Chinese health officials seem to make progress in the struggle against BA.2 in Shanghai

The National Health Commission of the People’s Republic of China reported that there had been 26,462 COVID-19 cases across mainland China. These were further characterized as 1,351 symptomatic cases, and 25,111 asymptomatic. Imported cases accounted for 107 of these, of which 33 were symptomatic. These figures are posted daily on their website, offering a comprehensive look at every location across China’s 31 provinces, Taiwan, Hong Kong, and Macao.

The bulk of infections continues to be reported in Shanghai, the epicenter of the current Omicron outbreak across the country. Yesterday, the national health authority said there had been 24,943 new infections in the financial hub, of which only 1,006 were symptomatic. The megacity, home to over 26 million people, underwent a two-phased lockdown on March 28, which was then extended to a city-wide lockdown on April 1 as cases continued to rise.

On April 4, a city-wide mass testing of the population led to uncovering of more silent, asymptomatic cases, prompting a second round of testing on April 8. The current rise in case counts has been attributed not to further community spread but to more comprehensive efforts to locate every infection across the megacity.

Dr. Wu Zunyou, chief epidemiologist with the Chinese Center for Disease Control and Prevention (CDC) and the counterpart to Dr. Anthony Fauci in the US, explained that the repeat PCR testing enabled public health officials to bring to an end the current outbreak. Speaking with the press, he attributed the increase in cases to the mass screening with PCR tests.

The average incubation period for infection with the Omicron BA.2 subvariant is around three days. Repeat testing will identify the portion of the potentially infected population that initial testing missed. Dr. Wu said, “The first test helps screen only people who have already started to shed the virus, while those who are infected but test negative would become infective if not identified immediately on the second and third tests.” He added, “If a round of tests takes two or three days, then theoretically the goal can be achieved in 10 to 14 days.”

Shanghai health officials announced Saturday that districts that have maintained zero COVID-19 infections for 14 days after repeated rounds of testing could leave strict lockdown, which will alleviate the severe constraints endured by the population and allow them to access markets for food and supplies.

Across Jilin province and the rest of mainland China, COVID-19 cases have continued to trend down since the implementation of measures to restrict social mixing and institute other cornerstones of infection control that have been tried and tested for centuries.

These public health efforts, including those being employed in Shanghai, are enormous achievements in light of the extremely contagious nature of the Omicron BA.2 subvariant. These experiences will provide important lessons for future pandemic preparedness and response in complex, densely populated urban settings.

Despite the repeated attacks and venomous language being used by the overseas capitalist press, denouncing the lockdowns as inhuman, the small number of deaths and mostly asymptomatic character of the infections attest to the efficacy of these relentless efforts at elimination. It means that the clinically severe aspects of the illness can be prevented through early intervention.

These findings are not unique to China’s experience. Every country that had employed an elimination strategy was able to lower rates of infections and complications, including deaths. Early intervention so that the health system is not overwhelmed has meant lives were spared.

Dr. Wang Guangfa, a respiratory specialist at Peking University First Hospital, explained that symptomatic patients are quickly sequestered at hospitals and treatment is rapidly initiated, which prevents cases from progressing to a more severe or critical state. If restrictions were lifted, infections would rapidly spread, leading to overwhelmed hospitals and a rise in preventable deaths. He pointed out that comparing Omicron to the flu is both misleading and dangerous.

When the Omicron wave surged through Hong Kong in February, it killed close to 8,500 people and infected more than 1 million in less than two months. The population of the special administrative region of China is approximately 7.5 million. During the surge, the per capita death toll was the highest ever experienced by any area during the pandemic.

By comparison, the severe 2018-2019 flu season killed only 352 people in Hong Kong. In other words, BA.2 has been 24-fold deadlier. These figures are important in reinforcing Chinese health officials’ commitment to zero-COVID.

Notably, in the face of the purported massive rates of vaccination across high-income countries and claims that the variant is “mild,” Omicron has killed nearly 1 million of the 6.2 million COVID patients reported to have lost their lives during the pandemic.

Globally, BA.2, the dominant version of Omicron, continues to infect more than 1 million people a day across the globe despite the dismantling of COVID-19 data trackers across many countries. At least 3,500 people are still dying every day, of whom half are in Europe, where BA.2 has seen spikes in cases and hospitalizations, particularly in Germany, France and the UK.

Globally, rates of vaccination for COVID-19 have been declining. Evidence is also emerging that the second booster appears to provide, in the short term, a modest improvement in protection against severe illness with Omicron. However, its impact on preventing infections drops rapidly in just four weeks and is negligible by eight weeks. With waning immunity and the rapidly declining efficacy of vaccines, the long-term implications remain uncertain and should weigh heavily in pandemic response, especially given the nature of viral evolution.

The United States will soon face the brunt of BA.2, which has begun its surge in the country. However, due to the nearly complete dismantling of state COVID-19 data trackers, the country is essentially flying blind into this surge. After the US CDC shifted to relying on hospital admissions and ICU capacity to determine community risk, state after state rapidly changed their reporting intervals from daily to twice or even once per week.

Dr. Scott Gottlieb, former US Commissioner of the Food and Drug Administration, speaking on “Face the Nation, said in response to host Margaret Brennan’s question on the current state of the pandemic, “There’s no question that we’re experiencing an outbreak in the northeast, also the mid-Atlantic, [and] parts of Florida as well … It’s driven largely by BA.2. And I think that we’re dramatically undercounting cases. We’re probably only picking up one in seven or one in eight infections. So, when we say there are 30,000 infections a day, there’s probably closer to a quarter of a million infections a day.”

Despite this enormous level of infection, given the current low number of hospitalizations, the majority of the country is considered low risk. Hospitalizations and deaths are lagging indicators of infection, and without detecting the infections, it will be far too late to do much of anything about it. And BA.2 is surging when there are no mitigation measures really in place to slow the course of infections.

Yesterday, Jonathan Karl, co-anchor of ABC’s This Week,” asked Dr. Fauci, the White House chief medical adviser, what he thought of a Washington Post op-ed by Dr. Leana Wen, one of the more vociferous advocates of the full-scale reopening of schools, businesses and public gatherings of all kinds.

He quoted her: “At this point in the pandemic, we have to accept that infections will keep occurring. During the winter Omicron surge, almost half of Americans contracted the coronavirus. The new Omicron subvariant BA.2 is even more contagious. The price to pay to avoid coronavirus infection is extremely high. Some Americans might choose to continue to pay that price, but I suspect most won’t.”

Fauci replied, “You know, Jon, I think she—Dr. Wen articulated that pretty well. There will be—and we’ve said this many times even in our own discussions between you and I, that there will be a level of infections. This is not going to be eradicated, and it’s not going to be eliminated.”

The contrast with his counterpart in China, Dr. Wu Zunyou, who patiently explained that the outbreak could be cleared at the community level within two weeks, couldn’t be more revealing. The class struggle will determine if the war against the virus can be won.