Institute for Health Transformation (IHT)
Joaquim Cardoso MSc
Founder and Chief Researcher & Editor
December 19, 2022
Executive Summary
What is the context?
- Over the past month, the Chinese government has dismantled many of the restrictions it imposed to quash the virus’s spread.
- It has ended the mass lockdown of entire cities, lifted restrictions on travel within and between regions and allowed people infected with SARS-CoV-2 to isolate at home instead of in centralized facilities. Testing is now voluntary,
- Officially, the number of reported cases has been dropping since late November because of the changes in testing requirements, but there are indications that infections in some regions are rising.
- Beijing, for example, is facing a rapid growth in infections, according to Chinese state media agency Xinhua.
What are the forecasts?
- Up to one million people in China could die from COVID-19 over the next few months, according to some of the first projections since the government lifted many of its strict ‘zero-COVID-19’ measures.
- However, two studies find that the number of deaths could be reduced by giving most of the population a fourth vaccine dose, combined with a high level of adherence to masking and reimposition of temporary restrictions on social interactions when death rates surge.
- These measures could also ease the burden on hospitals.
What are the options?
- One of the studies, … finds that hospitals will be overwhelmed if infections rise as rapidly as expected because of the latest easing of restrictions.
- This will probably result in about one million deaths over the next few months, the study forecasts.
- But these estimates include only deaths due directly to COVID-19, and do not take into account excess deaths because of delays in treating people with non-COVID-19 diseases,…
- The study suggests that if 85% of the population gets a fourth dose of a vaccine other than the inactivated-virus vaccines most people in the country have received, it could slow the rise in infections and reduce the number of severe infections and deaths.
- Pushing fourth vaccine doses, combined with giving antiviral drugs to people aged 60 and older and to other individuals at high-risk of developing severe disease, could reduce deaths by up to 35%.
What is the situation of the country?
- On 13 December, the government announced that people aged 60 and older, and other high-risk groups, should get a fourth dose of vaccine, preferably one based on a different technology from their primary dose.
- But of the more than 260 million people in China older than 60, only 70% aged 60 and older, and only 40% aged 80 and more, have received a third dose.
- He is also “not convinced an extra dose will make a big difference to transmission”, because circulating Omicron variants of the virus show a strong ability to evade the body’s immune response.
What are the forecasts of the IHME model?
- Another model estimates that China will face a COVID-19 death toll of half a million people by April, with 1.6 million deaths by the end of 2023, if the country continues on its current path.
- The model tracks and forecasts the global burden of COVID-19, and is developed and updated regularly by the Institute for Health Metrics and Evaluation at the University of Washington, Seattle.
- Deaths in China could rise to close to 9,000 a day by the end of March, says Ali Mokdad, an epidemiologist at the institute.
- The model forecasts that the total number of deaths could be reduced to around 290,000 between now and April if China brings in certain measures when the death rate passes a certain threshold.
- These involve reimposing restrictions, high rates of third- and fourth-dose vaccination and high antiviral drug treatment for at-risk groups.
- Widespread mask use could reduce deaths still further, to around 230,000. Adherence to masking is high in China, and the eased restrictions have led to changes in behaviour in which people are choosing to restrict their movement, says
What are the similarities amont the two studies?
- The two studies broadly agree on mortality estimates and the impact of interventions, says Cameron.
- “This similarity in large part reflects an agreement that herd immunity will only be achieved after a large, and difficult to contain, spread of transmission throughout the entire country.
ORIGINAL PUBLICATION
China COVID wave could kill one million people, models predict
Boosting vaccination rates , widespread mask use and reimposing some restrictions on movement could reduce the number of deaths.
Nature
Smriti Mallapaty
19 December 2022
Up to one million people in China could die from COVID-19 over the next few months, according to some of the first projections since the government lifted many of its strict ‘zero-COVID-19’ measures.
“There’s no doubt that China is in for a bad couple of months,” says James Wood, an infectious-disease modeller at the University of New South Wales in Sydney, Australia.
However, two studies find that the number of deaths could be reduced by giving most of the population a fourth vaccine dose, combined with a high level of adherence to masking and reimposition of temporary restrictions on social interactions when death rates surge.
These measures could also ease the burden on hospitals.
“It is never too late to flatten the curve,” says Xi Chen, an economist at Yale University in New Haven, Connecticut, who studies China’s public-health system.
Up to one million people in China could die from COVID-19 over the next few months, according to some of the first projections since the government lifted many of its strict ‘zero-COVID-19’ measures.
However, two studies find that the number of deaths could be reduced by giving most of the population a fourth vaccine dose, combined with a high level of adherence to masking and reimposition of temporary restrictions on social interactions when death rates surge.
Over the past month, the Chinese government has dismantled many of the restrictions it imposed to quash the virus’s spread.
It has ended the mass lockdown of entire cities, lifted restrictions on travel within and between regions and allowed people infected with SARS-CoV-2 to isolate at home instead of in centralized facilities.
Testing is now voluntary, and last week, the National Health Commission announced that it will stop reporting the number of infected people who have no symptoms.
It has ended the mass lockdown of entire cities, lifted restrictions on travel within and between regions and allowed people infected with SARS-CoV-2 to isolate at home instead of in centralized facilities. Testing is now voluntary, …
Officially, the number of reported cases has been dropping since late November because of the changes in testing requirements, but there are indications that infections in some regions are rising.
Beijing, for example, is facing a rapid growth in infections, according to Chinese state media agency Xinhua.
Fourth doses
One of the studies, posted as a preprint without peer review on 14 December, uses data from recent outbreaks in Hong Kong and Shanghai to compare different scenarios in China.
It finds that hospitals will be overwhelmed if infections rise as rapidly as expected because of the latest easing of restrictions.
This will probably result in about one million deaths over the next few months, the study forecasts.
But these estimates include only deaths due directly to COVID-19, and do not take into account excess deaths because of delays in treating people with non-COVID-19 diseases, says Ewan Cameron, a modeller at the Telethon Kids Institute in Perth, Australia.
It finds that hospitals will be overwhelmed if infections rise as rapidly as expected because of the latest easing of restrictions.
… this will probably result in about one million deaths over the next few months, the study forecasts.
But these estimates include only deaths due directly to COVID-19, and do not take into account excess deaths because of delays in treating people with non-COVID-19 diseases,…
The study suggests that if 85% of the population gets a fourth dose of a vaccine other than the inactivated-virus vaccines most people in the country have received, it could slow the rise in infections and reduce the number of severe infections and deaths.
Pushing fourth vaccine doses, combined with giving antiviral drugs to people aged 60 and older and to other individuals at high-risk of developing severe disease, could reduce deaths by up to 35%.
The study suggests that if 85% of the population gets a fourth dose of a vaccine other than the inactivated-virus vaccines most people in the country have received, it could slow the rise in infections and reduce the number of severe infections and deaths.
Pushing fourth vaccine doses, combined with giving antiviral drugs to people aged 60 and older and to other individuals at high-risk of developing severe disease, could reduce deaths by up to 35%.
“It is really critical for China to achieve the highest vaccination coverage possible in the period immediately before the major epidemic takes off,” says James Trauer, an infectious-disease modeller at Monash University in Melbourne, Australia.
He also notes that there is still a lot of uncertainty around the projections about the epidemic’s toll and the impact of measures to slow the spread.
On 13 December, the government announced that people aged 60 and older, and other high-risk groups, should get a fourth dose of vaccine, preferably one based on a different technology from their primary dose.
But of the more than 260 million people in China older than 60, only 70% aged 60 and older, and only 40% aged 80 and more, have received a third dose.
On 13 December, the government announced that people aged 60 and older, and other high-risk groups, should get a fourth dose of vaccine, preferably one based on a different technology from their primary dose.
Wood notes that it might already be too late for China to benefit from fourth doses because there is already widespread transmission now that many restrictions have been lifted.
He is also “not convinced an extra dose will make a big difference to transmission”, because circulating Omicron variants of the virus show a strong ability to evade the body’s immune response.
Wood notes that it might already be too late for China to benefit from fourth doses because there is already widespread transmission now that many restrictions have been lifted.
Fewer deaths
Another model estimates that China will face a COVID-19 death toll of half a million people by April, with 1.6 million deaths by the end of 2023, if the country continues on its current path.
The model tracks and forecasts the global burden of COVID-19, and is developed and updated regularly by the Institute for Health Metrics and Evaluation at the University of Washington, Seattle.
Deaths in China could rise to close to 9,000 a day by the end of March, says Ali Mokdad, an epidemiologist at the institute.
Another model estimates that China will face a COVID-19 death toll of half a million people by April, with 1.6 million deaths by the end of 2023, if the country continues on its current path.
The model forecasts that the total number of deaths could be reduced to around 290,000 between now and April if China brings in certain measures when the death rate passes a certain threshold.
These involve reimposing restrictions, high rates of third- and fourth-dose vaccination and high antiviral drug treatment for at-risk groups.
The model forecasts that the total number of deaths could be reduced to around 290,000 between now and April if China brings in certain measures when the death rate passes a certain threshold.
These involve reimposing restrictions, high rates of third- and fourth-dose vaccination and high antiviral drug treatment for at-risk groups.
Widespread mask use could reduce deaths still further, to around 230,000. Adherence to masking is high in China, and the eased restrictions have led to changes in behaviour in which people are choosing to restrict their movement, says Mokdad. “They will not [let it] rip.”
The model forecasts that the total number of deaths could be reduced to around 290,000 between now and April if China brings in certain measures when the death rate passes a certain threshold.
The two studies broadly agree on mortality estimates and the impact of interventions, says Cameron.
“This similarity in large part reflects an agreement that herd immunity will only be achieved after a large, and difficult to contain, spread of transmission throughout the entire country.”
The two studies broadly agree on mortality estimates and the impact of interventions,
“This similarity in large part reflects an agreement that herd immunity will only be achieved after a large, and difficult to contain, spread of transmission throughout the entire country.”
doi: https://doi.org/10.1038/d41586-022-04502-w
Originally published at https://www.nature.com on December 19, 2022.
References
Leung, K., Leung, G. M. & Wu, J. T. Preprint at medRxiv https://doi.org/10.1101/2022.12.14.22283460 (2022).
Modelling the adjustment of COVID-19 response and exit from dynamic zero-COVID in China
MedRxiv
Kathy Leung, Gabriel M. Leung, Joseph T. Wu
December 14, 2022.
Names mentioned
James Wood, an infectious-disea
Xi Chen, an economist at Yale University in New Haven, Connecticut, who studies China’s public-health system.
Ewan Cameron, a modeller at the Telethon Kids Institute in Perth, Australia.
James Trauer, an infectious-disease modeller at Monash University in Melbourne, Australia
Ali Mokdad, an epidemiologist at the institute., Institute for Health Metrics and Evaluation at the University of Washington, Seattle.
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