As China’s herd immunity wanes, citizens navigate living with Covid-19

Nearly six months since China abruptly lifted some of the strictest Covid-19 restrictions in the world, there remain concerns of a second wave amid waning herd immunity, even as the country attempts to coexist with the virus.

Elizabeth Law

Elizabeth Law

The Straits Times

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Given waning immunity, it is likely that the virus will persist as China settles into an endemic state. PHOTO: REUTERS

May 18, 2023

BEIJING – For the past three weeks, social media executive Ava Shen has avoided gatherings and crowded spaces, shuttling only between her home and the office while wearing a mask as much as possible.

She has been trying to minimise her social interactions. The 26-year-old, who is not vaccinated against Covid-19, is worried about catching the infectious disease a second time.

Nearly six months since China abruptly lifted some of the strictest Covid-19 restrictions in the world, there remain concerns of a second wave amid waning herd immunity, even as the country attempts to coexist with the virus.

“I was sick for nearly 10 days the first time round and it was the worst experience of my life because we couldn’t even see a doctor or get medication,” Ms Shen told The Straits Times.

On Dec 8, Beijing suddenly announced that it was abandoning its zero-Covid policy, a combination of mass testing, flash lockdowns and travel restrictions, causing the virus to rip through China.

Hospitals were overwhelmed, with queues lasting for hours in the winter cold. Pharmacy shelves were emptied of cold and fever medications.

“If I can avoid going through that again, what’s a few weeks of living like it’s 2022?” Ms Shen said, referring to last summer, when much of Beijing was put under lockdown amid a spate of infections.

Currently, about 25 per cent of fever cases in clinics around Guangzhou have tested positive for Covid-19, said top Chinese expert Zhong Nanshan on Monday. He added that serological testing suggests that up to 1.2 billion of China’s population of 1.42 billion have already been infected.

With an end to mandatory testing, the official figures merely provide a snapshot of cases in the country.

According to official data, new infections hit 6,752 on April 27 alone, the highest number of daily cases since Dec 25. But only 19 of these patients were severely ill.

The spike was expected, since natural immunity among the population from vaccines and prior infections is believed to have reached its lowest point in late April, said deputy director of the Department of Infectious Disease Prevention and Control Liu Qing during a May 8 media briefing.

“However, it is unlikely that there will be a large-scale regional epidemic, and it will not have a significant impact on medical facilities and society in the short term,” she said.

The authorities, however, have cautioned that the elderly and vulnerable are still at risk and are encouraging a third shot even after an infection.


Currently, about 25 per cent of fever cases in clinics around Guangzhou have tested positive for Covid-19. PHOTO: REUTERS

According to the latest available data from Jan 14, more than 3.4 billion shots of Covid-19 vaccines have been administered. These are largely domestically produced inactivated virus vaccines, widely believed to be less effective than foreign-made mRNA types.

Professor Adam Kleczkowski, who specialises in mathematical biology at the University of Strathclyde in Scotland, said that given the waning immunity but with little public appetite for lockdowns, it is likely that the virus will persist as China settles into an endemic state.

“We will see continuing multiple outbreaks per year, relatively small in magnitude and (probably lasting) a few weeks,” he added, noting that this is down to the Omicron variant causing less severe illness, as well as immunity.

Dr Huang Yanzhong, a senior fellow for global health at the Council on Foreign Relations in New York City, said that given that most of those infected for a second time are only mildly ill, the healthcare system is likely to be able to cope with subsequent waves.

“But the reshaping of the narrative about how successful the fight against Covid-19 was means there’s going to be a certain sense of complacency that doesn’t see anything wrong with the current system,” he told ST.

“And in an environment where focus is on economic recovery, with local governments now less fiscally sound, I worry that plugging the loopholes in the current healthcare system might not be done before the next pandemic.”

For some like retiree Ma Haixia, 51, who has neither been infected nor vaccinated, there was always little to worry about Covid-19 except the massive inconvenience that came with testing positive.

Previously, those infected and their close contacts would be hauled off to centralised quarantine and their homes would be thoroughly disinfected, while the rest of the neighbourhood would be put under a lockdown lasting up to two weeks.

Reports also emerged of health workers killing house pets during the disinfection.

“Right now, it’s just like getting the flu. So, honestly, even if there’s a new wave, I’m just going to live my life normally,” said Madam Ma.

“We spent our last three years living in fear. We can’t go on like that – it’s a waste of our lives.”

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