China wave proves that the ‘covid zero’ strategy is not sustainable in the long run

The mammoth covid-19 contagion wave which is currently China questions squarely the ‘covid zero’ policy that the country has been applying throughout these years. almost three years of pandemic. The Asian giant, the epicenter of SARS-CoV-2 (as it originated in an animal market in Wuhan), quickly became a example of how to curb covid-19. The discipline of China (or IRON HAND, depending on how you look at it) when it came to keeping the virus at bay was. admired initially. But few countries followed in its wake (most chose to live with the virus) and now, three years later, the strategy of minimizing the virus has backfired on China.

“What it shows [la situación de China] is that this strategy is not sustainable in the long term. It works very well, but only if it is for a short time, because in the long run it has too high an economic and social impact,” says the doctor. Salvador Macip, member of the covid-19 scientific advisory committee of the Conselleria de Salut de Catalunya.

For the member of the Spanish Society of Epidemiology (SEE). Joan Caylà, China’s mistake was not to have abandoned the ‘covid zero’ policy of ‘more gradual’ manner, as they did at the time South Korea o Australia, countries that also applied it.

China is a country with more than 1.4 billion inhabitants, of whom very few have passed the virus and who have been immunized with vaccines that are much less effective than those used in the European Union (EU), who has already offered China free vaccines to deal with the current wave.


The European Centre for Disease Control and Prevention. (ECDC) has ruled out that the increase in cases in China will affect the epidemiological situation in Europe, mainly due to the high immunity of the European population and that no new variants have been produced.

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But one thing is that, right now, there are no signs of returning to painful situations such as those experienced in 2020 or 2021, and another, that they will not go contagions in Europe are not going to increase. What is of most concern are the mutations. Macip acknowledges that among experts and health authorities there is “concern” that they will appear new variants.

“We have to watch for the virus to mutate and a variant to emerge that will force us to look for new vaccines and have to Re-immunize the entire population.” he says. At the moment, this has not happened and, in fact, the new variants that are appearing, such as the XBB.1.5 (sublineage of omicron, originating from the USA and more contagious), are not posing a “immediate problem”. “Several bad-looking variants have so far appeared, but most of them do not end up dominating. What you have to keep an eye on is whether they end up dominating; at the moment, it’s not a problem,” he says.

More vaccination

Macip takes it for granted that, in spite of the passenger controls from China (Spain requires a negative test for all of them, even if they are vaccinated, but not other European countries, such as Belgium), there will be an increase of cases also in Europe because, in a globalized world, it is impossible to put dams to the virus. That is why he advocates increasing the vaccination rate of the fourth doses, still very improvable (in Catalonia, for example, only 55% of those over 65 years of age have it).

Vaccination, remember, is the only way of avoid serious disease. Acknowledges that the covid-19 scientific advisory board is “concerned” about the Catalan health system, which is already “a little on the edge” After waves first of bronchiolitis and then of flu. “If the covid comes on strong, it can overwhelm the hospitals.” he warns. Even so, he insists that no restrictions are foreseen in this regard.

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“We are in a moment of tense vigilance, to see what happens. There is, at this time, no reason to take any action besides to encourage vaccination. But, at the same time, there is nothing more urgent right now,” insists Macip. “We are in this surveillance phase, to see where things are going. He regrets that the Spanish population has “relaxed” with the fourth doses, something he blames on the fact that people think the pandemic is “already over,” when it is not.

Developing countries

For his part, Caylà is more concerned about how China’s possible wave might affect the developing countries, with “very low” vaccination coverages and with which China has “many trade relations”. “There may be epidemic waves in Africa and Latin America, with very low vaccination coverage. Although ours is improvable, is greater than there and here we have some hybrid immunity. [inmunización natural vía contagia y vacuna]. Europe is of concern but these countries are much more worrying.” The epidemiologist warns that the millions of contagions that are taking place in China increase the chances of a mutation of the virus.

The number of cases of covid-19 has reached a record number in China, with a peak on December 2. In the last three weeks, the incidence has decreased, probably also due to the fact that fewer tests have been performed, resulting in fewer infections being detected.

In any case, the ECDC notes that. “there remains a lack of reliable data on covid-19 cases, hospital admissions, deaths, as well as intensive care unit (ICU) capacity and occupancy in China.”

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