Are COVID travel curbs on China making the world safer? | Coronavirus pandemic

With China lifting its strict zero-Covid lockdown policy, infections are on the rise across the country. Hospitals are full and crematoria are struggling to cope as the bodies come in.

In response, dozens of countries, from the United States and Europe to Asia and Africa, have imposed a series of restrictions on travelers from China. The United States, many European nations, India, Japan, South Korea and Ghana, among others, require travelers from China to show negative COVID-19 tests before boarding flights. Some are insisting that these passengers should be re-tested upon landing and quarantined if they test positive.

Japan has also limited the number of flights from China. South Korea stopped issuing tourist visas to Chinese visitors in early January. Morocco has temporarily banned the entry of visitors from China, regardless of their nationality.

In response, China suspended short-term visas for South Koreans and Japanese visitors, evoking visions of a return to the chaotic travel landscape of 2020 and 2021, when individual nations imposed patchy restrictions on each other with little global coordination. On January 29, China announced that it will restore visas for Japanese citizens.

The United States, European Union countries and many others have justified measures aimed at protecting their citizens. However, in an interview with England’s LBC radio, UK Transport Secretary Mark Harper recently acknowledged another potential rationale for these policies: to encourage Beijing to be more transparent about data on the COVID surge by increasing the consequences of opacity.

But what does science say? Will restrictions on Chinese travelers make the world safer?

Short answer: Scientists told Al Jazeera that there is little evidence that the restrictions will either significantly affect the number of COVID-19 cases in other countries or affect the spread of new variants. But the policies could work to pressure China to be more transparent.

Patients are given an intravenous drip in an emergency department in Beijing, China.
Patients are given an intravenous drip in an emergency department on January 19, 2023 in Beijing, China. Since December, China’s surge in COVID-19 cases has strained the country’s medical infrastructure. [Andy Wong/AP Photo]

Will China’s deadly wave spread?

China has been struggling to contain the rapid spread of the virus since it eased strict restrictions after massive protests in December. Between December 8 and January 12, hospitals across the country reported nearly 60,000 deaths from COVID.

A recent forecast from the University of Washington’s Institute for Health Metrics and Evaluation estimates that the lifting of zero-Covid regulations could kill nearly 300,000 people by April and a million more by the end of the year.

Other governments have expressed concern about travelers from China bringing the virus with them. Italy, for example, implemented the new rules after two flights from China disembarked after nearly half of the passengers on board tested positive for COVID-19. The Korea Agency for Disease Control and Prevention said the number of people carrying the virus from China to South Korea rose from just 19 in November to 349 in December.

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However, multiple meta-analyses – comparing several different types of studies – have shown that such measures are most effective during an outbreak, where they can slow the spread of the virus.

Travel restrictions have only worked alongside domestic policies such as strict mask mandates, social distancing and lockdowns since the infection became widespread around the world. Few today have the patience or appetite for such internal regulations, Summer Marion, a lecturer and researcher in global studies and health policy at Massachusetts-based Bentley University, told Al Jazeera.

Most countries targeting visitors from China have eased mask mandates and other restrictions on their populations even as they grapple with significant workloads. For example, the US averages more than 40,000 new cases per day.

Epidemiologist Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the visibility of the response to the crisis in China in the eyes of its own citizens may be a factor influencing the actions governments take. .

According to experts, the science is probably not.

“Even if every traveler from China tested positive,” it would represent only a small fraction of the total COVID-19 burden in the United States today, said Karen Anne Grapen, an associate professor at the University of Hong Kong. Public Health.

South Korea, for example, reported 31,106 new cases between January 14 and 21 — nearly 100 times the monthly figure of 349 Chinese COVID-positive travelers that prompted it to impose restrictions.

But the US CDC cited another concern in explaining the travel restrictions: the potential emergence of “new variants.”

Passengers from China walk through a COVID-19 testing center at Incheon International Airport in Incheon, South Korea.
Passengers from China walk past a COVID testing center at Incheon International Airport on January 10, 2023 in South Korea. [Ahn Young-joon/AP Photo]

Can borders stop the new variant?

So far, there is no evidence that the rise in cases in China is due to any new variant of the virus.

On January 4, the World Health Organization (WHO) reported that data from China showed that more than 97 percent of all new cases were from two known subvariants of the Omicron coronavirus strain.

The EU’s European Center for Disease Prevention and Control also recently concluded that “variants circulating in China are already circulating in the bloc’s countries” and “do not challenge the immune response” of their citizens.

To be sure, this does not mean that new variants cannot mutate from existing ones, as infections remain high in China. The US CDC cited this risk when announcing travel restrictions.

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“If we believe what public health officials are telling us,” the travel restrictions “are intended to stop the importation of potential new variants that may still be developing in China but have not yet been established,” Grepin told Al Jazeera.

According to him, this reasoning is empty. China isn’t the only country to have seen a recent surge in cases — Japan and South Korea saw spikes in infections last year — but it has been the only country hit by travel measures. There is little evidence to suggest that China is at significantly higher risk of deploying new variants.

Grapepin noted that the new variant currently spreading like wildfire in the United States and possibly spreading from the United States to other countries is the Omicron subvariant US XBB.1.5, which was first detected in New York.

In late 2021, when Omicron itself was new, Grépin argued in an opinion piece for the Washington Post that Western travel restrictions on South Africa — where it was first found — and other African nations would be ineffective. By the end of December 2021, Omicron had indeed become the dominant option in the US, despite tighter border controls.

Peter Chin-Hong, a professor of infectious diseases at the University of California San Francisco Department of Health, said the new variants today are cause for less concern than at the beginning of the pandemic.

“You can give me the Doomsday option,” Chin-Hong said, “but it won’t have the same effect as it did at the beginning of the pandemic.” That’s because “the population is in a very different place with multiple vaccinations, boosters and natural waves of infection,” Al Jazeera said.

Drugs such as Paxlovid and Remdesivir, which are widely available today, also help. They are highly effective in preventing the worst complications from new viral variants because they target enzymes that are essential for viral replication, regardless of the variant.

Experience with past public health crises like Ebola also shows that, in addition to dealing with new and localized outbreaks, travel restrictions work better against diseases with severe, rapid onset of symptoms, Chin-Hong said.

COVID-19, with its low infection rate, long latency – symptoms can appear days after a person is infected – and wide global spread do not meet these conditions. A passenger who tests negative can still carry the virus.

According to experts, there is another reason why countries impose strict rules on travelers from China.

German Health Minister Karl Lauterbach, along with North Rhine-Westphalia Health Minister Karl-Joseph Laumann and Lower Saxony Health Minister Daniela Behrens, hold a press conference to comment on the imposition of COVID-19 restrictions on travelers from China and hospital reform.  Federal-State meeting, Berlin, Germany, 5 January 2023.  REUTERS/Annegret Hilse
German Health Minister Karl Lauterbach, center, speaks about travel restrictions on visitors from China, Berlin, Germany, January 5, 2023 [Annegret Hilse/Reuters]

Will China be open to information?

Beijing, for its part, called the restrictions “discriminatory”. But other governments and experts argue that China has only itself to blame.

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The US has reportedly offered vaccine doses and other aid to China. But he insisted his vaccine and medical supplies were adequate and “the COVID situation is under control.”

Osterholm of the University of Minnesota told Al Jazeera that Beijing’s position is not credible.

China has, in many ways, kept the world in the dark about the COVID-19 data. It has often been accused of reporting COVID deaths only as deaths from underlying conditions aggravated by the virus. Even his latest estimate of a sharp spike in deaths in December and January is far below reality, many experts fear.

“Right now, I’m getting more intelligence from China, from news reporters on the ground or from private sector companies [than from the government]”said Osterholm. Either way, the picture is one of an undervaccinated population with inadequate supplies of appropriate antiviral drugs, compromised by ill-prepared reversals of zero-COVID policies.

So even if the current testing and travel restrictions in place in China have little chance of affecting outbreaks in other countries, there is still something that governments around the world can achieve through these measures. “The only thing left is to encourage the Chinese authorities to share more information and do more sequencing of the virus,” Chin-Hong said.

The US CDC hinted as much in its initial announcement of the new travel restrictions, highlighting the “lack of adequate and transparent epidemiological and viral genomic sequencing data” by China. The WHO also cited China’s lack of information transparency to call the travel restrictions “understandable.”

Pressure can produce some results.

Since late December, China has dramatically increased contributions of genomic data to the Global Initiative for Sharing Avian Influenza Data (GISAID) sequence database, allowing scientists from elsewhere to better study the nature of infections in China. It only submitted 52 sequences between December 1 and 24, but it submitted 540 over the next six days. According to GISAID, the pattern continued into January: China submitted 2,641 sequences over the past four weeks.

Many experts, such as Marion of Bentley University, are reluctant to attribute measures aimed at travelers from China to a single motivation. However, transparency appears to be a key incentive – making these initiatives examples of data-driven policies rather than data-driven policies.

Nevertheless, two things are clear. First, Osterholm said, “If you can’t control the country where people are going, you won’t control your border.” Second, a more transparent China would only bode well for the world’s response to COVID-19.


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