U.S. and global health officials are worried about lack of transparency from China on Covid outbreak

U.S. and global health leaders say Beijing is not sharing enough information about the spread of Covid-19 in China, leaving the international community in the dark about the scale and severity of the current wave of infection in the world’s most populous country.

The U.S. Centers for Disease Control and Prevention, in a statement Wednesday, said the lack of transparency from China could delay the identification of new Covid variants that pose a threat to public health. China is sharing very few genomic sequences used to identify such variants, according to the CDC.

The CDC on Wednesday announced new testing requirements for airline passengers whose trips originate in China. All passengers, regardless of nationality or vaccination status, must get tested for Covid no more than two days before their flight to the U.S. and present a negative result to the airline before departure. The requirements go into effect on Jan. 5.

India, Italy, Japan and Taiwan have also imposed Covid test requirements on airline passengers originating in China. The Chinese government is battling a surge of infections after easing its stringent zero-Covid policy in the wake of social unrest earlier this year.

People receive inhaled COVID-19 vaccine at the Center for Disease Control and Prevention in Bijie, Guizhou province, China, December 29, 2022.
CFOTO | Future Publishing | Getty Images

A U.S. federal health official, in a call with reporters on Wednesday, said the Biden administration has very limited information on the number of new Covid cases, hospitalizations and particularly deaths in China. Testing and casing reporting has also decreased in the country, which makes the true infection rate difficult to determine, the official said.

China’s zero-Covid policy, which sought to crush outbreaks through severe measures, means a large portion of the population does not have any immunity to the highly transmissible omicron variants, the official said. As a consequence, the Biden administration is forecasting that a large number of people will be infected relatively quickly in China.

“What we’re concerned about is a new variant that may emerge actually in China,” said the official, who declined to be named as a condition of the press call. “With so many people in China being affected in a short period of time there is a chance, a probability that a new variant may emerge.”

The latest genomic sequencing data shared by health authorities in China indicates that Covid variants circulating in the country are similar to those known in the rest of the world, according to a statement this week from GISAID, a public database based in Germany.

In the past 180 days, China has sequenced and shared 412 Covid cases with GISAID, compared to more than 576,000 shared by the United States. Health authorities in China have shared fewer than 1% of reported and sequenced Covid cases, while the U.S. has shared more than 4% and the U.K. nearly 12%.

The World Health Organization has also called on China to share more information about what’s transpiring on the ground as the virus spread.

“WHO is very concerned over the evolving situation in China with increasing reports of severe disease,” said Dr. Tedros Adhanom Ghebreyesus, the head of the global health agency, during a press briefing in Geneva last week.

“In order to make a comprehensive risk assessment of the situation on the ground, WHO needs more detailed information on disease severity, hospital admissions, and requirements for ICU support,” Tedros said.

The WHO largely has anecdotal reports of emergency rooms and in some cases intensive care units filling up in China, according to Dr. Mike Ryan, head of the global health agency’s emergencies program.

“We don’t have complete knowledge of the impact,” Ryan said of the Covid wave in China during the press conference in Geneva last week.

Dr. Maria van Kerkhove, the WHO’s Covid technical lead, said last week that omicron subvariants BA.5, BQ.1, BF.7 and BA.2.75 are all circulating in China. XBB has also been detected in China, which is one of the most immune evasive variants yet.

The Institute for Health Metrics and Evaluation, in a report published Dec. 15, said a massive wave of infection in China is inevitable as Beijing relaxes its zero-Covid policy. There will be huge numbers of severe disease in the elderly population and the death toll will be considerable, according to the report.

China faces a difficult situation because its domestically developed vaccines are not as effective as Pfizer’s and Moderna’s mRNA shots. Vaccine coverage among the elderly population in China also lags behind other countries.

“One in seven people on the planet live in China and the acceleration of vaccination, the protection of the health system during this period, is in the interest of seven out of seven people on this planet, Ryan said.

The U.S. has offered China mRNA Covid vaccines and other support but Beijing has declined the offer, the federal health official said on Wednesday’s call.

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