Analysis: China struggles with political challenges as Covid death toll rises 2022-04-27 04:50:00


Beijing is pointing to the strategy’s past successes — including just two COVID-related deaths for the whole of 2021 — to polish its claims to outsmarting Western governments.

Chinese President Xi Jinping – who has openly reiterated his support for the “zero COVID” policy recently “should spare no effort to attend every case, save every patient, and truly respect the value and dignity of every human life.” weeks – said at the World Health Summit last year.

Now, that picture is changing, as for the first time in nearly two years, the number of Covid deaths in China is rising on a daily basis, amid the outbreak in Shanghai that has put the city of 25 million people under a seemingly endless level, strict insurance.
where April 17city officials have reported 238 Covid-related deaths — most of them elderly, and all of whom, authorities say, have died from underlying conditions in the outbreak that has spread to more than 500,000 people since March 1.

The deaths represent a new phase of loss for China as well as a very serious political challenge.

Health security expert Nicholas Thomas, assistant professor at City University of Hong Kong, said reporting death figures “is a double-edged sword for the authorities”.

“If the numbers are too low, then not only will there be a confidence issue, it will make quarantine restrictions seem excessive. If the numbers are too high, then lockdowns are justified but the authorities have failed to contain the virus.”

So far, government officials have prioritized suppressing the virus over anything else, even as public discontent and economic risks mount under strict lockdown restrictions.

So far, there is no sign of a change in policy, with Beijing “instead doubling down on its message of stopping the virus,” even as epidemics spread, according to Thomas.

With the zero-Covid policy still explicitly linked to Chinese leader Xi, he said, “it is clear that this line will remain in place for the foreseeable future.”

in numbers

With the number of deaths and severe Covid cases soaring in Shanghai in recent days, city health officials have spoken with increasing urgency about further strengthening the critical care response and increasing vaccination in the elderly — even though lockdowns and mass testing appear to have prioritized. Vaccination so far.

“We need to coordinate the city’s medical resources, increase critical medical teams…reduce the proportion of seriously ill patients…and do our best to reduce the death rate,” Zhao Dandan, deputy director of the Shanghai Health Commission, said Sunday. .

“Eligible elderly people should be vaccinated as soon as possible,” he said.

Shanghai officials said earlier this month that 62% of those over the age of 60 were vaccinated in Shanghai, with an increase of 38%, but that number has fallen to only. 15% are fully immune For the most vulnerable age group of over 80, according to state media. Of the 238 deaths in recent days, only 13 have been vaccinated, the authorities said on Wednesday, without specifying details on full vaccination or booster injections.
Late vaccination rates in this group are a critical flaw in Chinese Covid-19 planning: While focusing Huge resources to develop and manufacture local vaccineshe failed to ensure that these In the arms of the elderly The population, who are more likely to die from Covid-19.

Now, that authorities have endorsed expectations that the country’s death rates will remain low, they have no choice but to rely on lockdowns to protect the vulnerable.

But already, an unknown number of deaths appears to be linked to the city’s strict controls, as the restrictions have been put in place Challenges in getting medical care Unrest in the city that officials have repeatedly vowed to address.
One concern was that Shanghai could experience a crisis similar to the one in Hong Kong, where outbreak Which started at the beginning of the year led to a high death rate in the city to Among the highest rates worldwide since the epidemic began.
Hong Kong, too, has faced low vaccination rates among its large elderly population, only 48% Of people aged 70 or over fully vaccinated as of early March, only 25% of the population aged 80 or over had been vaccinated at the beginning of this year.

counting cases

But the Hong Kong comparison also raises questions about how Shanghai has been able to keep death rates so low.

Hong Kong mentioned more than 9,000 Covid-19 deaths Out of a total of 1.19 million cases since January this year.

At that rate, Shanghai should have seen as many as 700 deaths per 100,000 cases, according to infectious disease doctor Peter Collignon, also a professor at the Australian National University School of Medicine.

Workers disinfect a residential community during the Covid-19 lockdown in Shanghai.

Experts also noted a lack of transparency about the criteria Chinese officials use to classify a Covid-19 death.

“If there is no black-and-white definition of Covid-related deaths or Covid-related deaths or how these deaths should be reported, it is all up to the expert panel to decide,” said Jin Donjian, a professor at the University of Hong Kong. College of Biomedical Sciences. “this is the truth”.

Some of these reflect concerns about whether there was a full accounting of infections and deaths during China’s initial outbreak of 2020 in Wuhan, which overwhelmed hospitals — although China has defended its transparency throughout the pandemic.

“China calculated and reported its confirmed cases and deaths based on facts…The relatively low number of confirmed cases and deaths can be attributed to the comprehensive and strict measures taken by the Chinese government,” the Chinese Foreign Ministry said in a 2020 statement.

But experts also caution that it is difficult to make comparisons between places with different strategies for testing and disease control, social factors and demographics.

For example, Shanghai’s extensive testing has picked up hundreds of thousands of asymptomatic cases, some of which may have missed in case counts elsewhere, potentially distorting comparisons.

Bureaucratic processes and the time it takes for positive cases to succumb to the disease could delay reported deaths, with some experts suggesting the worst in Shanghai may be yet to come.

Meanwhile, understanding the overall toll — not just of the virus — but of the lockdowns that have been deployed across Shanghai and other cities is critical to assessing the true cost of China’s control measures, experts say.

Xi Chen, an assistant professor at the Yale School of Public Health, said the long-term repercussions from the Shanghai lockdown, including missed cancer checks or mental health stress, will take time — and the data — to become clear, and even then they may be difficult to measure.

“We will often look at two types of negative shocks,” he said of the fallout beyond the initial burden of death. “One, for those who eventually died, and the other, for those who survived but live with the trauma associated with them.”

CNN’s Beijing bureau contributed to this report.