this to happen until definitely after the holiday. Most people, especially when this was first announced, and especially when they talked about reopening borders, things like that, people were happy and they were glad to see the back of zero COVID. This was something that it was started to feel incredibly draconian, was seen to be stretching out forever. That's what sparked the protests in November was the frustration with the controls and the sense that they might never go away. But at the same time, they are concerned at the level and the scale of the outbreak. And then there's also frustration at this kind of, you know, gaslighting by the government, which is insisting that it, you know,

hasn't relaxed controls that actually, you know, it's it's easy now in a kind of scientific and gradual way and that China is blazing a new path of how to control the virus, whereas really, they're responding, just as a lot of other countries did earlier in the pandemic. Let's talk about some of the geopolitical aspects here, though, because, of course, countries now, including Canada, the US, the UK, Japan and others are bringing in new travel restrictions on people arriving from China. There has been criticism that these measures won't actually stop the virus from spreading much. But might these measures have a political effect on Chinese leadership, on President Xi Jinping? I don't know if the travel restrictions will necessarily have a political effect. I think certainly the confidence in Xi Jinping as an

administrator and as absolute leader of China has definitely waned somewhat. It's also not great for China to be being told by a lot of the rest of the world that people are now concerned again. It's again, you know, that kind of return to 2020 vibes. Beijing has acted, has reacted quite angrily to these travel restrictions. Even as places have said, look, if you don't want us to impose these, then be more transparent and tell us what's happening. When you say China's reacted angrily, what do you mean? So we had the foreign ministry spokeswoman this week said that Beijing opposed the practice of using the pandemic and manipulating prevention measures to achieve political goals. And Chinese media has been highlighting that a lot of the countries imposing these restrictions are rivals

and critics of China. So places like Japan, the United States, Canada, whereas countries that are more economically dependent on China, and especially economically dependent on Chinese tourists have not been putting these restrictions in place. So, you know, there is potentially geopolitics at play, or at least there's definitely the appearance of geopolitics at play in this. And one thing that we kind of alluded to, James, that seemed to have an effect on Xi Jinping's decision to open up is the economy. And earlier, you talked about the projections of a huge number of people getting sick from the COVID outbreak. So how might all of this impact China's economy, and by extension, the global economy? So I think it's important before we start

talking about this to acknowledge the fact that zero COVID controls were already having an effect on the economy. So, you know, this is not like they went from a really rosy picture to a bad one. It's they've kind of swapped two bad ones and there were different reasons for why these are happening. But certainly towards the end of last year and as we start 2023, the economy is not looking in great shape. Manufacturing service sector activity is some of their lowest levels since 2020. We've got labor shortages all over the country, various cities, including Shanghai, parts of Beijing. They've been kind of calling out to people that if you're out of work or you only work part-time, can you come and pick up some shifts as the delivery driver because we don't have any. And so, you know, that's really bad. You know Potentially one benefit of this happening before the Lunar New Year travel period and before the holiday is that we were headed for an economic pause anyway, as most of the country was on vacation.

And so if all those people hurry up and get sick during their official vacation days, they can then come back to work in early February and get things going again. And certainly we're expecting there were already stimulus measures happening last year. I'm sure there will be a huge amount of stimulus going forwards into 2023 to really kickstart the economy again. But yeah, it's not going to be a strong last quarter for 2022. And it's definitely not going to be a strong first quarter for this year. And China is obviously a huge manufacturing hub. I remember those supply chain issues that we were experiencing, especially in the last couple of years. Is there the risk that we might be facing those shortages again? Yeah, I think we'll definitely get some knock-on effects. People saw towards the end of last year, there was problems with Apple's supply chain because of

the amount of manufacturing that it does in China. There will definitely be some knock-on effects from that. Again, Lunar New Year is the kind of unknown factor in this because some of this slowdown will have been factored in already into supply chains because the factory shut for a while or they definitely are much lower staffing. But I think we will definitely see economic knock on effects from China for the rest of the world. And just before I let you go here, James, what are you watching, both in terms of signs of trouble there, or signs that maybe China will pull out of this relatively unscathed? So on January 8, the international borders to China, which have been closed since 2020,

will be reopening. Millions of Chinese people will start to travel around the world again. That'll be great for lots of places that have really been suffering the lack of Chinese tourists. Millions of people will also be traveling within China because January 8th is also the start of the Lunar New Year travel period. I think we'll be looking to see kind of how normal that looks. Are things getting back to kind of 2019? Or are people going home and being sick and overwhelming rural hospitals or small hospitals in smaller cities? Or are people not traveling because they're sick and they're stuck in their apartment in Beijing or Shanghai? So you know, I think this Lunar New Year that's coming up will be a real key test for just how China is going to deal with this current outbreak.

James, thank you so much for taking the time to talk to me today. Thank you. That's it for today. I'm Mainika Raman-Wilms. Our producers are Madeleine White, Cheryl Sland, and Rachel Levy-McLaughlin. David Crosby edits the show. Kasia Mihailovic is our senior producer, and Angela Pichenza is our executive editor. Thanks so much for listening, and I'll talk to you tomorrow.