As many as 1 million people could die from COVID-19 in China in the coming months, according to some preliminary forecasts since the government lifted many of its strict “zero COVID-19” measures.
“There’s no question that China is going to have a bad few months,” said James Wood, an infectious disease modeler at the University of New South Wales in Sydney, Australia.
However, two studies found that the death toll could be reduced by giving most people a fourth dose of the vaccine, while maintaining high levels of mask-wearing adherence and reimposing temporary restrictions on social interaction when the death rate spiked. Such measures could also reduce the burden on hospitals.
“It’s never too late to flatten the curve,” said Xi Chen, an economist at Yale University in New Haven, Connecticut, who studies China’s public health system.
Over the past month, the Chinese government has lifted many of the restrictions imposed to curb the spread of the virus. It ended mass lockdowns of entire cities, lifted restrictions on intra- and inter-regional travel, and allowed people infected with SARS-CoV-2 to quarantine at home rather than in centralized facilities. Testing is now voluntary, and last week the National Health Commission announced it would stop reporting the number of asymptomatic infections.
Reported cases have been falling since late November due to changes in testing requirements, according to official statistics, but there are signs that infections are rising in some areas. Beijing, for example, is facing a rapid increase in infections, according to Xinhua, China’s state-run media agency.
fourth dose
One of the studies published as Preprints that have not been peer-reviewed On December 14, use data from recent outbreaks in Hong Kong and Shanghai to compare different situations in China. Hospitals would be overwhelmed if the number of infections rose as rapidly as expected due to the recent easing of restrictions, the study found. Research predicts this could kill around 1 million people in the next few months.
But those estimates only include deaths directly attributable to COVID-19 and don’t take into account additional deaths caused by delays in treating patients with non-COVID-19 illnesses, said Ewan Cameron, a modeller at the Telethon Children’s Institute in Perth, Australia.
The study suggests that if 85% of the population received the fourth dose of the vaccine instead of the inactivated virus vaccine that most people in the country receive, it could slow the rise in infections and reduce the number of serious infections and deaths. Rolling out a fourth dose of the vaccine, along with giving antiviral drugs to people aged 60 and over and others at high risk of severe disease, could reduce deaths by as much as 35%.
“Achieving the highest possible vaccination coverage is very important for China on the eve of a major epidemic,” said James Trauer, an expert in infectious disease modeling at Monash University in Melbourne, Australia. Predictions of the impact of dissemination measures remain subject to many uncertainties.
On Dec. 13, the government announced that people 60 and older and other high-risk groups should receive a fourth dose of the vaccine, preferably one based on a different technology than the first dose. But among China’s more than 260 million people over the age of 60, only 70% of those aged 60 and over and 40% of those aged 80 and over have received the third dose.
Wood pointed out that it may be too late for China to benefit from the fourth dose of the vaccine, because many restrictions have now been lifted and transmission is already widespread. He also “does not believe that additional doses will have a significant impact on transmission” because circulating variants of the Omicron virus have shown a strong ability to evade the body’s immune response.
fewer deaths
Another model estimate China faces 500,000 COVID-19 deaths by April and 1.6 million deaths by the end of 2023 if the country continues on its current path. The model tracks and predicts the global burden of COVID-19 and is regularly developed and updated by the Institute for Health Metrics and Evaluation at the University of Washington in Seattle. Ali Mokdad, an epidemiologist at the institute, said the death toll in China could rise to nearly 9,000 a day by the end of March.
The model predicts that if China takes certain measures when the death rate exceeds a certain threshold, the total number of deaths could be reduced to about 290,000 between now and April. These include the reimposition of restrictions, high rates of third and fourth doses of the vaccine and high antiviral drug treatment for high-risk groups. Widespread use of masks could further reduce the death toll to around 230,000. Mokdad said that in China, where compliance with wearing face masks is high, the easing of restrictions has led to a change in the behavior of people choosing to restrict movement. “They won’t [let it] torn.
Cameron said the two studies were broadly consistent in terms of mortality estimates and the impact of the intervention. “This similarity largely reflects a consensus that herd immunity can only be achieved after the spread of large-scale and uncontrollable transmission across the country.”
This article is reproduced with permission, has been reprinted first published December 19, 2022.
