POST 240. March 15, 2022. ““China is modifying its Covid-19 playbook amid a surge in cases as it seeks to avoid strains on its healthcare system.”

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“The news: China reported 5,370 new covid cases today, the biggest one-day increase since the pandemic began, and more than double the number reported yesterday. It’s a tiny proportion of China’s population of 1.4 billion people, but it has prompted the government to extend an existing lockdown to the entire Jilin province, meaning over 80 million people in China are now locked down.

A major test: Right from the start, China has pursued a “covid zero” policy of eliminating the virus through lockdowns, travel restrictions and mass testing. However, omicron, which is far more transmissible than any previous covid variant, will make this policy harder than ever to achieve. Although China has reportedly vaccinated over 85% of its population, omicron is better than any previous variant at evading immunity from vaccines (although vaccines still hold up well at preventing severe disease.) China is hampered by the fact that it doesn’t have access to mRNA vaccines, which have proved especially effective against omicron. Although China is working on its own mRNA vaccines, it will be many months before any shot could become available to the general population there.” (A)

“The outbreak is being fueled by the BA.2 version of the omicron variant, a strain that scientists say is “stealthier” than the variant that led to the record spread of COVID-19 in the U.S. in January. While the BA.2 variant is widespread in Asia and Europe, CBS News reports that it has yet to take hold in the U.S., and scientists are hopeful that a previous omicron infection will offer some immunity to the new variant.” (B)

““China is modifying its Covid-19 playbook amid a surge in cases as it seeks to avoid strains on its healthcare system.

Health authorities said patients with no symptoms or only mild ones should go to centralized isolation facilities so that hospitals can focus on more serious cases.

The change in the mandatory hospitalization rules that have seen China through most of the pandemic is an acknowledgment that its current approach risks overwhelming hospitals amid a rapid increase in cases…

Seven hospitals were ordered to empty their wards and turn all efforts to treating at-risk and seriously ill Covid-19 patients. The province is also building five makeshift treatment facilities to house and observe mild and asymptomatic cases, bringing the available bed count to almost 30,000, according to data provided by the Jilin provincial government during a news briefing Tuesday.

These strategies were also picked up in updated official guidance for the diagnosis and treatment of Covid-19 patients released by the National Health Commission on Tuesday evening.

It also formally included the use of Pfizer Inc.’s Covid-19 antiviral drug Paxlovid in the treatment plan. Chinese regulators gave a conditional approval of the drug for emergency use in China last month…

A Covid-19 forecasting system by China’s Lanzhou University predicted Monday that if health authorities implement their containment measures in a timely and effective way, case numbers in the current wave would peak around now, with infections under control by early April and resulting in about 35,000 infections.” (C)

“China, where the virus was first detected in late 2019, has maintained a strict zero-Covid policy enforced by swift lockdowns, travel restrictions and mass testing when clusters have emerged.

But the latest flare-up, driven by the highly transmissible Omicron variant and a spike in asymptomatic cases, is challenging that approach.

Zhang Yan, an official with the Jilin provincial health commission, admitted on Sunday that local authorities’ virus response so far had been lacking.

“The emergency response mechanism in some areas is not robust enough, there is insufficient understanding of the characteristics of the Omicron variant … and judgment has been inaccurate,” he said at a government press briefing.” (D)

“As COVID-19 cases sprouted in several Chinese cities, drug companies are working to develop more effective vaccines and medicines against COVID-19.

Kintor Pharma, a Chinese company whose COVID-19 molecule candidate is under international multi-center Phase III clinical trials, told the Global Times on Tuesday that they are accelerating the trials to make the candidate contribute to the fight against the COVID-19 epidemic as soon as possible.

The Global Times also learned from Beijing-based Global Health Drug Discovery Institute that they are expected to deliver two COVID-19 drug candidates into clinical trials this year.

China Meheco announced on March 9 in a statement that it had successfully signed with Pfizer a license that enables the former to sell Pfizer’s oral drug in the Chinese market, making it the exclusive distributor of the country’s first COVID-19 oral drug.

The Pfizer oral drug is yet to be put on shelves in Chinese mainland.

Voices calling for quicker R&D and wider approval of new vaccines also gained momentum among health experts as cases surge in China. China has approved seven COVID-19 vaccines so far. The country also approved in December 2021sales of its first home-developed anti-COVID-19 medication using antibody cocktail therapy.

A total of 25 vaccine candidates had been delivered into clinical trials and seven of them had obtained emergency use approval or conditional approval for the market, Chinese officials said in late February.

China’s National Medical Products Administration announced on Tuesday that it is accelerating the approval process of COVID-19 medicines and antigen self-test kits.

The NHC has updated its treatment playbook for COVID-19 on Tuesday, saying that cases with mild symptoms should be collectively quarantined and transferred to hospitals until they develop severe symptoms. The renewed plan also includes the antiviral medicine Paxlovid and domestically made monoclonal antibodies BRII-196 and BRII-198 into the treatment of COVID-19.” (E)

“Health officials have warned tighter restrictions could be on their way, as concerns mount over the resilience of China’s “zero-Covid” approach in the face of the highly-transmissible Omicron variant.

Sharing a news story about the same, epidemiologist Dr Eric Feigl-Ding took to Twitter on Monday to say that he has a “bad feeling” about the situation.

“I have a bad feeling again—China is reinstating measures and has fired the mayors of two key cities. Thus far, China has shut down an industrial city, urged residents not to leave Beijing and closed down schools in Shanghai due to increase of Covid-19,” wrote Ding.

Lamenting the effects this can have on global supply chains, he said: “If mainland China follows the way of Hong Kong — then China will be royally screwed. And the world’s supply chain might completely melt down for a period. HK deaths are surging so high it is approaching NYC in spring 2020–and HK hasn’t peaked yet.”

Citing China’s decision of allowing rapid antigen testing this year, he said that “something is very different this year”.

“Outbreak is still early in China, but look at that near-vertical surge. The fact that it’s simultaneously happening with lockdowns in multiple cities at once shows urgency that we haven’t seen before. And keep in mind Shenzhen and Shanghai are critical industrial cities!” wrote Ding.

This comes as Chinese authorities reported 2,300 new virus cases nationwide on Monday and almost 3,400 a day earlier, the highest daily figure in two years.

“There have been many small-scale clusters in urban villages and factories,” Shenzhen city official Huang Qiang said at a Monday briefing.

“This suggests a high risk of community spread, and further precautions are still needed.”” (F)


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