China has exited zero-Covid. What happens now?

China is opening up quickly after years of its “zero Covid” policy, with strict lockdowns, mandatory testing and major travel restrictions. But the major policy change could create further complications in China as people resume international travel, and geopolitically, as a patchwork of countries imposes restrictions on Chinese air travelers.

USA, UK, Italy, India, Israel, Spain, Canada, South Korea and France are all introducing some form of restrictions on air travel from China; that typically means that a passenger boarding in China and bound for one of these countries will not be able to board without a negative test, or, in the case of Spain, without being vaccinated. But infectious disease policy is difficult to make without accurate data on the number of cases, hospitalizations and deaths, which China has not collected and disseminated since rolling back from zero-Covid in late December.

It is much too early to say exactly what the effect of the policy change will be will have; while China appears to be experiencing a major wave of infections at the moment, that has not translated into major infections outside the country. But because Chinese air travelers haven’t gone through multiple waves of variants, they may be more vulnerable to infection.

Plus, there’s no great scientific evidence to back up travel restrictions; “We have seen time and time again with this pandemic that a patchwork of responses, both nationally and globally, does little to contain the disease,” said Saskia Popescu, an assistant professor in the biodefense program within the Schar School of Policy. and Government by George Mason. University, cafemadrid told me via email. “In addition, travel bans and testing requirements are not as effective because they ignore the porous nature of borders and the realities of disease transmission, and are reactive rather than preventive.”

China is rolling back Xi Jinping’s zero-Covid policy and cases are rising

Chinese President Xi Jinping restrictions reverted to its signature policy after widespread protests against strict lockdowns and mandatory testing began in November. Although Xi’s government had announced a 20-point plan to ease those restrictions earlier that month, the protests, some of which called for Xi to step down, appear to have accelerated the unraveling of Xi’s policies.

Draconian lockdowns, particularly in Shanghai, at FoxConn’s iPhone factory in Zhengzhou and in Urumqi, Xinjiang, have reportedly prevented people from accessing food, and many in Xinjiang believe the zero Covid measures are therepreventing people from leaving their apartments, aid workers prevented people trapped in their homes when a fire broke out in an apartment building in Urumqi.

In the following month, the set of policies Xi once said: “priority to the people and their lives above all elsehas rapidly crumbled, resulting in a significant rise in cases and a strained health care system.

“I think we should be concerned about what is happening in China – for the Chinese,” said Andrew Pollard, the chairman of the UK’s Joint Committee on Vaccination and Immunization. BBC News Hour on Saturday. “A lot of Covid is currently spreading within the country, the omicron variant is there, and it spreads extremely well between people. And they haven’t had Covid waves before… so we would expect a huge number of infections.”

Officially, China has included just over 5,000 dead of Covid-19 since the start of the pandemic, which Pollard admitted, is possible if that number only counts people who have died from the disease without any other underlying condition. But the numbers are likely much higher, he said, if those cases are included, and they’re likely to rise as the disease spreads, especially among the elderly who are less likely to get vaccinated.

Reports coming out of China already show that the hospital system is under strain due to the rise in Covid-19 cases, as well as crematoria and funeral homes tense under the death toll.

Shutting down zero-Covid was, as Victor Shih, an expert in Chinese politics at the UC San Diego School of Global Policy and Strategy told the New Yorkers Isaac Chotiner, probably a complex decision motivated by domestic economic and employment problems, as well as general discontent and protest. But Xi will face the fallout from his decisions — both the draconian lockdowns he has applied and proclaimed for three years, and the likely spate of Covid-19 infections and deaths that will follow China’s reopening. Those fallout, Shih said, are likely to lead to more protests like in November, and possibly more skepticism about China’s economic and governance models, both inside and outside China.

“Serious damage is being done to public trust,” said John Delury, a China expert at Yonsei University in Seoul, told the Financieele Dagblad. “We may not see the immediate effects of that. But what matters in the public analysis is how competent their government is. This is the worst possible start to Xi’s third term.”

The world is better equipped to deal with Covid-19, but there are still many unknowns

The end of covid-Zero also means the end of disease surveillance at the national level. Like Yang Zhang, professor of sociology and Chinese politics at American University tweeted in December about tracking China’s Covid-19 cases“I don’t think the Chinese state had the capacity to collect, model and assess provincial/municipal infection data on a daily basis [sic] during the past month. After the sudden opening, this is a daunting job (for any state). They just gave up.”

Without adequate information on vaccine efficacy, infections, hospitalizations and deaths, it is difficult to model how the disease might spread and make sensible policies around disease containment – ​​hence the patchwork of air travel restrictions now.

“We’re flying blind without more information, but that’s also a problem we’re facing in the U.S. as the CDC has changed community transmission thresholds, test centers are closed, and home tests go unreported,” Popescu said. “Ultimately, this should be a lesson that we can’t really handle an outbreak or pandemic if the data is incomplete somewhere.”

As in the beginning of the pandemic, countries are not in agreement on how they will handle possible new cases coming in through air travel; three years later, Popescu said, the countries that do impose restrictions aren’t necessarily choosing effective ones. “Even [in the beginning of the pandemic] a travel ban was not backed by science and, frankly, it turned out to be ineffective control.” The best travel restrictions that can be done with a disease of this magnitude is to give governments time to prepare for its spread.

Italywhich has a testing restriction on air travelers from China has encouraged other European Union countries to do the same; France and Spain have also introduced restrictions, but the EU in general has so far refused to do so. In a place like Europe, where overland travel between countries is quite painless, “testing passengers from one country is not effective in controlling disease (the horse is essentially out of the stable),” Popescu said. In addition, she said, “testing is reactive,” not proactive, she said — Italy was implementing its testing mandate after cases were discovered in flights arriving in Milan on 26 Dec.

A positive sign from Italy’s testing program is that no new variants appear to be coming out of China – meaning that, as far as researchers know, travelers from China infected with Covid do not pose a greater risk to the US, for example. population than a Covid-19 infected US citizen.

The risks may be greater for Chinese travelers, who may be introduced to an unknown variant during their travels or may not be vaccinated, even though about 91 percent of the population is fully vaccinated. according to the New York Times.

While the world is better equipped to contain Covid-19 than it was in 2020, the patchwork of restrictions in response to China’s reopening still shows major flaws in the world’s ability to tackle the pandemic in a unified, consistent manner said Popescu. Covid-19 will likely be endemic for years to come; incidents such as the reopening of China and the potential for new disease variants and waves “should be a reminder of the importance of global health, vaccine equity, and partnerships in proactive public health interventions.