Covid, China, variants and travel restrictions

Wow, I’ve managed to get through a long period without writing anything about COVID.  Whilst some people are still wearing facemasks and posting their test results and whilst others contiine to refuse vaccination, generally the subject has quietened down.

However, in the past few weeks, COVID debates seemed to have burst back into life again primarily due to China bringing its “Zero COVID” policy to an end leading to a fresh and overwhelming surge in cases there with concerns about a rising death toll.  Ending the zero COVID policy of suppression through lockdown has also included an end to pre-travel quarantining.  This, combined with the high case rate in China has led to some countries introducing new travel restrictions of their own on people coming from the People’s Republic.

One response I’ve seen to the China situation is that those who were always extremely suspicious of NPIs arguing that this proves that lockdowns were ineffective, expensive failures.  There are two problems with this. First, the approach in China to NPIs via very strictly enforced lockdowns is significantly different to what we experienced in the West.  Second, China has relied on a Zero-COVID policy of attempting to eliminate through suppression without the benefit of an effective vaccine policy.  There has been a much lower take up of the vaccine and the primary vaccine used has been China’s own which is considered much less effective than Pfizer, Moderna and AZ. 

A second response has been for some to push for Britain to introduce COVID quarantining for visitors from China in order to slow spread from there. Now, if the virus was contained within China’s borders, say if we were right back at the beginning of the pandemic then such measures may be of use. However, I’m not sure what benefit there would be from such measures given that COVID19 is endemic here and we’ve been enduring our own winter wave here.

One argument put forward for restrictions is that the high prevalence of cases in China may provide the perfect breeding ground for new variants that might evade vaccines.  However, there seem to be a few problems with the logic there. Megan Kall explains why, succinctly in this tweet.

In other words, the Chinese population has low immunity to existing variants because the majority of people have not yet been subjected to the virus due to lockdown measures or have received a vaccine which delivers low levels of immunity.  Therefore, alternative variants are less likely to gain a competitive advantage over existing ones through immunity evasion.  Furthermore, even if there is some immunity escape through mutation, it is unlikely to be total.  We would still have a level of immunity against serious illness should a new variant come on the scene, whether from here or from China.

Megan rightly argues that vigilience through sequencing is crucial and I understand there are concerns that China isn’t sharing enough data with world health authorities on this. Therefore, I agree with her that it makes sense for the UK to use its resources to try and track and sequence cases as they arrive here.

To respond to the situation with new travel bans, lockdowns, social distancing and masking would however be to try and fight today’s crisis using yesterday’s tactics.

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