It may be too early to declare the global end of the Covid-19 pandemic emergency because of a potentially devastating wave to come in China, according to several leading scientists and World Health Organization advisers.
Their views represent a shift since China began to dismantle its zero-Covid policy last week after a spike in infections and unprecedented public protests. Projections have suggested the world’s second-largest economy could face more than a million deaths in 2023 after the abrupt change in course.
China’s zero-Covid approach kept infections and deaths comparatively low among the population of 1.4 billion, but a relaxation in rules has changed the global picture, experts said.
“The question is whether you can call it post-pandemic when such a significant part of the world is actually just entering its second wave,” said Dutch virologist Marion Koopmans, who sits on a WHO committee tasked with advising on the status of the Covid emergency.
“It’s clear that we are in a very different phase [of the pandemic], but in my mind, that pending wave in China is a wild card.”
As recently as September, the WHO chief, Tedros Adhanom Ghebreyesus, had said “the end is in sight” for the pandemic. Last week, he told reporters in Geneva that he was “hopeful” of an end to the emergency some time in 2023.
Most countries removed Covid restrictions as threats of dangerous new variants of the virus or a resurgence of infections receded in the second half of 2022.
Tedros’s earlier comments spurred hopes that the UN agency could soon remove the highest alert level designation for Covid, which has been in place since January 2020.
Koopmans and other WHO advisory committee members are due to make their recommendation on the alert level in late January. Tedros makes the final decision and is not obliged to follow the committee’s recommendation.
On Tuesday, cities across China scrambled to install hospital beds and build fever screening clinics, as authorities reported five more deaths and international concern grew about Beijing’s surprise decision to let the virus run free.
Alongside the risks for China, some global health figures have warned that allowing the virus to spread domestically could also give it the chance to mutate, potentially creating a dangerous new variant.
At the moment, data from China shared with both the WHO and the virus database GISAID shows the variants circulating there are the globally dominant Omicron and its offshoots, although the picture is incomplete due to a lack of full data.
“The bottom line is, it’s not clear the wave in China is variant-driven, or whether it just represents a breakdown of containment,” said Tom Peacock, a virologist at Imperial College London.
The United States on Tuesday indicated it stands ready to assist China with its surging outbreak, warning that an uncontrolled spread there may have implications for the global economy.
“We’re prepared to continue to support countries around the world, including China, on this and other Covid-related health support,” state department spokesperson Ned Price said. “For us this is not about politics, this is not about geopolitics.”
Asked if the US had offered to provide China with vaccines, Price said: “I’m not going to go into private discussions, but we’ve made the point many times publicly that we are the largest donor of Covid-19 vaccines around the world.
“We also note that what happens in China does have implications for the global economy.
“We also know that whenever the virus is spreading anywhere widely in an uncontrolled fashion, it has the potential for variants to emerge.”