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It feels like only yesterday – and sometimes a lifetime ago – that the novel coronavirus, SARS-CoV-2, first appeared.

On Dec. 31, 2019, the World Health Organization was informed of several cases of a “pneumonia of unknown etiology” in Wuhan, China, all of them connected to the Huanan Seafood Wholesale Market.

No one could have imagined how that seemingly routine public health alert would play out. The ensuing pandemic produced historic levels of political upheaval and an explosion of misinformation and charlatanism, while leaving millions dead and the global economy in tatters.

Three Earth-shattering years later, all eyes are focused on China again.

The autocratic superpower managed to do what few other countries did – keep the spread of COVID-19 in check. But years of lockdowns, mass testing, electronic tracking of citizens, quarantine, travel restrictions and more took their toll, leading to unrest and unprecedented levels of protest.

In early December, the regime dropped its zealous pursuit of “zero COVID.” Unlike other countries, though, China did not gradually loosen restrictions – it shifted abruptly, and with no apparent plan B.

In doing so, it lifted the lid off a simmering pot.

What has happened since is unclear, largely because China strictly controls the flow of information.

Dropping all mitigation measures will almost certainly lead to the rapid spread of COVID-19, especially in a country where citizens have had little exposure to the virus, and therefore little immunity.

Before it jettisoned “zero COVID,” China was reporting about 30,000 new COVID-19 infections daily. Now the official number is a little more than 5,000 – but routine testing has been dropped.

At the same time, officials in Zhejiang province said on Dec. 25 that they were seeing one million new cases daily and expected that number would double by the new year.

Another report said that the country had seen 250 million new infections in the first 20 days of December.

Mortality numbers are equally murky.

Prior to China dropping its COVID-zero approach, it had reported only 5,246 deaths during the entire pandemic. By contrast, Canada has reported 48,948 COVID-19 deaths, and the U.S. close to 1.2 million. Now, China’s death toll likely exceeds 9,000 daily, according to the U.K. data analysis firm Affinity.

But the official number is much lower, in large part because China now says it will only count those who die of respiratory failure. (Many COVID victims die of heart and kidney failure.) There are also reports that hospitals and crematoriums are being pressured to not list COVID-19 as a cause of death.

Experts are predicting between 500,000 and 1.6 million people will die of COVID-19 in China in the coming months, which could have a dramatic effect on the labour market and a ripple effect around the world.

A lack of credible data means that experts are looking to anecdotal reports to get a sense of what is really going on. There is a lot of evidence that hospitals are overwhelmed, just as they were in January, 2020, and as happened in Western countries during the beginning of the Omicron wave a year ago.

One of the main reasons analysts are making dire predictions is China’s poor vaccination rate, particularly among elders – those at the highest risk of COVID death. There are more than 260 million people over the age of 60 in China; about 70 per cent of them have received three doses of a vaccine, but that number falls below 40 per cent among those over the age of 80.

While China has stepped up vaccination efforts in recent days, it is only administering about three million shots daily. It has also banned the use of foreign mRNA vaccines, which have proven more effective at preventing serious illness and death than Chinese-made vaccines.

Widespread infection within the world’s most populous country (population: 1.4 billion) also increases the risk of mutations, and the emergence of new COVID variants, which could spark new waves globally.

Some countries, like Canada, the U.S. and Japan, have imposed restrictions on travellers from China, but those targeted border controls will have little impact.

China’s abandonment of its draconian “zero-COVID” policy will almost certainly have catastrophic consequences domestically, at least in the short term. What is less clear is whether it will prolong the pandemic globally or accelerate the transition to COVID-19 becoming an endemic disease. Have years of containment at the pandemic’s point of origin left us better prepared? Or have they simply delayed the inevitable?

As we know, making predictions about how this wily virus, and the pandemic it sparked, will evolve is as perilous an exercise today as it was three years ago.

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