With record covid cases, China scrambles to plug an immunity gap

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A coronavirus outbreak on the brink of becoming China’s largest pandemic has exposed a key flaw in Beijing’s “Zero Covid” strategy: a vast population without natural immunity. After months with only occasional hot spots in the country, most of its 1.4 billion people never contracted the virus.

Chinese authorities, which reported a record 31,656 infections on Thursday, are scrambling to protect the most vulnerable population. They have launched a more aggressive vaccination campaign to boost immunity, expanded hospital capacity and begun restricting the movement of at-risk groups. The elderly, who have particularly low vaccination rates, are a prime target.

The efforts, which miss out on foreign vaccine approval, are an effort to prevent the virus from overwhelming a health care system unprepared for the flood of very sick Covid patients.

More intensive care beds and better vaccination coverage “should have started 2½ years ago, but the one-sided focus on containment means there are fewer resources to focus on,” said Yanzhong, senior global health fellow at the Council on Foreign Relations. Huang said.

Huang believes that even mRNA boosters, which have proven more effective in fighting the disease than newer omicron variants, will no longer address the fundamental problem with China’s goal of eradicating infections rather than reducing symptoms. . Extending immunity by allowing a degree of community transmission is “still not acceptable in China,” he said.

China’s containment strategy actually protected daily life and the economy while preventing severe illness and death. But this is becoming increasingly expensive as the most stringent measures fail to keep up with highly transmitted variants.

Earlier this month, the government announced the most significant easing yet on paper, shorter quarantine times and Low testing requirements. Officials insist the 20-point “reform” plan is not a prelude to accepting the outbreak.

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But efforts to break the cycles of disruptive lockdowns have had a rocky start. Some cities relaxed measures, while other districts ordered residents to stay indoors. The result: confusion, fear and anger.

Clashes have erupted in some places, most prominently at a huge Foxconn plant in central China that makes half the world’s iPhones. The scene turned violent there this week as thousands of workers protested the company’s failure to isolate people who tested positive and honor the terms of employment contracts.

Controlling the outbreak is again a top priority. Shijiazhuang, a city of 11 million about 185 miles from the capital, suspended its minimum testing requirements for mass testing on Monday and announced five days of citywide screening.

The first deaths reported since May – albeit only one or two per day – have fueled concerns that hospitals are ill-equipped to handle the surge in serious cases. Bloomberg Intelligence estimates that a completely relaxed coronavirus control could put 5.8 million Chinese in need of intensive care in a system with only four beds per 100,000 people.

At a news conference on Wednesday, Chinese health officials said more than 100 critical cases meant more hospital beds and treatment facilities were “absolutely necessary” for the elderly and those with pre-existing conditions. There are health risks. He added that the spread of infection is accelerating in several places, with some provinces facing the worst outbreak in three years.

Major cities including Beijing, Guangzhou and Chongqing have ordered residents in certain neighborhoods to stay at home. Shopping malls, museums and schools have been closed once again. Large conference centers are being turned into temporary quarantine centers, mirroring the approach taken in Wuhan at the start of the pandemic. Some of the strictest restrictions are for nursing homes, with 571 such facilities in Beijing implementing the strictest control measures and barring all essential exits and entries.

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Officials fear that an outbreak in a world now mostly living with the virus will cause a wave of deaths. China’s vaccines were initially limited to adults between the ages of 19 and 60, a policy that still affects vaccination rates today. Only 40 percent of Chinese over 80 have received a booster shot, despite months of campaigning and giveaways to encourage motivation. (Among people over age 60, two-thirds have received a booster.)

Since the start of the pandemic, China has relied entirely on domestic vaccine manufacturers. It approved nine locally produced options, more than any other country, with the oldest and most widely used vaccines coming from state-owned Sino-Pharm and privately-owned Sinovac. Both received approval from the World Health Organization early last year after it was found to have significantly reduced the number of deaths and hospital admissions.

Sinopharm and Sinovac distributed their products widely around the world as part of a Chinese push to become a leading supplier of global public goods and improve China’s image. Yet in late 2021, Chinese vaccine demand began to decline as Pfizer’s and Moderna ramped up production and distribution.

China has yet to approve any foreign vaccine or explain its decision to avoid what could be an effective way to close its immunity gap. German Chancellor Olaf Schulz’s visit to Beijing in early November ended with a deal to make the Pfizer-BioNTech vaccine company’s Chinese partner Shanghai Fusun Pharmaceuticals available to foreigners based in China.

BioNTech has a development and distribution agreement with Fosun that gives the Chinese company exclusive rights to supply the country. But Chinese regulators have repeatedly delayed signing off on the vaccine, despite it being available in Hong Kong, Macau and Taiwan.

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When asked last week whether the government would approve BioNTech for public use, the director of the Chinese Center for Disease Prevention and Control said officials were working on a new vaccination plan to be released soon. .

Without access to the most effective mRNA-based candidates from Pfizer-BioNTech and Moderna, which have been updated to fight the omicron variant, the world’s most populous country uses the original strain of the virus. Depends on the vaccine developed.

Some health experts find it difficult to justify Beijing’s restraint. “China should approve biotech and moderna vaccines for the general Chinese population as soon as possible,” said Jin Dongyan, a virologist at the University of Hong Kong. “It’s ridiculous that they only allowed foreigners to get the BioNTech vaccine in China. It’s like they think Chinese people are inferior to foreigners.

China is instead looking to develop 10 of its own mRNA candidates. Together at the forefront from biotechnology group Abogen Biosciences and the government’s Academy of Military Medical Sciences. Indonesia approved it for emergency use in September, but it has not received approval from Chinese regulators and may not receive it until data are available from phase 3 clinical trials in Indonesia and Mexico. . The trials are expected to be completed in May.

Other options in China include an inhalable vaccine made by CanSino, which has been available in Beijing, Shanghai and Hangzhou since October. A Chinese-made antiviral drug, Azvudine, originally used for HIV patients, was approved in July to treat Covid. Traditional Chinese medicine is widely used.

But new and more effective vaccines remain a top priority, and the country’s leading pharmaceutical companies are ready to mass-produce them. CanSino is completing a production facility in Shanghai that – once approved – will be able to produce 100 million doses a year.

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