The Covid situation in China is not looking good right now. The authorities have trapped themselves into a situation from which there’s no obvious escape strategy. Whatever they choose – or will be forced – to do next will be very costly.
The country is extremely poorly prepared for a major surge of the virus
So far China has only managed to suppress Covid with brutal restrictions. Those are becoming increasingly untenable and the population is suffering. Unrest is spilling out into the streets in cities across the country. A major surge seems largely inevitable in the short term unless the authorities choose to enforce even more ruthless measures.
A major Covid wave in China would lead to a dramatic death toll. Current Omicron lineages in circulation are ‘milder’ than Alpha or Delta, but the associated morbidity/mortality is in line with early pandemic lineages for those with no prior immunity.
The country is extremely poorly prepared for a major surge of the virus. Very few people have acquired immunity through prior exposure and vaccination rates in the elderly are dismally low.
The population is not particularly young nor healthy (China's median age is 38 compared with a global average of 30) and its healthcare system is fragile, in particular outside major cities. It would be easily overwhelmed by any significant surge in Covid cases.
Hong-Kong faced a similar set of challenges earlier this year, and despite far better fundamentals (higher vaccine up-take and a more resilient health service), it fared poorly when Omicron spread as the below graph shows:
The most plausible scenario to me is that China will experience a major Covid surge in the near future leading to massive morbidity and mortality, which could be amplified by a collapse of the entire healthcare system.
Beyond the immediate death toll, the failure of their zero-Covid strategy would be difficult to handle by Chinese authorities, given the immense political capital they’ve invested into it since the pandemic began.
This article is an edited extract from Professor Balloux's twitter.
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