China must import mRNA vaccines to stop Covid-19 ‘disaster’, US health experts say

As Beijing abandons zero-Covid, foreign jabs and antiviral medicine are key to limiting deaths, according to epidemiologists
Without imported shots or strict mitigation measures, the country can expect up to 500,000 coronavirus-related deaths by April, says disease expert

Coronavirus China

Robert Delaney

Published: 3:00pm, 22 Dec 2022

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Following its sudden withdrawal of strict Covid-19 containment measures, the Chinese government has no choice but to import mRNA vaccines and antiviral medications if it hopes to limit a looming surge in Covid-19-related deaths, according to two US-based experts.

Without lockdowns or other mitigation measures, and in the absence of mRNA vaccines, China can expect as many as 500,000 Covid-related deaths by April of next year, said Ali Mokdad, a professor at the University of Washington’s Institute for Health Metrics and Evaluation.

He said that number could be cut in half if Chinese authorities enforce proper masking, introduce lockdowns where hospitals are filled beyond 80 per cent of capacity and adopt full transparency on the number of local infections.

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“Ninety-eight per cent of Americans have been infected at least once with Covid-19, and this will happen in China, but it’s going to happen in a shorter time,” said Mokdad, a former senior epidemiologist with the US Centres for Disease Control and Prevention.

“The fact that it’s going to happen in shorter time means it will overwhelm the medical system and a lot of deaths will happen.”

Beijing’s sudden pivot away from strict Covid-19 prevention measures included an end to testing and reporting requirements, making the scale of China’s outbreak nearly impossible to gauge in a population that is more vulnerable to the illness than most other countries.

With less stringent containment measures and higher vaccination rates, mostly with mRNA vaccines, the US and many other countries have contended with multiple waves of Covid-19 infections since the pandemic started nearly three years ago.

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Hospital in China overwhelmed with patients after Covid controls eased

While vaccines approved for use in China are not as effective as the mRNA varieties used in the US and elsewhere, they are effective enough to prevent hospitalisation and death in most cases, Mokdad said.

He called on Chinese health authorities to arrange to import mRNA vaccines made by Pfizer and BioNTech, as well as antiviral medications such as Pfizer’s Paxlovid, which are the most effective tools for limiting mortality.

China approved the use of Paxlovid in February but the amount of the medication imported and how widely it is used in hospitals remains unclear.

With a month before the start of the Lunar New Year, now is the best time to tell the public to get the vaccine to boost immunity and reduce the risk of spreading the contagion, he said.

“The only thing that China could do is to spread the infections throughout the year and not let them happen all at once, because that is a recipe for disaster.”

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Jumping from zero-Covid to zero restrictions has the potential to wipe out the success China achieved in the first two years of the pandemic, said Dr Jennifer Huang Bouey, an epidemiologist and specialist in China policy at the RAND Corporation.

She agreed that mRNA vaccines and antivirals, including Paxlovid and Merck’s Lagevrio, also known as molnupiravir, are key to curbing China’s Covid-19 onslaught in a significant way.

Asked last week about whether US officials had offered their Chinese counterparts support to help them cope with the consequences of Beijing’s policy shift, US National Security Adviser Jake Sullivan suggested that they had in a recent meeting held in Beijing, and were waiting for a response.

“The topic of Covid-19 and the ways in which all countries, including China, are dealing with this pandemic was on the agenda at these meetings, but I am going to refrain from getting into details of what those discussions entailed because I want to give an opportunity for us to be able to have those conversations in sensitive diplomatic channels,” Sullivan said. “We’ll see what, if anything, comes out of it.”

Chinese foreign ministry spokeswoman Mao Ning shunned the question on Wednesday when asked whether China would accept the offer. She only said booster shots were being rolled out and that medications and test supplies could generally meet demand.

“We believe … our economic and social undertakings will enter a new stage of steady and orderly growth,” she said.

Ending China’s Covid controls could lead to 1.5 million deaths, study says

Huang Bouey pointed to an analysis published in May by Nature Medicine, in which researchers at Fudan University in Shanghai estimated that the complete removal of pandemic restrictions in China would lead to as many as 1.6 million deaths within six months, as the most reliable model for estimating mortality.

She said that estimate took into account the likelihood that a sharp surge in infections would overwhelm the country’s healthcare system, leading to higher mortality among those with cancer, heart disease and other conditions.

The circulation of respiratory syncytial virus (RSV) and the flu along with Covid-19 – sometimes referred to as a “tripledemic” – could push the near-term mortality rate higher, although an overwhelmed medical system makes it difficult to track which viral respiratory ailment is killing people.

“I think the death toll … would be an astronomical number, just because the population base is huge,” she said.

02:16

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Huang Bouey said China’s ability to keep Covid-19 under control – and keep its economy running – before the emergence of Omicron was a “success”.

However, that victory came with a price in the form of a looming mortality surge that could have been lowered if the country had managed to vaccinate more of its population.

“The real problem is that there was no promotion of booster shots or stockpiling of antivirals before they changed the policy,” she said. “If China says, ‘Well, we can’t do it, we reject all support’, that could be a disaster for a vulnerable population.”

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