As China is to see a significant spike in Covid cases and death toll, its top leaders must lead by example, taking booster shots publicly to encourage vaccination

Beijing should also waste no time approving foreign vaccines

Thought of the Day on China

Wang Xiangwei

A mixed bag of hopes and fears has driven the public discourse and private discussions in China ever since the Chinese leadership appeared to have abandoned the three-year-old controversial zero-Covid policy overnight following at least five days of unprecedented mass protests late last month.

Hope are rising that China is moving quickly to reopening after the central government has drastically relaxed the excessive controls measures which caused widespread grief and misery across the country over the past three years. The harsh pandemic controls including prolonged lockdowns, mass testing and contact tracing were dropped. A ubiquitous health code which contains a negative PCR test is no longer needed to enter public venue or travel except when entering hospitals, schools and homes for the elderly. People with mild symptoms or without symptoms as well as their close contacts are allowed to isolate at home instead of being forcibly sent to live in a central quarantine facility or a makeshift hospital. The government has renewed a push for the elderly to get vaccinated.

Meanwhile, fears are also rising that China is expected to experience a significant spike in confirmed cases and Covid-related death tolls in the next three months partly because the government is woefully underprepared and tens of millions of elderly people have not received a third shot for stronger protection against the Omicron variants. There are already reports of long queues at the fever clinics and an acute short supply of self-test Covid kits and fever medicine.

Judging from experiences of other countries, initial reopening is bound to trigger a spike in cases and chaos. The risks of the country’s hospitals being overwhelmed are still very real despite the fact that the majority of cases are mild. China, being the last major economy to reopen, should have learnt a great deal from experiences of other countries and made better preparations. But the truth of the matter is that the Chinese government is nowhere near ready. It has repeatedly ignored useful advice and suggestions from the international community, wasted so many opportunities and misspent trillions of yuan on mass testing and makeshift hospitals, not to mention the devastating impact on the overall economy.

A serious and comprehensive review of China’s public health system and its responses to health emergencies is inevitable.

Before that happens, China must waste no time in navigating a less messy exit from its zero-Covid policy.

In a meeting with European Council President Charles Michel this month, President Xi Jinping signaled he was ready to loosen China’s tight Covid controls, suggesting that the dominant Omicron variant was less lethal.

But he expressed concern about vaccinating the elderly as the vaccination rate among the most vulnerable group was not very high. According to media reports, only 68.7 per cent of people over 60 have had three doses of a Covid-19 vaccine, official figures show. For those aged 80 and over, only 40.4 per cent have had had a booster dose.

Much has been written about why vaccine hesitancy is pervasive among the elderly. Some are risk averse; many don’t trust domestically-made vaccines, and others believe they don’t need to because of China’s success in virus suppression controls.

But the biggest but less talked reason is that the Chinese government messed up its vaccination strategy right from the start. When China first started to roll out vaccines, the National Health Commission strongly recommended that only those people aged from 18 to 59 year old should be jabbed, giving distinct impression that the vaccines are not suitable for people over 60, particularly those with underlying medical conditions. Its main reason appeared to be that those people aged between 18 and 59 year-old would have to work and need protection against the virus while the elderly mostly stay home.

The NHC’s advice run counter to the prevailing practice in most countries where the priority is given to the elderly and other vulnerable groups. This has subsequently made it very difficult for the authorities to encourage the older people to get vaccinated.  

Another less talked but very indicative reason is that unlike the leaders in most countries where they were among the first group of people to get jabbed, often televised on national television to encourage vaccination and demonstrate the safety of vaccines, China’s top leaders whose ages are all above 60 are conspicuously silent on whether they have received vaccine shots.

In a country where leaders pride themselves on leading by example and tirelessly keep reminding people of this, their conspicuous silence on vaccine is telling and intriguing, resulting in conspiracy theories such as whether the senior Chinese officials trusted the domestically manufactured vaccines or whether they took Pfizer or BioNTech jabs while the government refused to import the western vaccines for the general use.

It was only in July when the Chinese officials confirmed for the first time that all the “incumbent” Communist Party and government leaders had completed the two-dose domestically manufactured vaccines, a claim the officials repeated again at a press briefing on Wednesday (December 7th). The deliberate use of the word “incumbent” means that the retired leaders who are mostly above 70 are not necessarily jabbed.

At this critical moment when China needs to launch a proactive campaign to encourage the elderly to receive a third or fourth vaccine shot for stronger protection on its way to reopening, China’s top leaders must learn from their foreign counterparts and lead by example by having the booster shots publicly, preferably televised on national television. That will go a long way to accelerate the vaccine campaign and boost the public confidence.

Wrong vaccine priority is not the only bad advice that NHC has given to the leadership.

For the past two years, the commission has focused only on inactivated vaccines and dragged its feet over approving protein-based vaccines even though studies have shown mixing the two different vaccines could produce stronger protection against the dominant Omicron variant.

For example, the China-based Clover Biopharmaceuticals has developed a protein-based vaccine which showed results superior to the inactivated vaccines but the commission only gave the nod for emergency use this month.

To further overcome the vaccine hesitancy, the leadership must set aside the politics and approve imports of the foreign vaccines and Covid treatment drugs as soon as possible.

On Friday, the foreign ministry confirmed that Beijing would allow BioNTech’s mRNA vaccine in the Chinese mainland but would limit its use to German nationals.

China’s reluctance to import any foreign-made Covid 19 vaccines for widespread use in the country make no sense.

There is nothing wrong with making China’s own vaccines a point of national pride but allowing imports of foreign vaccines will go a long way to accentuate China’s commitment to opening up to the outside world.

More importantly, those vaccines help protect and save people’s lives.

End.