The news almost every day reminds us of the draconian policies of the Chinese government with respect to the delayed emergence of the omicron variants of SAR-CoV2 now infecting segments of their population. I think that there are lessons for us in this Chinese experiment. The Chinese were fairly successful in using the tools of a totalitarian government to shut down the initial outbreak of COVID beyond Wuhan in 2020.
First, let us recognize that despite the waning efficacy of our mRNA vaccines over time, our vaccines were much more effective than the Chinese versions. There is limited data from China but this conclusion seems fairly straightforward.
Second, we in the West have tolerated and survived a fairly widespread pandemic which has led somewhere in the neighborhood of 60-70% of our population to get COVID infection and experience the partial protection of natural immunity. The Chinese through their “zero tolerance” policies have denied their population the protection of natural immunity and thus their population is much more vulnerable to the widening impact of the very contagious omicron variants.
Third, in our country, we have a growing consensus that infection from the omicron variants are not a significant risk to most of our population, albeit with a recognition that the elderly and immunocompromised remain at risk of serious complications and even death. Many of our most vulnerable are at less risk due to partial efficacy of vaccines and boosters or from natural immunity. The Chinese are responding to the outbreak of omicron variants based on the presumption that they put much of their population at risk of serious complications, which is likely a miscalculation. The draconian response with lockdowns has had serious economic side-effects and major protests from their population due to the stifling social impacts.
Why have the Chinese leaders responded in such an exaggerated manner? I believe that the Chinese have embraced “elite panic”, a term I learned in 2020 from Noah Rothman writing in Commentary Magazine. They were successful with the less contagious alpha variant, so why not try it again? All one needs to produce elite panic is to imbue self-appointed experts into positions of decision-making while ignoring the experience and actions of other equally intelligent experts in other locations. Another ingredient is to suppress dissenting opinions, a skill honed to near perfection in totalitarian countries. Gretchen Whitmer, Governor of Michigan, was a classic example of a leader who believed in the rightness of her onerous policies while ignoring lessons from Sweden and Florida and dissenting voices in her own state. The Chinese experts have recently just decided that the social costs of their strict lockdowns were probably not worth the risks seen in widespread resistance to government policies.
We have learned that the risks and costs of the pandemic have changed as the virus has mutated and the American public has acquired more immunity. The calculations have changed for parents of healthy children as the potential benefits of vaccines have lessened, unless in close contact with grandparents or an immunocompromised individual and the small risks become more intimidating. Some also wonder if the aggressive RSV and influenza seasons might be in some way resulting from too many COVID vaccines. On this last point, I remain unconvinced by any of the theories I have read on Substack or on line.
Lastly, let us look at Africa. In early 2021, when vaccines were first available in the USA and Europe, there was a groundswell of sincere efforts to make the vaccines available worldwide despite technologic and financial barriers. The most recent information from Africa, even understanding how much less accurate public health data is likely from these countries, suggests that the overwhelming majority of its citizens have experienced natural infection by COVID and have measurable natural immunity. In addition, it appears that COVID mortality is also much lower than in the Western First World. How can this be explained? Well, demographics provide some clue: there are far fewer extreme elderly in the Third Word and fewer immunocompromised individuals (cancer survivors and organ transplant recipients). Another possibility is that Africans have more robust immune systems due to a lifetime of repeated exposures to all sorts of pathogens - viral, bacterial, fungal and parasitic. For whatever reason, this disparity in outcome is a rich and attractive target for current and future study. I look forward to careful, comparative studies noting the differences in pandemic strategies and outcomes in the years to come.