The Indian Express | 3 weeks ago | 07-01-2023 | 05:40 pm
China on Saturday marked the first day of “chun yun”, the 40-day period of Lunar New Year travel known pre-pandemic as the world’s largest annual migration of people, bracing for a huge increase in travelers and the spread of Covid-19 infections.This Lunar New Year public holiday, which officially runs from Jan. 21, will be the first since 2020 without domestic travel restrictions. Over the last month China has seen the dramatic dismantling of its “zero-Covid” regime following historic protests against a policy that included frequent testing, restricted movement, mass lockdowns and heavy damage to the world’s No.2 economy. Investors are hoping that the reopening will eventually reinvigorate a $17-trillion economy suffering its lowest growth in nearly half a century.But the abrupt changes have exposed many of China’s 1.4 billion population to the virus for the first time, triggering a wave of infections that is overwhelming some hospitals, emptying pharmacy shelves of medicines and causing long lines to form at crematoriums. The Ministry of Transport said on Friday that it expects more than 2 billion passengers to take trips over the next 40 days, an increase of 99.5% year-on-year and reaching 70.3% of trip numbers in 2019.There was mixed reaction online to that news, with some comments hailing the freedom to return to hometowns and celebrate the Lunar New Year with family for the first time in years. Many others, however, said they would not travel this year, with worry of infecting elderly relatives a common theme.“I dare not go back to my hometown, for fear of bringing the poison back,” said one such comment on the Twitter-like Weibo.Also Read |BF.7 and BA.5.2: The Omicron sub-variants driving the China surgeThere are widespread concerns that the great migration of workers in cities to their hometowns will cause a surge in infections in smaller towns and rural areas that are less well-equipped with ICU beds and ventilators to deal with them. Authorities say they are boosting grassroots medical services, opening more rural fever clinics and instituting a “green channel” for high risk patients, especially elderly people with underlying health conditions, to be transferred from villages directly to higher level hospitals.“China’s rural areas are wide, the population is large, and the per capita medical resources are relatively insufficient,” National Health Commission spokesman Mi Feng said on Saturday.“It’s necessary to provide convenient services, accelerate vaccination for the elderly in rural areas and the construction of grassroots lines of defense.”INFECTION PEAK REACHEDSome analysts are now saying the current wave of infections may have already peaked. Ernan Cui, an analyst at Gavekal Dragonomics in Beijing, cited several online surveys as indicating that rural areas were already more widely exposed to Covid infections than initially thought, with an infection peak already reached in most regions, noting there was “not much difference between urban and rural areas.”On Sunday China will reopen its border with Hong Kong and will also end a requirement for travelers coming from abroad to quarantine. That effectively opens the door for many Chinese to travel abroad for the first time since borders slammed shut nearly three years ago, without fear of having to quarantine on their return.More than a dozen countries are now demanding Covid tests from travellers from China. The World Health Organization said on Wednesday that China’s Covid data underrepresents the number of hospitalizations and deaths from the disease. Chinese officials and state media have defended the handling of the outbreak, playing down the severity of the surge and denouncing foreign travel requirements for its residents.On Saturday in Hong Kong, people who had made appointments had to queue for about 90 minutes at a Centre for PCR tests needed for travel to countries including mainland China.Also Read |What is BF.7, the Omicron sub-variant driving the new surge in China?TREATMENT TO THE FOREFor much of the pandemic, China poured resources into a vast PCR testing program to track and trace Covid-19 cases, but the focus is now shifting to vaccines and treatment. In Shanghai, for example, the city government on Friday announced an end to free PCR tests for residents from Jan. 8.A circular published by four government ministries Saturday signaled a reallocation of financial resources to treatment, outlining a plan for public finances to subsidies 60% of treatment costs until March 31. Meanwhile, sources told Reuters that China is in talks with Pfizer Inc to secure a license that will allow domestic drugmakers to manufacture and distribute a generic version of the U.S. firm’s Covid antiviral drug Paxlovid in China.Many Chinese have been attempting to buy the drug abroad and have it shipped to China. On the vaccine front, China’s CanSino Biologics Inc announced it has begun trial production for its Covid mRNA booster vaccine, known as CS-2034. China has relied on nine domestically-developed vaccines approved for use, including inactivated vaccines, but none have been adapted to target the highly-transmissible Omicron variant and its offshoots currently in circulation.The overall vaccination rate in the country is above 90%, but the rate for adults who have had booster shots drops to 57.9%, and to 42.3% for people aged 80 and older, according to government data released last month. China reported three new Covid deaths in the mainland for Friday, bringing its official virus death toll since the pandemic began to 5,267, one of the lowest in the world. International health experts believe Beijing’s narrow definition of Covid deaths does not reflect a true toll, and some predict more than a million deaths this year.
Written by David Pierson, Keith Bradsher and Muyi XiaoAfter China’s abrupt reversal of “zero Covid” restrictions, the nation’s vast machinery of virus surveillance and testing collapsed, even as infections and deaths surged. Now, authorities face another problem: Angry pandemic-control workers demanding wages and jobs.In the southwestern Chinese city of Chongqing, hundreds of workers locked in a pay dispute with a Covid test kit manufacturer hurled objects at police officers in riot gear, who held up shields as they retreated. Standing on stocks of inventory, protesters kicked and tossed boxes of rapid antigen tests on to the ground, sending thousands of tests spilling.In the eastern city of Hangzhou, witnesses said several workers climbed on the roof of a test kit factory and threatened to jump to protest unpaid furloughs. And at a separate test manufacturing plant in the city, workers protested for days over a wage dispute.The unrest this month highlights a little-noticed aspect of the social and economic fallout from China’s “zero Covid” policy U-turn. Mass testing was a cornerstone of China’s strategy of isolating the virus before it could spread. But Covid testing of any sort is no longer in high demand. Companies that manufactured test kits and analysed results in a lab are seeing their revenues plummet, leading to layoffs and pay cuts for their workers. One report suggested that mass testing in large cities accounted for about 1.3% of China’s economic output.The consequence has been a new source of turmoil that challenges the ruling Communist Party’s efforts to maintain stability amid high youth unemployment, a flagging economy and an explosion of Covid across the country. China said on Saturday that it had recorded nearly 60,000 fatalities linked to the coronavirus in the month since it lifted “zero Covid,” though experts said the actual death toll was likely much higher.The New York Times visited three Covid test making factories in Hangzhou where workers and residents confirmed that there had been labor protests in recent days. At one plant operated by a firm called Xinyue Biotech, a fire truck, an ambulance and a police van could be seen in the factory yard on Wednesday responding to a worker who had climbed on to the fifth-floor roof and threatened to jump to protest unpaid wages. The shuttered plant had been the scene of days of demonstrations, witnesses near the factory said.The Times also examined videos that have circulated on social media of protests in Hangzhou as well as Chongqing, where workers confronted the police in large numbers.The disputes in Chongqing and Hangzhou could portend more unrest to come. Many among China’s armies of “big whites,” low-level government workers charged with enforcing Covid restrictions and named after their signature white hazmat suits, have been let go, muddying an already volatile labor market.Factories across China are still strapped for cash amid the broader slowdown. Workers have next to no recourse to resolve their grievances other than to lash out, said Li Qiang, founder and executive director of China Labor Watch, a New York-based Chinese labor rights group.“These protests have been very violent because the channels to defend workers’ rights are very limited, while the trust toward the government and laws is low,” Li said. “It demonstrates that if a company ignores workers rights, especially the most vulnerable temporary workers, it will face serious consequences.”In Chongqing, protesters at a test kit manufacturer chanted “Pay me back” as they faced off with lines of police on Jan. 7. It was not immediately clear what sparked the dispute between workers and the test kit manufacturer, Zybio. Videos posted on social media leading up to the protests warned of labor agencies in the area exploiting job seekers by inflating how much work Covid test manufacturers were offering and how much they would pay.The Times verified the location of the Zybio protest videos by matching buildings in videos with online photos and satellite images of the industrial park. One clip showed protesters throwing plastic containers, stools and a traffic cone at police equipped with riot gear. The company did not respond to requests for comment, and several protesters contacted by The Times declined to be interviewed.In Hangzhou, protests flared after workers at the Acon Biotech plant were told at the start of this month they would be furloughed for two weeks because the company’s revenues had dwindled since “zero Covid” measures were dropped.One employee who participated in the protests, who agreed to speak only if not quoted by name given the political sensitivity of labor unrest, said workers were enraged by the furlough because it meant they could not earn money before the Lunar New Year, which starts this weekend.At one point, distraught employees threatened to jump off the roof of a company building. The workers were finally given 3,000 yuan, or roughly $445, apiece a week ago, and the bulk of the workforce then left for the holiday.Many Chinese testing companies had been amassing fortunes during nearly three years of stringent COVID containment measures. But the emergence of the highly transmissible omicron variant made containing the virus all but impossible, and China abandoned the strategy in early December.Even without omicron, China’s strategy of mass testing was proving financially unsustainable. Many local governments — already under significant financial pressure from the slowdown and a dearth of land sales for real estate development — struggled to pay for the millions of free swabs that residents were ordered to take virtually every day.To fund testing and other pandemic controls, money was diverted from public projects in some provinces, while cities cut bonuses for officials and imposed pay cuts on civil servants. Several provinces and municipalities, including Guizhou in China’s southwest, began charging for the tests.Lab testing firms that earlier reaped huge windfalls began reporting that governments were late on payments, leaving them exposed to bad debt. Among them was Dian Diagnostics, a large testing company in Hangzhou, which reported in October that the amount of money it was owed had surged by nearly 80% compared with a year before.Shenzhen Hezi Gene Tech, another fast-growing testing firm, opened six new labs across China in October only to shutter half of them in the last few weeks. It was unclear if the closures were spurred by debt or a lack of business. The company did not respond to a request for comment.“The whole industry has been hit particularly hard with the elimination of mandatory testing in the country. The demand is no longer there,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations, who argued that “zero Covid” had been partly prolonged because it served so many business interests.“They made a lot of money working for the government implementing ‘zero Covid,’” Huang said of labs and test manufacturers.Just how disruptive the collapse of testing and all the employment associated with Covid controls will be to China’s economy remains to be seen. The lifting of “zero Covid” will remove constraints on economic activity, and that could spur growth that would overshadow the loss of Covid-related businesses, said Taylor Loeb, a senior economic analyst for Trivium China, a consulting firm.“A lot of these jobs were never going to be long-term, stable employment opportunities,” Loeb said.To many migrant workers, the timing could not be worse. Employees are usually eyeing bonuses and counting their savings in the weeks leading up to Lunar New Year so that they can travel home for the holiday, settle debts and lavish their family and friends with gifts.In Hangzhou, a tense standoff between the police and hundreds of workers at an Alltest Biotech factory devolved into a shoving match Jan. 9, a video showed. Dozens of them were taken away by the police, several eyewitnesses said in interviews.Workers hired by a temporary employment agency on Alltest’s behalf had complained they were being paid less than permanent workers, according to an employee interviewed at the factory gate, who spoke on the condition of anonymity because of the sensitivity of the matter. An employee who answered a phone at Alltest said operations had returned to normal, but declined to provide a name or discuss the unrest.
Union Health Minister Mansukh Mandaviya on Wednesday said the Omicron sub-variant, BF.7, has been found in several of the 200 Covid-positive samples of international air passengers that have so far been genome-sequenced.More than 15 lakh international air passengers have so far been screened and 200 of them have tested positive for COVID-19, Mandaviya said on the sidelines of a book launch.The minister released a book titled “Braving A Viral Storm”, which has been authored by Aashish Chandorkar and Suraj Sudhir, at the Constitution Club here on Wednesday.“The genome-sequencing of the 200 samples showed that the BF.7 variant was present in several passengers. Our vaccines are effective against this sub-variant,” he said.The health ministry had, on January 9, said the sentinel-sequencing of 324 Covid-positive samples lifted from the community between December 29 and January 7 had revealed the presence of all the Omicron variants, such as BA.2 and its sub-lineages including BA.2.75, XBB(37), BQ.1 and BQ.1.1(5), among others.No mortality or rise in transmission was reported in the areas where these variants were detected, the ministry had said in a statement.Besides, XBB(11), BQ.1.1(12) and BF7.4.1(1) were the main variants detected in the positive samples of 50 international passengers that have so far been genome-sequenced
Serum Institute of India chief executive officer Adar Poonawalla on Sunday said its Covovax vaccine will get approval as a booster in the next 10 to 15 days, adding it works well against the Omicron variant of coronavirus.Speaking to reporters on the sidelines of an event at Bharti Vidyapeeth University here, Poonawalla, when asked about states and districts not getting Covishield vaccines, said there are ample stocks with the Union government for supply.“Covovax will be approved as a booster in the next 10-15 days. It is actually the best booster because it works very well against Omicron, more than Covishield,” said Poonawalla.He said everyone was looking at India, not just in terms of healthcare but because the country managed to take care of a huge and diverse population and also helped 70 to 80 nations during the COVID-19 pandemic.“This was all possible because of the leadership of our Central government, our state governments, healthcare workers, manufacturers, all of whom worked together with one common goal,” he said.Poonawalla was conferred the first Dr Pantangrao Kadam Memorial Award at the hands of NCP Chief Sharad Pawar and Deputy Chief Minister Devendra Fadnavis in an event to mark Kadam’s birth anniversary.Appealing to students who wished to pursue education abroad, he said there was no place like India to fulfil dreams due to the presence of institutions like Bharti Vidyapeeth and others.“Even if you have to go abroad, come back as soon as possible,” he said.
Top experts have reiterated the need to be vigilant and avoid panic as the US-based Centers for Disease Control (CDC) and Prevention indicates that the Omicron sub-variant XBB.1.5 has led to a rise in cases in the US.Experts have stressed the need for a higher genome-sequencing in the country as INSACOG (Indian SARS CoV2 Genomics Consortium) data has shown up five positive samples for the XBB.1.5 sub-variant. Says noted virologist, Dr Gagandeep Kang, “XBB.1.5 is now more than two-third of all cases in the USA. Since XBB and further sub-lineages have evolved in immunised populations, we should expect them to be able to infect more easily and that is what they are doing. Infection with BA.5 seems to give some protection against infection with XBB. There is not much difference with severe disease, so we can expect a fair number of infections. Severe disease will continue in known risk groups.”The XBB.1.5 variant of Covid is actually a sub-variant of XBB. It is a combination of BA.2.75 and BA.2.10.1 and was first reported in India.It is considered more contagious than BF.7, which is driving the current spate of infections in China. It has a greater immune-escape potential.According to Sanjay Pujari, member of the Indian Council of Medical Research (ICMR) task force, “the XBB.1.5 is a recombinant of the Omicron’s BA.2 sub-variants. This has originated in the USA and the rate of transmission (RT) is 1.8.Reports are indicating that most hospitalisations are in the elderly population and those who have not taken the booster dose vaccination. So far in India all five cases had mild illness and have recovered well.” He points out that one cannot generalise how geography-specific sub-variants will behave and hence genomic surveillance is important.Dr Rajesh Karyakarte, coordinator for genome sequencing in Maharashtra, explains that in the USA, a descendant of XBB — that is XBB.1.5 — is replacing the previously dominating BQ.1 and BQ.1.1 sub lineages. Currently XBB.1.5 is growing in New York ahead of others. “We have already seen in Maharashtra that XBB is the most dominant variant and has not allowed BA.5 and its sublineages like BQ.1 to dominate. XBB already has greater immune evasiveness than others and adds more mutations. For example XBB.1.5 ,” says he.In Maharashtra, no case of the XBB.1.5 sub variant has been recorded so far. Over the last several months, the state has already reported 270 cases of the XBB and top surveillance officer Dr Pradeep Awate told The Indian Express that there has not been a significant rise in cases. These are sublineages and overall the infection has been a mild one.Dr Shashank Joshi, noted endocrinologist and diabetologist at Lilavati Hospital, Mumbai, argues for vigilance as there seems to be no clinical correlation in terms of hospitalisation and deaths. “There should be no panic at all as all these are Omicron sub-lineages. However it is important to keep a check on cold, cough and respiratory illnesses which are common this time of the year,” he adds.
Thirty-year-old Tanu Dogra dreads getting another round of COVID-19 as she has had it three times already, during every wave, and has been left with battling a leftover symptom and a much compromised body that has meant making adjustments in her work life. “I don’t have it in me to take it anymore,” says Dogra, who has had cumulative weight loss (she weighed 75 kg and can rarely go above 60 kg over the last two years) episodes of brain freeze and forgetfulness, has 70 per cent taste and smell functions and crumbles in a heap after a moderate day at work. Twenty eight-year-old Srishti Sharma, who has also battled three rounds of the virus, dreads every seasonal change as she invariably gets fever, which shoots up to 103 degrees, a persistent cough that never goes away before a month and has patchy sleep. What makes their story different is that they didn’t come back from the brink or had to be hospitalized that could easily explain their long Covid effects. Their infection seemed symptomatically milder but had done an equal damage and left them with no immunity shield.As Dr Nikhil Modi, Consultant, Pulmonology and Respiratory Medicine, Indraprastha Apollo Hospital, says, “There is no concrete finding yet as to why certain people get recurrent infections but the genetic make-up of each individual is different as is their immunity. Some develop long-standing antibodies that can counter the virus, some do not. And as the coronavirus mutates rapidly, the changed strain may not be covered by antibodies already formed in the body. That, however, doesn’t mean that such people cannot control the infection once they get it. Recurrent COVID 19 infection is a new clinical entity and is rarely diagnosed. Research has shown it can occur due to reactivation of primary infection or reinfection by SARS-CoV-2 in patients who fail to develop antibodies against primary infection.”Also, studies on long COVID are ongoing and there is still no concrete finding if recurrent infections are part of long COVID. “What we do know is that long COVID lasts up to a year. And we are seeing COVID survivors become susceptible to other viruses as well, causing them to fall sick frequently.”Dogra, a publicist in the publishing industry had three bouts of Covid, during Delta (March-end 2021), Omicron (January 2022) and then Omicron which turned to a case of pneumonia onset in August-September 2022, the last being the least expected. “For context, I’m a primary caregiver for my father, who’s fighting an advanced case of pancreatic cancer and we frequent the hospital every week/fortnight. Therefore, we are more exposed to infections and Covid in general despite all precautions in place. Still, he got the infection once while I had it thrice. I was treated at home all three times and didn’t need oxygen. Except in the third episode, I had to be on nebulisation for a month,” says she.Describing her symptoms, Dogra says, “My symptoms in episode 1 were classic delta — high fever, shortness of breath, loose motions, body pains, no olfactory sense for over 45 days but I had no cough. Symptoms in episode 2 were much better as Omicron wasn’t meant to be challenging and by now, we’d had two doses of the vaccine. I had fever and cold for a week with some body pain. Symptoms in episode 3 started off mild but by the second week, I really struggled to breathe. When I complained of wheezing even while breathing normally, I was asked to get an HRCT again, which showed pleural thickening on both lungs with upper lobe that had a focal dense area. This resulted in nebulisation with steaming (as I suffer from sinusitis too) and steroids. Long Covid is not a myth and the third tryst made me realise how unfit my body was. I couldn’t sustain another hit if it were a possibility in the future. I had cumulative weight loss, forgetfulness, episodes of brain freeze. I struggled with work and memory in general and as a primary care giver to my father, it took a toll on me. It took me 65 days to recover from my third bout. I’m much better now but my appetite remains to be grey, and other health concerns continue, especially the lack of/failure to build immunity.”Doctors have never been able to give a satisfactory explanation for Dogra’s condition except that her immunity has been badly compromised. “I can no longer have three of my favourite foods, rice, coffee and potato, something I could gorge on every day. Now my belly churns thinking of them. My taste and smell come and go and are on good days about 70 per cent. My weight doesn’t go up at all beyond 62 and I definitely have lost the energy I had two years ago. My sinuses get activated at the smallest provocation,” says Dogra who has now opted for a hybrid routine for work . When she was laid up in bed during Delta, she had even coordinated COVID relief as an online volunteer.Sharma got infected with COVID-19 for the first time in March 2021. “I kept on testing negative but my symptoms wouldn’t disappear. I tested positive only after 21 days. Post- recovery in the first phase, frequent headaches and acute weakness stayed with me for over a month. The cough was not gone either. When I got infected the second time in December 2021, my fever was mild but I experienced heavy coughing. Not only that, I suffered major hair loss and peeling of dry skin. Got infected the third time in August, 2022 with mild manifestations and tested negative in five days. But my coughing wouldn’t stop and lasted a month,” says Sharma, who works with a hospital. Well-informed, she has done a chest CT to rule out lung disorders whenever she has had non-stop coughing bouts. “But they didn’t show up anything alarming. So I now manage my cough with gargles and steaming, live with it,” says she.Sharma, who has been fully vaccinated now, feels her immunity system has taken a permanent hit. “A very mild change in weather means I suffer from high fever, no less than 103 degrees with persistent coughing. I end up using my sick leaves this way. I certainly do not have the energy that I once had,” she adds. And after two years, life is still a limping struggle to get back to normal for these two young women.