New study finds that lifting Zero-COVID in China caused 1.4 billion infections and up to 2.6 million deaths

A significant study published July 1 in Nature Communications sheds light on the horrific wave of COVID-19 infections and deaths that swept across China last winter after the Chinese Communist Party (CCP) abruptly ended its life-saving Zero-COVID policy. The study, titled “Swift and extensive Omicron outbreak in China after sudden exit from ‘zero-COVID’ policy,” is the most comprehensive model published to date detailing the impacts of the rapid lifting of all mitigation measures, testing, and reporting of cases.

On November 11, 2022, China began to lift its longstanding Zero-COVID policy, instead adopting a suite of 20 measures that could be characterized as a stringent mitigationist strategy. City-wide lockdowns were replaced with targeted, smaller-scale lockdowns. Travel restrictions were partially lifted, and compulsory mass testing and reporting were ended. Contact tracing was limited to direct contacts of infected persons, and quarantine periods were shortened.

On December 7, all core public health measures associated with Zero-COVID were fully lifted. Lockdowns were prohibited, all contact tracing was stopped and quarantining at home was encouraged instead of at a centralized location. Testing and reporting became voluntary.

The study provides a granular breakdown of the respective effects of the November 11 and December 7 policy changes, showing how the highly transmissible Omicron BA.5 and BF.7 subvariants ravaged the population of 1.4 billion people after December 7 in particular. In this short time period of less than two months, an estimated 97 percent of the Chinese population (1.37 billion people) were infected.

The model-inferred daily cases (orange bands) during the three policy periods (zero-COVID, 20 Measures, and 10 Measures) near the end of 2022, and official case counts (points). Shades of orange show the median, 50% credibility interval (CrI), and 95% CrI. [Photo by Goldberg, E.E., Lin, Q., Romero-Severson, E.O. et al. / CC BY 4.0]

Due to the drastic decline in COVID-19 testing and reporting starting on November 11, the official figures quickly became inaccurate. Thus, the study draws data from online surveys conducted by a website for the Chinese health authorities on December 26. The authors note:

We developed a modeling approach that integrates both the official case count data before Nov 11 and the December survey data to reveal a more complete picture of the dynamics of SARS-CoV-2 before and after the dismantling of zero-COVID. Extensive sensitivity analyses confirm that our conclusions are robust to many assumptions about the data and model, and our findings are validated by comparison against two other independent datasets.

The study found that the December 7 full lifting of Zero-COVID caused a precipitous increase in transmission, reducing the total infection doubling time from 4.7 days to 1.6 days, producing these shocking figures:

Our results suggest that on Dec. 7, the day when full exit from zero-COVID was announced, there were ~1 million new infections. Because of the extremely high rate of spread afterwards, the outbreak ballooned such that 97% [95%, 99%] of the population (i.e., 1.37 billion people) became infected in December. As a result of the exponential nature of the spread, the vast majority of people (88% [83%, 93%] of the population) became infected during the short window of time between Dec. 15 and 31, 2022….

With an infection fatality ratio between 0.1 and 0.2% for the Omicron variant, we would expect between 1.3 and 2.6 million COVID-19 deaths in China during Dec. 2022 as well as Jan. 2023 (because of the delay from infection to death).

The conclusions of the study validate the continuous warnings made by the World Socialist Web Site on the dangers of lifting Zero-COVID. On November 15, the WSWS was the first outlet in the world to note that the CCP was initiating the process of lifting Zero-COVID, after over a year of intense pressure from Western governments and corporate media outlets. We warned, “There is no scientific justification for this move, which is based solely on political and economic considerations. In the coming days and weeks, the situation could quickly spiral out of control, particularly in places with lower vaccination rates.”

In the first of many Perspective statements on the lifting of Zero-COVID in China, we deepened these warnings and advocated for the reversal of this policy change, noting:

[T]he objective laws of viral transmission could quickly spiral out of control. Any shift away from a Zero-COVID elimination strategy carries with it the potential for a monumental catastrophe…

The lifting of Zero-COVID is a political question which confronts the entire world’s population. Allowing the virus to spread in this immunologically naive population could provide it with over 1 billion new hosts in which it could further mutate and spawn new variants. This reactionary policy change in China thus poses the need for workers internationally to renew their struggle against the policies of their own governments and to unify across national boundaries.

These warnings by the WSWS were developed throughout November, as we continued to advocate the full deployment of all available public health measures. Examining the time period between November 11 and December 7, the study makes clear that it was still possible to reverse the lifting of Zero-COVID and contain the growing outbreak.

Throughout the first phase of scrapping mitigation measures, the “20 measures” phase, the CCP still could have reversed course. But the government and media downplayed the dangers as the number of infections grew. The dramatic increase in cases that occurred as the “10 measures” phase began on December 7 shows how quickly the situation became catastrophic.

The emergency ward of a hospital in China, January 3, 2023. [AP Photo/Andy Wong]

Fundamentally, the lifting of Zero-COVID was not done in the interests of public health, but in response to enormous financial and geopolitical pressures from the imperialist powers and growing opposition within sections of the Chinese ruling class and upper middle class.

The tipping point that prompted the November 11 transition away from Zero-COVID came when multinational corporations, including Nike and Apple, threatened to move their business out of China. Then, in late November a series of small, choreographed protests against Zero-COVID were trumpeted in the bourgeois media internationally.

The CCP seized upon these “white paper” protests against Zero-COVID to fully implement a policy they were already intending to carry out. In this, they were supported by virtually every pseudo-left political tendency in the world, who share with the protesters a social base among the upper middle class.

The latest study on China’s first COVID-19 wave was published roughly one month after the World Health Organization (WHO) and US President Joe Biden rescinded their COVID-19 public health emergency declarations. At the behest of global finance capital, capitalist world governments have demanded that there be no interruptions in the process of wealth accumulation regardless of the cost in human life. The Western media, after continuously demanding the end of Zero-COVID in China, has now dropped the subject of the pandemic altogether.

The study, which was first submitted on March 7, contains the following statement warning about a second wave of the pandemic in China:

A slower epidemic wave would help to ease hospital burden, allow sufficient health care for infected people, prevent epidemic overshoot (i.e., a large final epidemic size because of rapid spread), and ultimately reduce the number of deaths. Such considerations may be of renewed importance later in 2023, when the large cohort of people infected at the end of 2022 may become susceptible to reinfection.

This second wave is currently ripping through China just as the study was published, while the government and the media are working to cover it up. The WSWS recently published a four-part series on this second wave, by far the most comprehensive report on this ongoing catastrophe.

The experience of the COVID-19 pandemic has made clear that world capitalism is unwilling and unable to implement the necessary public health measures globally in order to stop the spread of this preventable illness, as well as future pandemics that may appear. The capitalist system is incompatible with sustaining life on this planet, and the working class must mobilize to implement a scientifically based socialist society. Only through the building of a world socialist society, in which human needs take precedence over private profit, will public health be restored.