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After an abrupt easing of its “zero-Covid” policy late last year, China has declared a “big and decisive triumph” in its control of the coronavirus outbreak that has swept the country in recent months.

The judgement was given during a closed-door meeting on Thursday presided over by Chinese leader Xi Jinping, in the latest indication that the country is attempting to limit the political consequences from zero-Covid.

The years-long programme had sparked significant resentment, including rare statewide rallies, before being terminated in December under mounting economic expenses, in a surprise decision to the public.

The abrupt repeal of strict disease regulations triggered a surge in cases, leaving hospitals overloaded and people scurrying for basic medicines. However, the outbreak appears to have subsided in recent weeks, with government numbers showing visits to fever clinics back to pre-restrictions levels after declining from a peak in late December.

According to a report released by state-run news agency Xinhua, the Politburo Standing Committee announced Thursday that the country had “made a miracle in human history” by successfully surviving a pandemic.

According to the summary, the group claimed that China had the world’s lowest Covid-19 fatality rate – a metric that China’s top leadership touted throughout the pandemic, as its lockdowns, enforced quarantines, and border restrictions kept case numbers – and fatalities – low compared to some other major economies.

Experts believe the assessment, the first from China’s top authorities since the outbreak appears to be subsiding, just highlights the many unanswered issues about the outbreak’s impact on the country.
Unknown cost

China has officially reported more than 80,000 fatalities since the end of zero-Covid, a statistic that includes persons who were tested for Covid-19 and died in hospital but excludes deaths that remained untreated or those who died at home during the virus’s spike. According to experts, those omitted could be a substantial number because testing was halted and many patients were likely to have avoided hospitals.

“There are still many questions about the Covid death toll in China – it might be useful if they could release more information, particularly about all-cause deaths compared to pre-Covid years,” said virologist Jin Dongyan, a professor at the University of Hong Kong’s School of Biomedical Sciences, pointing to one method for assessing a more complete picture of fatalities in the country.

The World Health Organization has also chastised China for its lack of data transparency during the outbreak, notably its earlier and more restrictive definition of a Covid-19 fatality, which Chinese health officials modified in January.

It’s also unclear how many people have been infected since China relaxed its zero-Covid policy, raising further questions about how authorities calculated the undisclosed Covid fatality rate, which is typically calculated by dividing the number of deaths by the total number of cases, according to experts.

Late last year, Chinese health officials ceased disclosing data for so-called asymptomatic cases across the country, as they destroyed the country’s huge Covid-19 mass testing equipment and allowed people to test and recover at home.

Wu Zunyou, chief epidemiologist of the Chinese Center for Disease Control and Prevention (CDC), stated on his own social media account in late January that approximately 80% of people in China had already been infected.

Reported mortality statistics have also decreased, with China reporting only 912 hospital deaths for the week of February 3-9, according to the most recent CDC data, which also shows that fatalities peaked on January 4 with a total of 4,273 deaths.

According to Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations in New York, providing a more detailed picture of the outbreak – including the death toll – may not serve the government’s aims of comforting the public about their handling of the virus.

Huang cited various international assessments based on modelling that put the actual death toll over the last two months at well over a million. “You can’t expect the government to admit to this (magnitude) because people will ask how we could have paid so much economic and social cost (from zero-Covid) to essentially come up with an outcome that is equal, if not worse, than the (toll in) US,” he said.
Going forward

Instead, Huang added, Chinese policymakers were grabbing the opportunity to control the narrative around the outbreak now that the surge seemed to have subsided.

“People’s lives are returning to normal, and the viral wave is ending, so that kind of uncertainty (about the outbreak) is no longer there, and there is a need to reconcile the contradictory narrative, the credibility crisis that the abrupt policy U-turn created,” Huang said, referring to the abrupt shift in official tone as China quickly adjusted from warning about the virus’s dangers and the need to contain it to allowing it to spread.

“Now is the right time to declare that the decision was justified,” Huang remarked.

Even though there are indicators that China’s population has extensive natural immunity, as in other countries, experts believe this does not mean the virus is gone or that China’s health-care systems are prepared for potential future surges caused by probable new variations.

According to the Xinhua account, the Politburo Standing Committee “urged all localities and departments to optimise associated processes and measures, enhance the medical service system,” and called for preparation for the next phase of vaccines and improving medical supplies.

Even while the last spike appeared to be stopped, Jin at the University of Hong Kong agreed that China needs to continue to prepare.

“Covid is still with us and will remain for a long time,” he stated. “They still have the new issue of improving the health-care system after this tsunami.”

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