Virus and fear surge in China: what’s happening and why?

China has nearly 1.4 billion people, most of whom are susceptible to infection. The rapid spread of Covid-19 could mean very large numbers of people falling sick at the same time.

A surge of Covid-19 infections in China in the past few weeks has prompted warnings that the country could witness over a million deaths in the coming months, even though official figures presented a very different picture.

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China reported five deaths for Monday and two for Sunday, according to a Reuters report, taking its total death count to 5,242. Just about 2,700 new cases were reported on Monday, substantially lower than the nearly 40,000 cases that were being reported a couple of weeks ago. However, several media reports suggested that the situation was far more serious.

China Covid-19 surge: What’s happening?

China has been seeing a surge in cases ever since it relaxed the suffocating restrictions last month following rare public protests. Infections have been spreading rapidly after that — the daily case count touched new records in the first two weeks of this month. While the official daily numbers have since come down, there have been reports of hospitals being overwhelmed, of shortages of flu medicines, and of schools moving back online.

China had been following a zero-Covid policy for the last three years, which involved extremely restrictive measures to deal with any surge in cases. Every known case, even asymptomatic, was mandatorily hospitalised, small outbreaks triggered hard lockdowns, and suspected cases, and all their contacts, were kept under long isolation. Foreign travellers had to mandatorily go through 10 days of isolation.

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The measures were painful but effective in keeping a check on the spread of the virus for three years. However, it also meant that a large proportion of the population was never infected by the virus, and had no natural immunity, thereby rendering it extremely susceptible. So, once the virus was able to break through the defences, as it sometimes did, it spread rapidly in the population. That is what happened in March-April this year when China saw an explosion of cases for the first time.

Fast-transmitting variant

The dominant virus strain in China is BF.7, a sub-variant of Omicron that has been in circulation for over a year now. There are over 500 Omicron sub-variants currently in circulation.

BF.7 is the name for the BA.5.2.1.7, which itself has evolved from the BA.5 sub-variant. BF.7 is not unique to China. It accounted for over 5 per cent of the cases in the US in October and over 7 per cent of the cases in the UK.

But the surge in China has nothing to do with the type of variant circulating there, according to virologist Dr Ekta Gupta.

“There is no scientific evidence to suggest that there is one particular variant that is driving the surge in China. Neither is there evidence to suggest that any new variant is the cause. If you look at the Gisaid data (a global database of Sars-CoV-2 genomes), nothing vastly different has been uploaded from the country,” virologist Dr Gupta said.

She said it was the large susceptible population that was the key driver of the surge.

“From what I can understand, the strict lockdowns in China meant that a huge proportion of the population did not get the infection. We have seen that a natural infection provides a wider and longer immunity against Covid-19. In India now we are seeing people out and about, even without masks, but we are not reporting a high number of cases because people have a hybrid immunity from natural infection as well as high levels of vaccination,” Dr Gupta said.

Concern for the world

While the surge has remained confined to China, there are fears that it might spread to other countries as well since international travel is back almost to pre-Covid levels now. An even bigger concern, considering that large numbers of infections are taking place in China, is the possibility of the virus evolving into more dangerous variants, as reported by The IndianExpress

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