The start of the new year has unshakeable feeling of Groundhog Day to it. We’re not even a week into January, and already epidemiologists are warning of new Covid variants, while passengers travelling from China to the UK will once again be required to show a negative Covid test before boarding. Many of us have been left wondering: have we woken up in 2023 — or 2020?
As the past year came to an end, the same stubborn arguments which have been spinning around the world’s hamster wheel for the last three years were aired again — this time about China’s decision to abandon Zero Covid, and what this might mean for the rest of the world in terms of variants, Covid spread and the health of the general population. We don’t want to rehearse these arguments again, but they are vital: they cut to the heart of what lessons global societies will take from the Covid-19 pandemic and associated policy response, and how institutions will balance health and disease in the future. It’s too easy to say that we should just move on, because the future health of human societies depends on what decisions now are taken.
It’s pretty clear that China abandoned Zero Covid because it didn’t work, was causing huge socioeconomic and psychological harm, and threatened to undermine the political control of Xi Jinping. The writing was on the wall when footage emerged in August of shoppers in a Shanghai Ikea stampeding for the exit after authorities sought to seal off the store and send everyone in it to quarantine following the discovery of one shopper who had been exposed to an asymptomatic six-year-old child. Once mass protests began to spread in November, the decision was taken to move on before they became a threat to the regime.
To us, a number of conclusions can be drawn, which we discuss in The Covid Consensus. Clearly, lockdowns could only work in a very limited way, to reduce spread for a short period of time; they were therefore impractical for any length of time without causing enormous harm, which is why Zero Covid was impossible. Moreover, in spite of China’s severe attempts to prevent travel, the spread of a highly infectious respiratory virus cannot be shut down completely in the era of global supply chains, even with hermetically sealed borders, as proved to be the case in Australia and New Zealand.
Nevertheless, many seem to be trying to draw different and nonsensical lessons, showing that nothing has been learned from the past three years. Once again, the Western media is stoking unnecessary fears with panic-stricken reports of “China’s new Covid nightmare”. The rapid infection of potentially more than a billion Chinese people, we are told, is likely to result in countless deaths among the population, and spark the emergence of dangerous new variants that could lead to “a global catastrophe”, as millions of potentially disease-carrying citizens prepare to celebrate the reopening of the country’s borders by travelling to all corners of the world.
So, instead of celebrating the end of the Zero Covid prison in which so many Chinese have been incarcerated, during the past week, several countries — including the US, Japan, Italy, Spain, France and, most recently, the UK — have reacted by reintroducing restrictions for passengers from China, requiring them to show a negative PCR or antigen test before boarding.
But are such fears justified? First, let us explore whether China is really heading for a public health disaster of apocalyptic proportions, as the news would have us believe. According to the Chinese government, the country is registering around 5,000 new cases, and only a handful of Covid deaths, per day. Official deaths since the start of the pandemic are just over 5,000. These numbers are universally considered to be hogwash; China has routinely been accused of downplaying infections and deaths for political reasons. The World Health Organization, for example, reports around 150,000 new cases, and 400 deaths, per week, and a total of just over 30,000 deaths.
As far as the latest wave is concerned, there is at least an official explanation for the discrepancy: China recently announced that it will include only deaths from pneumonia or respiratory failure in its official Covid-19 death toll; deaths that occur in patients with pre-existing illnesses, on the other hand, will not be counted as Covid-19 deaths. If true, this contrasts starkly with the very “liberal” approach to Covid-19 deaths (and hospitalisations) adopted by most Western countries throughout the pandemic, and still widely used, whereby any deceased person who has recently (or even not so recently) tested for Covid is classified as a “Covid death”, even if the death was manifestly unrelated to Covid. Figures related to new cases are even more unreliable, since they obviously depend on the number (and method) of tests that are carried out.
One thing, however, is certain: in the coming weeks and months, a huge portion of the Chinese population is going to catch the virus. The Institute for Health Metrics and Evaluation (IHME), for example, estimates that around 1 million Chinese people are already getting infected every day. Some reports claim that 250 million people across the country have been infected just in December. How many deaths this leads to depends on a number of factors, including the ability of the Chinese authorities to put measures in place to protect those who are actually at risk of developing a serious illness from Covid-19, namely the elderly and those with serious medical conditions. The IHME expects close to 300,000 Covid deaths by April 2023 — roughly 100,000 deaths per month (3,000 per day).
These numbers may seem shocking, but they need to be contextualised. Assuming that a large percentage of the 1.4 billion-strong Chinese population eventually catches Covid, as seems likely, this would amount to a minuscule infection fatality rate (IFR) — less than 0.001%. Most of the deceased are also likely to be very elderly people who would have died within a short time — as was the case for the overwhelming majority of Covid-related deaths in Western countries. In fact, since more than 10 million people died in China in 2021 (the most recent year for which there are statistics), this figure — even if it continued at that rate throughout the year — would lead to around a 12% mortality increase, broadly in line with global averages elsewhere in 2020.
We also need to keep in mind that the dominant strain in China at the moment appears to be a subvariant of the Omicron variant BA.5 (BA.126.96.36.199), also called BF.7, which we know to be more transmissible but much less lethal than previous variants — exactly the kind of evolution you would expect to see in a virus like SARS-CoV-2. Indeed, Chinese authorities have confirmed that the virus causes relatively mild symptoms in the vast majority of those infected. There’s little reason to doubt this, as much as one may be sceptical of the information coming out of China.
And yet, Western politicians are now telling us that the reason we need new restrictions is that, as the Chair of the Defence Select Committee Tobias Ellwood said, “we simply cannot trust Chinese data”. Such claims would hold more water if that same Western establishment hadn’t spent the best part of the past three years taking the Chinese Covid-19 statistics at face value, and using them as evidence for the effectiveness of lockdowns. Up to March 2020, 39 of 42 reproduction number estimates were based on Chinese data, as was the Imperial College report that predicted 510,000 deaths in the UK, which would fall to somewhere between 5,700 and 39,000 with Chinese-style “suppression” measures. Needless to say, those predictions turned out to be wildly inaccurate.
In other words, the Chinese data was deemed perfectly reliable insofar as it was useful to justify restrictions in the West. Today, on the other hand, it is accused of being unreliable… in order to justify restrictions in the West. The doublethink is jarring — and the results are likely to be similarly flawed. Just as lockdowns failed to contain the spread of the virus within countries, previous attempts to prevent Delta and Omicron variants from spreading beyond India and southern Africa, respectively, also failed miserably. Even the WHO considers travel bans to be “usually not effective”, while Andrew Pollard, chairman of the UK Joint Committee on Vaccination and Immunisation, also admitted that “trying to ban a virus by adjusting what we do with travel has already been shown not to work very well”. Neither is there any evidence that pre-departure testing will “help slow the spread” of the virus, as claimed by the CDC’s director Rochelle Walensky. In July, for example, French researchers found the Omicron variant in wastewater from two commercial airplanes that flew from Ethiopia to France in December 2021 even though passengers had been required to take Covid tests before boarding, concluding that mandatory testing before boarding “did not prevent massive importation of Omicron variant into Europe”.
More importantly, why would we want to do that? Data from last month suggests a majority of people in Western countries have had coronavirus infections, and that prior infection, even in the unvaccinated, offers strong protection against BA.5 Omicron hospitalisation. Moreover, the Omicron subvariant that has been spreading in China has been detected in the US, Europe and rest of the world for many months, which means we also have good levels of natural immunity to that subvariant (as well as high vaccination rates, which were told were the golden bullet to end the pandemic). So, there’s no reason to fear coming into contact with a Chinese tourist any more than there is to come into contact with any other human being.
Furthermore, not only is there “currently no evidence” to suggest that a new and dangerous strain of the virus has emerged in the Chinese population, but there’s no reason to believe this is likely to happen either — or at least it’s not more likely to happen in China than anywhere else. “The likelihood of variants emerging [in China] is the same as it is in other places where there are Covid waves,” said Pollard. Besides, as noted already, even if it were to emerge, it would spread across the world regardless of the measures put in place, just like all previous variants.
Why, then, are policymakers once again going down this route? Part of the explanation is that politicians, by peddling a pro-lockdown narrative for the past three years, have now created an artificial demand for restrictive measures among their fear-stricken constituents, some of whom are now even making the case for wearing masks forever or for the permanent institutionalisation of what Giorgio Agamben might call “bare life”. Even more worryingly, it appears to indicate that Western governments have little intention of giving up the powers they’ve claimed under the guise of “fighting the virus”. While these current travel restrictions won’t affect the daily lives of Western citizens, they nonetheless show how easily “lockdown laws”, many of which remain in place in the UK and other countries, can be reinstated. If restrictions can be arbitrarily brought back at any moment in the name of public health, what’s to stop governments from abusing these powers once again in the future? For instance, the British government’s “Living with Covid-19” guidance, published in February 2022, states that it “will retain contingency capabilities and will respond as necessary to further resurgences or worse variants of the virus”.
The threat of such “capabilities” relates to a more fundamental issue, which is how human societies relate to illness and disease. The pandemic threw this into the foreground, and offered two contrasting approaches. The first is the biomedical approach, which has been championed by Bill Gates in his book on the pandemic and subsequently by Joe Biden in his new pandemic policy, which relies on the rapid production of vaccines, while citizens will need to wait in lockdown until these new products are available.
The alternative requires us to move beyond the guidance — or tyranny, depending on your point of view — of “the science”, and to recognise the role that philosophy and humanistic knowledge has in human life. Whether or not humans choose to embrace this way of living is ultimately a question of values. We can either confront the truth that death is — and always will be — a fundamental part of life, embrace the case for living well and healthily while we are alive, and recognise the place that human contact, exchange, and the sharing of bodily and social space has in well-being and therefore in health. Or, we can assign more value to the technical shield which we have been constructing around ourselves for the past decades. Looking at what’s now playing out in China, we know which we prefer.