Explained: Why China ending zero-COVID rules may lead to over a million deaths

China may have eased some of the world’s most restrictive COVID-19 controls, but don’t expect Beijing to do away with them entirely.

That’s because ending the zero-COVID rules that have left millions confined to their homes and set off protests demanding the resignation of President Xi Jinping may result in a staggering number of deaths.

Let’s take a closer look:

Vaccination rates among elderly

Vaccination rates remains one of the main reasons the ruling Communist Party remains adamant over its zero-COVID strategy.

While nine in 10 Chinese have been vaccinated, those numbers don’t reveal the full picture.

A deeper dive shows only 66 per cent of people over 80 have gotten one shot, while 40 per cent have received a booster. Eighty-six per cent of people aged 60 and above are vaccinated. Those are terrible numbers and leaves wide swathes of the population vulnerable.

The government announced plans last week to vaccinate millions of people in their 70s and 80s, a condition for ending “zero- COVID restrictions that keep most visitors out of China and have disrupted manufacturing and global trade.

That spurred hopes for a quick end to zero COVID.” But health experts and economists warn it will be mid-2023 and possibly 2024 before vaccination rates are high enough and hospitals are prepared to handle a possible rash of infections.

China is not ready for a fast reopening yet, Morgan Stanley economists said in a report Monday. We expect lingering containment measures. … Restrictions could still tighten dynamically in lower-tier cities should hospitalizations surge.

That problem is compounded by China’s vaccine nationalism – its domestically-made vaccines based on an inactivated form of the virus simply aren’t as efficient as the messenger RNA vaccines developed by the West which order the body’s own cells to build a replica of a key coronavirus protein to trigger an immune response.

Even adopting the mRNA vaccines may not be enough at this point, Celine Gounder, a senior fellow at the Kaiser Family Foundation and an infectious-disease specialist, told the Washington Post.

Gounder said that’s a challenge because citizens simply don’t trust Beijing’s COVID-19 policies at the moment.

Eric Topol, director of the Scripps Research Translational Institute in La Jolla, California, told Japan Times, “Unless they get uptake of better vaccines and boosters quickly across the whole population, it looks like lockdowns will no longer hold and a huge surge is in store.”

“It looks like major trouble is brewing,” Topol added.

Lack of natural immunity

It can be argued that the XI government initially had no choice to fight COVID-19.

Given China’s patchy healthcare system, not implementing a zero-COVID strategy could have resulted in millions of deaths and the collapse of the Xi government itself.

While the Xi regime has touted its zero-COVID strategy as proof of the superiority of Beijing’s system compared to the West – China’s official toll stands at 5,235 against compared to 1.1 million in the US alone – a side-effect of the lockdowns mean that natural COVID-19 immunity among the populace remains low.

A study in the journal Nature Medicine estimated that around 1.55 million people could be left dead by a new wave of Omicron infections.

Zhou Jiatong, head of the Center for Disease Control in southwestern Guangxi region, said last month in a paper published by the Shanghai Journal of Preventive Medicine that mainland China faces more than two million deaths if it loosened COVID curbs in the same way Hong Kong did this year.

Infections could rise to more than 233 million, his forecast showed.

They forecasted that peak demand on intensive care would be more than 15 times capacity, causing roughly 1.5 million deaths, based on worldwide data gathered about the variant’s severity.

China could see 1.3 million to 2.1 million people die if it lifts its zero-COVID policy due to low vaccination and booster rates as well as a lack of hybrid immunity, British scientific information and analytics company Airfinity said on Monday.

The company said it modelled its data on Hong Kong’s BA.1 wave in February, which occurred after the city eased restrictions after two years.

Xi Chen, a health-policy professor at the Yale School of Public Health, told The Atlantic many protesting youths think far fewer people will die than these studies predict.

“I was circulating the number from that Nature paper to younger friends in my network earlier this year, [and> they don’t buy this idea.”

“The government should address these concerns, because without jobs, people cannot pay for food and medications,” Chen added. In the end, China will need to navigate reopening while attempting to mitigate loss, Ko told me. “This should have been done much earlier.”

“We have to admit that the policy was a success early on and saved lives, but it cannot be sustained, and they do not have a plan B,” said epidemiologist Ali Mokdad of the University of Washington’s Institute for Health Metrics and Evaluation told Washington Post. “The government did not plan for a move out of this policy, so they are stuck with it. If they open up, they will have lots of deaths and hospitalisations.”

“Literally, there’s only one way out,” added Lawrence Gostin, a global health law expert at Georgetown University. “That way out is highly effective vaccinations, with a wide uptake among elderly populations. Right now, [Xi> has neither.”

With inputs from agencies

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