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| Covid patients in the emergency room of a hospital in Shanghai (January 4, 2023) |
The Technical Advisory Group on Virus Evolution (TAG-VE), which focuses on the evolution of the novel coronavirus SARS-COV-2, issued a statement on Wednesday (January 4) on the discussion of the new coronavirus outbreak in China, introducing the virus gene sequencing data provided by Chinese scientists invited to participate in the debate on January 3.
According to the latest report, a senior WHO official said on Wednesday that China’s epidemic data did not accurately account for the epidemic situation, and seriously underestimated the number of severe hospitalizations and deaths from the new coronavirus infection. The WHO official’s comments come on the eve of the WHO’s preparations for another meeting with Chinese scientists on Thursday to discuss coronavirus data.
“We continue to ask China to provide more rapid, routine, and credible data on hospitalization and mortality,” WHO Director-General Tedros Adhanom Ghebreyesus said at a WHO online press conference on the 4th. WHO experts believe that the hospitalization and mortality data provided by China do not reflect the real situation, depressing the impact of the epidemic, especially the mortality rate.
Mike Ryan, executive director of WHO’s Health Emergencies Programme, told the media, “We believe that the latest figures released by China seriously underestimate the true impact of the new coronavirus disease in terms of hospitalization rates, intensive care rates, and especially deaths.”
Ryan stressed that the WHO believes the Chinese government’s definition of coronavirus deaths is “too narrow.”
“We still don’t have complete data,” Ryan said.
Last month, the Chinese government defined coronavirus-related deaths as pneumonia or respiratory failure caused by the coronavirus, prompting shockwaves among health experts around the world.
Since the CCP authorities suddenly announced on December 7 last year that they had lifted the strict “zero” epidemic prevention and control lockdown that had been strictly enforced for nearly three years, in just a few weeks, at least hundreds of millions of people across the country were infected positively, hospitals were overwhelmed, countless elderly people and people with underlying medical conditions died, and funeral homes and crematoriums were overloaded. However, China reports only five or fewer deaths per day. International health experts predict that China will have at least 1 million coronavirus-related deaths this year if urgent measures are not taken.
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| A man in a wheelchair guards a patient infected with the new crown in Tianjin’s Nankai Hospital. (28 December 2022) |
At the same time, WHO’s Technical Advisory Group on Virus Evolution meets regularly to discuss and review the latest scientific evidence on new coronavirus variants and provide recommendations on whether WHO should change its public health strategy. The group met Tuesday afternoon Geneva time and invited Chinese scientists to participate.
During the meeting, scientists from the Chinese Center for Disease Control and Prevention provided genetic data on what they called cases of foreign and indigenous novel coronavirus SARS-COV-2 infection, the statement said. For indigenous infections, the data provided by Chinese scientists is based on more than 2,000 complete sets of genetic sequences collected and sequenced since December 1, 2022.
Analysis by the Chinese Center for Disease Control and Prevention showed that the vast majority of local infections were Omicron lineages of BA.5.2 and BF.7, and genetic sequencing showed that these two Omicron subvariants accounted for 97.5% of indigenous infections.
Other known Omicron subvariant lineages have also been found, but at low rates, the statement said. These Omicron subvariants are known and have been circulating in other countries. At present, the Chinese Center for Disease Control and Prevention has not reported new subvariants.
As of January 3, 773 gene sequences from the Chinese mainland were submitted to the GISAID EpiCoV database (National Gene Bank Life Big Data Platform), most of which (564 sequences) were collected after December 1, 2022, of which only 95 were indicated as autochthonous cases of infection, 187 were foreign and 261 did not provide specific information. Of the autochthonous cases, 95% belong to the BA.5.2 and BF.7 lineages. This is consistent with genetic sequencing from Chinese arrivals submitted by other countries to the GISAID EpiCoV database. No known significant new variants or mutations were found in publicly available gene sequencing.
Hospitals in Shanghai remained overcrowded on January 5. A video released by Reuters on the same day showed that the corridors of Shanghai’s Tongji Hospital were crowded with patients and their families. At the same time, China’s external epidemic information and death data have caused widespread doubts around the world. Several countries have recently adopted stricter screening measures for inbound passengers from China.
While noting the information that has been shared so far, the Technical Advisory Group on Virus Evolution emphasized the critical need and importance of further analysis and sharing of genetic sequencing data to understand the evolution of the novel coronavirus and the emergence of mutations or variants of concern, the statement said.
The statement also said that this should be done regardless of whether a gene sequencing has been assigned a Pango lineage (phylogenetic assignment of named global outbreak lineages) (Pango lineages (phylogenetic assignment of named global outbreak lineages”). The best way to submit this data quickly and regularly to publicly accessible databases is the best approach.
The statement highlighted that maintaining a high level of representative genetic sequencing surveillance in China and globally, annotating genetic sequencing with clinical and epidemiological metadata, and rapid sharing of these data are the three pillars of timely global risk assessment.
The statement also said that the World Health Organization will continue to closely monitor the outbreak in China and globally, urging all countries to continue vigilance, surveillance and reporting sequencing, and independent and comparative analysis of different Omicron sublineages, including the severity of the disease caused by these subvariants.
The statement added that the Viral Evolution Technical Advisory Group is also assessing the rapidly increasing proportion of XBB.1.5 strains circulating in the United States and other countries, and will update the risk assessment of XBB.1.5 beyond previous statements. The Technical Advisory Group on Virus Evolution meets regularly and continues to evaluate data on transmissibility, clinical severity, and potential for immune evasion of variants, including potential implications for diagnosis, treatment, and effectiveness of vaccines against infection and prevention of severe disease.
Earlier, WHO Director-General Tedros Adhanom Ghebreyesus stressed on 30 December the importance of maintaining transparency and sharing data regularly. He said earlier that the WHO needed more detailed information in order to conduct a comprehensive risk assessment of the outbreak in China.
“In the absence of comprehensive information about the outbreak in China, it’s understandable that countries around the world are acting in ways they believe they can protect their citizens,” he said. ”
“Someone told me that the government’s single-digit death toll is completely ridiculous and implausible,” a citizen in Beijing told Reuters. Another Beijing resident expressed an understanding of measures taken by other countries to test travelers from China. A Beijing fever clinic visited by Reuters on the 4th and a nearby funeral home still seems to be busy. The number of new crown deaths reported by China on the 3rd was 5.
Meanwhile, scientists said they hoped China’s top experts would provide a “more realistic” report on the COVID-19 situation as concerns about the rapid spread of the coronavirus in China intensified.
China held two similar exchanges with WHO experts in the past nearly a month before Chinese scientists participated in a closed-door video meeting with the WHO Technical Advisory Group on the Evolution of Viruses on January 3, presenting data on variants circulating in China. WHO hopes to have a detailed discussion with China about the evolution of the new coronavirus, and looks forward to China regularly sharing specific and real-time data on epidemiology, including more genetic sequencing data, and data on the impact of diseases, including hospitalizations, intensive care unit admissions, and deaths. The conference is not open to the public or the media.
Reuters quoted several WHO committee members as saying before the Jan. 3 discussion that some data from China, such as hospitalizations, was “not very credible.” “It is in China’s own interest to provide more reliable information,”
Reuters said, adding that some experts also doubted China would be very candid. An expert in Singapore was quoted as saying he did not think China would be very sincere in disclosing data because transparency was an issue.
But just before the meeting, state-run media controlled by the Communist Party tried to downplay the severity of the surge in infections.
After China required strict multiple testing and long-term quarantine for arrivals in the past three years and even refused visas to some Chinese who wished to return to China for mourning, in the face of some countries worried about this round of epidemic outbreaks and requiring 48-hour nucleic acid testing and other temporary epidemic prevention measures for arrivals from China, Chinese Foreign Ministry spokesman Mao Ning on January 3 criticized “lack of scientific basis” and “unacceptable”, and threatened to “take corresponding measures in response to different situations and in accordance with the principle of reciprocity.” ”。
Meanwhile, Chinese experts were quoted as saying on Tuesday by the People’s Daily, the mouthpiece of the Communist Party, that for most people, the symptoms caused by the new coronavirus are relatively mild. Tong Zhaohui, vice president of Beijing Chaoyang Hospital, told People’s Daily that severe and critical diseases account for 3% to 4% of the infected people currently admitted to Beijing-designated hospitals.
Kang Yan, director of West China Tianfu Hospital at Sichuan University, said that in the past three weeks, only 46 patients had been admitted to intensive care, accounting for only about 1 percent of symptomatic infections.
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| Covid patients in the emergency room of a hospital in Shanghai (January 4, 2023) |
However, Reuters reported that a witness said the emergency department at Zhongshan Hospital in Shanghai was packed with patients. Some patients drip on their beds in hospital corridors, and many are waiting in line to see a doctor. It is not possible to verify how many of them are in need of treatment due to the coronavirus.
In addition, Bloomberg reported on Tuesday that a family in Shanghai waited five days before finding a funeral van to pull the remains of loved ones parked at home.
According to the report, a notice posted by Shanghai Longhua Funeral Home over the weekend indicated that the place received more than 500 bodies a day, about five times more than usual. After waiting for hours, families were taken in and out of the room like they were put on a conveyor belt, and each family was allowed only five to ten minutes to perform a simple farewell ceremony in a crowded room full of yellow body bags, completely devoid of the dignity of a traditional Chinese funeral.
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| Staff at a crematorium in Shanghai walk past several body bags of the deceased. (4 January 2023) |
A staff member at Longhua Funeral Home who answered the phone said the entire system was paralyzed beyond what it could bear. A similar situation is playing out in funeral homes and crematoriums across China. Grieving family members and exhausted workers show the impact of the “epidemic tsunami” on Chinese people and families when the Chinese authorities suddenly lifted the “zero” epidemic lockdown on December 7 last year.
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