China has recorded 2,000-3,000 new cases every day for the past week. The country’s zero-COVID policy has resulted in the population having a naive immune profile, because their exposure to different variants has been less compared to the rest of the world. This will give the virus many chances to mutate.

On 20th December, the union health ministry urged state governments to ramp up genome sequencing efforts of all positive test results. Barring China, the United States, South Korea , Brazil and Japan were also listed as countries recording a surge in COVID-19. Wearing masks and increasing booster uptake is advisable according to VK Paul, head of the national taskforce on COVID-19. No guidelines have been changed for international travel as yet.

China continues to strengthen genome monitoring but over the coming three months, 60% of China’s population is expected to get infected with COVID-19, experts believe. As per local reports, omicron sub-variant BF.7, which is not unique to China, is driving up the caseload in the geography.

According to Dr Vinod Scaria (scientist at the Council of Scientific and Industrial Research Institute of Genomic and Integrative Biology (IGIB) ) China has been an outlier on two key factors; immunity profile and human mindset given their strict approach until now. Use of poor vaccines along with waning immunity are not a strong defense against the extremely immune evasive omicron and its sublineages.

This is allowing the virus to spread uncontrollably in a susceptible, and aging, population.

But since the virus is circulating in a vulnerable population in China, the variant to emerge out of there “may not have the same fitness against hosts with prior infection from other variants of omicron,” according to Ryan Gregory, (evolutionary biologist and professor at the University of Guelp’s Biodiversity Institute of Ontario in Canada).

Having said that, human-animal interaction is high in China. The virus can easily jump to animals, mutate further in ways we can’t predict right now, and come back into humans. A One Health which recognizes the interconnection between people, animals, plants, and their shared environment is needed to tackle the current situation efficiently.

Models have estimated one million COVID-associated deaths in the wake of the country giving up its zero COVID policy. However, its National Health Commission made it clear on 20 December that only those dying of respiratory failures will be counted as COVID deaths, excluding anyone with comorbidities who succumbs to the virus.

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