China grapples with political challenges as Covid death toll rises

hong kong

For two years, the Chinese Communist Party has imposed a costly regime of strict border quarantines, instant lockdowns and mass digital tracking in the service of one goal: zero Covid cases.

And Beijing is pointing to the strategy’s past successes – including only two Covid-related deaths reported for the whole of 2021 – to re-gild its claims of superiority over Western governments.

“No effort should be spared to assist every case, save every patient, and genuinely respect the value and dignity of every human life,” said Chinese leader Xi Jinping – who explicitly reiterated his support for the “zero-Covid” policy. ” these last weeks. – said at a global health summit last year.

Now that picture is changing, as for the first time in nearly two years, China’s Covid death toll is rising daily, amid an outbreak in Shanghai that has seen the city of 25 million residents placed under a strict and seemingly endless lockdown.

Since April 17, city officials have reported 238 Covid-related deaths — largely elderly people, who authorities say all died of underlying conditions in an outbreak that spread to more than 500,000 people since March 1.

These deaths mark a new phase of loss for China as well as a high-risk political challenge.

According to health security expert Nicholas Thomas, an associate professor at City University of Hong Kong, the death report is “something of a double-edged sword for the authorities”.

“If the numbers are too low, not only is there a problem of trust, but it will also make quarantine restrictions excessive. If the numbers are too high, then lockdowns are justified but authorities have failed to contain the virus. »

To date, government officials have prioritized suppressing the virus above all else, even as public resentment and economic risks grow under brutal lockdown restrictions.

So far, there are no signs of a change in policy, with Beijing “instead doubling down on its messages to stop the virus”, even as outbreaks spread, according to Thomas.

And as the zero-Covid policy continues to be explicitly tied to Chinese leader Xi, it’s clear “that line is going to be maintained for the foreseeable future,” he said.

As the number of deaths and severe Covid cases have risen in Shanghai in recent days, the city’s health officials have spoken with growing urgency about further strengthening the intensive care response and increasing the vaccination in the elderly – although lockdowns and mass testing seem to have taken precedence over vaccination so far.

“We should coordinate the city’s medical resources, increase essential medical teams…reduce the proportion of serious patients…and do our best to reduce the death rate,” Zhao Dandan, deputy director of the Health Commission, said on Sunday. Shanghai health.

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

– Source: CNN

China ‘sows doubt’ over Shanghai report on Covid death toll

Earlier this month, Shanghai officials said 62% of people over the age of 60 were vaccinated in Shanghai, with 38% increased, but that number has fallen to just 15% fully vaccinated for the most vulnerable age group over 80, according to state media. Of the 238 deaths in recent days, only 13 have been vaccinated, authorities said Wednesday, without specifying details about full vaccination or boosters.

Lagging vaccination rates in this group are a fatal flaw in China’s Covid-19 planning: while it has focused massive resources on developing and manufacturing local vaccines, it has failed to ensure these fall into the arms of the elderly population, who are most likely to die of Covid-19.

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

But already an unknown number of deaths appear to be linked to tight controls in the city, as restrictions have posed problems with access to medical care – a disruption that city officials have repeatedly promised to address.

There were fears that Shanghai could experience a crisis similar to that of Hong Kong, where an epidemic that began at the start of the year pushed the city’s death rate to among the highest in the world since the start of the pandemic.

Hong Kong has also faced low vaccination rates among a large elderly population, with only 48% of people aged 70 or over fully vaccinated at the start of March, and only 25% of residents aged 80 or older vaccinated earlier this year.

But the comparison with Hong Kong also raises questions about how Shanghai managed to keep its death rates so low.

Hong Kong reported more than 9,000 deaths linked to Covid-19 out of 1.19 million total cases since January this year.

At this rate, Shanghai should have recorded up to 700 deaths per 100,000 cases, according to infectious disease doctor Peter Collignon, also a professor at the Australian National University Medical School.

Experts have also pointed to a lack of transparency around the criteria Chinese officials use to classify a Covid-19 death.

“If there is no black and white definition of Covid deaths or Covid-related deaths or how these deaths should be reported, it is up to this panel of experts to decide,” said Jin Dongyan, professor at the University of Hong Kong. School of Biomedical Sciences. “It’s reality.”

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

China’s Ministry of Foreign Affairs said in a 2020 statement: “China has 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 measures and strict measures taken by the Chinese government.

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

For example, Shanghai’s intensive testing detected hundreds of thousands of asymptomatic cases, some of which may have been missed in case counts in other places, which can skew comparisons.

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

Meanwhile, understanding the overall toll – not just of the virus – but of the lockdowns rolled out in Shanghai and other cities is key to assessing the true cost of China’s control measures, experts say.

Xi Chen, an associate professor at the Yale School of Public Health, said the long-term fallout from the Shanghai lockdown, including missed cancer screenings or mental health issues, will take time – and data – to become clear, and even then can be difficult to measure.

“We will often look at two types of negative shocks,” he said of the fallout after the initial burden of death. “One, for people who ultimately died, and the other, those who survived but are living with trauma attached to them.”

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