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After the government lifted a number of restrictions, the number of new coronavirus infections in China rose
.
Source: Shen Qilai/Bloomberg/Getty
According to the first projections since the government lifted many strict "zero COVID-19" measures, up to 1 million people in China could die from COVID-19
in the coming months.
James Wood, an infectious disease modelling expert at the University of New South Wales in Sydney, Australia, said: "There is no doubt that the situation in China has been bad
these months.
"
However, two studies have found that deaths could be reduced by giving most people a fourth dose of the vaccine, as well as high adherence to mask wearing and re-imposing temporary restrictions on social interactions when mortality soars
.
These measures can also reduce the burden
on hospitals.
Xi Chen, an economist at Yale University in New Haven in Connecticut who studies China's public health system, said: "It's never too late
to flatten the curve.
"
Over the past month, the Chinese government has lifted many of the restrictions imposed to curb the spread of the virus
.
China ended massive lockdowns across cities, lifted intra- and inter-regional travel restrictions, and allowed people infected with the virus to isolate at home rather than in centralized facilities
.
Testing is now voluntary, and last week, the National Health Commission announced it would stop reporting the number of
infected people without symptoms.
The number of officially reported cases has been declining since late November due to changes in testing requirements, but there are signs that the number of infections is rising
in some areas.
According to Xinhua, China's official media agency, the number of infections is growing rapidly in Beijing
.
One of the studies was published in a preprint on December 14 and was not peer-reviewed
.
The study used data from recent outbreaks in Hong Kong and Shanghai to compare different situations
in China.
The report found that hospitals will be overwhelmed if the number of infections increases as quickly as expected due to the latest easing of restrictions
.
The study predicts that this could lead to about 1 million deaths
in the coming months.
But Ewan Cameron, a modeller at the Telethon Children's Institute in Perth, Australia, said the estimates only included deaths directly from COVID-19 and did not include additional deaths
due to delays in treatment for patients with non-COVID-19 diseases.
This study shows that if 85% of the population received the fourth dose of the vaccine, instead of the inactivated virus vaccine that most people in the country received, the growth of infections could be slowed and the number of
people with serious infections and deaths reduced.
Promoting a fourth dose of the vaccine, along with antiviral drugs for older people aged 60 years and older and others at high risk of severe disease, could reduce mortality by 35%.
James Trauer, an infectious disease modelling expert at Monash University in Melbourne, Australia, said: "It is really critical
for China to achieve the highest possible vaccination coverage in the period leading up to a major outbreak.
" He also noted that there is still a lot of uncertainty
in projections about the number of deaths from the epidemic and the impact of measures to slow transmission.
On 13 December, the government announced that seniors aged 60 and older and other high-risk groups should receive the fourth dose, preferably using a different technique
than the first dose.
But of China's more than 260 million people over 60, only 70% and 40% of those over 80 have received a third injection
.
Wood noted that it may be too late for China to benefit from the fourth dose, as many restrictions have now been lifted and widespread transmission
has occurred.
He also "does not believe that additional doses will have a significant impact on transmission" because the circulating Omicron variant of the virus has shown a powerful ability to
evade the human immune response.
Another model estimates that if China continues on its current path, it will face 500,000 COVID-19 deaths by April and 1.
6 million
by the end of 2023.
The model, which tracks and predicts the global burden of COVID-19, is regularly developed and updated
by the Institute for Health Metrics and Evaluation at the University of Washington, Seattle.
Ali Mokdad, an epidemiologist at the institute, said the death toll in China could rise to nearly 9,000 a day by the end of March
.
The model predicts that if China takes certain measures when the death rate exceeds a certain threshold, the death toll could be reduced to around
290,000 between now and April.
These include re-imposing restrictions, increasing third- and fourth-dose vaccination rates, and high-dose antiviral treatment
for high-risk groups.
The widespread use of masks could further reduce the number of deaths to around
230,000.
Mokdad said that in China, there are many people wearing masks, and the easing of restrictions has led to changes in people's behavior, and people choose to restrict their activities
.
"They're not going to break (it)
.
"
Cameron said the two studies were broadly consistent
in terms of mortality estimates and the impact of the intervention.
"This similarity largely reflects a consensus that herd immunity
can only be achieved after large-scale and uncontrollable transmission across the country.
"
