Child hospitalizations soar across China one year after the lifting of Zero-COVID

In recent weeks, pediatric hospitals across China have been inundated with patients suffering from a variety of respiratory illnesses, causing growing alarm across the country and internationally.

The public health crisis in China began in mid-October and has only worsened. On October 23, a social media post from a parent in the Pediatrics Department at Tianjin Medical University General Hospital noted that there were 100 people in line, and they had to wait for three hours for their child to be seen by a doctor. A comment replying to the post stated that more than 900 patients were in line at the door of Tianjian’s Children’s Hospital, while another noted that more than 2,000 children were then on intravenous therapy at Beijing Children’s Hospital roughly 85 miles away.

A man comforts a child at a children's hospital in Beijing. [AP Photo/Dake Kang]

By mid-November, there were growing reports of schools being forced to close due to the spread of disease. Under a November 13 social media post on schools closing in Shenzhen, numerous comments were left sharing similar experiences from Yunnan, Shandong, Beijing, Guangdong, Jilin and Hebei.

Over the past week, reports have indicated a further deterioration of the situation.

On November 19, officials at the China-Japan Friendship Hospital in Beijing announced, “The number of patients waiting to be seen in pediatrics now exceeds 400, and the wait time is estimated to be over 6 hours. We suggest going to nearby pediatric clinics to help reduce the pressure here.” Similar wait times and experiences were reported at Capital Institute of Pediatrics in Beijing, as well as other hospitals throughout the country.

It is not yet clear what pathogen or pathogens are responsible for the deluge of child hospitalizations, but government reports are stating that the primary infection spreading has been mycoplasma pneumoniae, as well as influenza, adenovirus, respiratory syncytial virus (RSV), and SARS-CoV-2, the virus that causes COVID-19.

There is also speculation that the spike in hospitalizations could be attributable to the fact that mycoplasma pneumoniae is acquiring resistance to the macrolides class of antibiotics. In recent years, China has experienced a greater degree of antibiotic resistance than most countries, with reports that Zithromax, the most widely prescribed macrolide in the country, is now ineffective in up to 80 percent of children.

Finally, there are also concerns that a dangerous novel pathogen or influenza, A/H9N2 (bird flu), could unknowingly be spreading due to inadequate public health surveillance in China. The possibility of H9N2 circulating was raised by Epiwatch, an Australia-based artificial intelligence-driven pandemic early warning system, which detected reports of possible H9N2 infections.

On Tuesday, the Program for Monitoring Emerging Diseases (ProMED), one of the largest publicly available emerging diseases and outbreak reporting systems in the world, published an abridged version of a report on the crisis from Taiwan-based media outlet FTV News, with commentary from ProMED Rapporteur Dan Silver.

The FTV News report described the growing crisis in Beijing and Liaoning, which are separated by 800 kilometers, stating, “With the outbreak of pneumonia in China, children’s hospitals in Beijing, Liaoning and other places were overwhelmed with sick children, and schools and classes were on the verge of suspension. Parents questioned whether the authorities were covering up the epidemic.”

The article quoted a Beijing citizen who stated, “Many, many are hospitalized. They don’t cough and have no symptoms. They just have a high temperature (fever), and many develop pulmonary nodules.”

The report went on to note, “Some school classes have even been canceled completely. Not only are all students sick, but teachers are also infected with pneumonia.”

Commenting on this report, Silver wrote:

This report suggests a widespread outbreak of an undiagnosed respiratory illness in several areas in China as Beijing and Liaoning are almost 800 km apart. It is not at all clear when this outbreak started as it would be unusual for so many children to be affected so quickly. The report does not say that any adults were affected suggesting some exposure at the schools. ProMED awaits more definitive information about the etiology and scope of this concerning illness in China.

It is too early to project whether this could be another pandemic but as a wise influenza virologist once said to me “The pandemic clock is ticking, we just do not know what time it is.”

In response to this report and the lack of adequate data from Chinese officials, on Wednesday the World Health Organization (WHO) submitted “an official request to China for detailed information on an increase in respiratory illnesses and reported clusters of pneumonia in children,” as documented in a WHO press release the same day.

Reviewing the immediate background to this crisis, the WHO statement notes:

At a press conference on 13 November 2023, Chinese authorities from the National Health Commission reported an increase in incidence of respiratory diseases in China. Chinese authorities attributed this increase to the lifting of COVID-19 restrictions and the circulation of known pathogens such as influenza, mycoplasma pneumoniae (a common bacterial infection which typically affects younger children), respiratory syncytial virus (RSV), and SARS-CoV-2 (the virus that causes COVID-19). Authorities stressed the need for enhanced disease surveillance in healthcare facilities and community settings, as well as strengthening the capacity of the health system to manage patients.

The WHO added:

On 22 November, WHO requested additional epidemiologic and clinical information, as well as laboratory results from these reported clusters among children, through the International Health Regulations mechanism. We have also requested further information about recent trends in the circulation of known pathogens including influenza, SARS-CoV-2, RSV and mycoplasma pneumoniae, and the current burden on health care systems. WHO is also in contact with clinicians and scientists through our existing technical partnerships and networks in China.

On Wednesday, the official local Beijing government website posted an article reporting that “Beijing’s CDC deputy director and chief epidemiologist Wang Quanyi said that judging from the number of visitors to the Children’s Hospital and Capital Institute of Pediatrics outpatient, the spread of mycoplasma pneumoniae has declined to fourth in ongoing children’s respiratory infectious diseases. Ranked in the top three are the influenza, adenovirus and respiratory syncytial virus.”

The report added, “Wang Quanyi said that due to the simultaneous spreading of multiple pathogens, there will be an upward trend in the overall number of infections, which may lead to a prolonged plateau period where the number remains high. This will also give rise to an increase in healthcare demand. Healthcare organizations need to be prepared to cope with such pressure.”

The lifting of Zero-COVID and the collapse of public health

It remains to be seen precisely what pathogens are now spreading across China and why so many children are being hospitalized, but the underlying cause of this crisis is undoubtedly the collapse of public health in China and internationally over the course of the ongoing COVID-19 pandemic.

As noted in the November 13 briefing by the Chinese National Health Commission, the present surge of respiratory infections is directly attributable to the lifting of the Zero-COVID policy one year ago.

While they do not state this, the fact is that this comprehensive public health elimination program was incredibly successful at stopping the spread of SARS-CoV-2 and had the unintended byproduct of drastically limiting many other respiratory pathogens. This phenomenon was seen throughout the world in 2020 and much of 2021, when even limited mitigation measures are believed to have eliminated the Influenza B/Yamagata family of flu viruses, while nearly eliminating other strains of influenza, as well as RSV.

Chart showing the number of confirmed weekly RSV infections in the US, from October 2020 to October 2022.

Outside of China, the total scrapping of all mitigation measures in response to the emergence of the Omicron variant in November 2021 led to the mass infection and reinfection of the majority of the global population with SARS-CoV-2 and a resurgence of RSV, influenza, adenovirus and other pathogens. One year ago, in the aftermath of this ending of all semblance of public health, a similar horrific wave of child hospitalizations ripped through the United States and many other countries.

The universal response of the bourgeois media and political establishment was to do nothing to improve public health and prevent the spread of these pathogens. Rather, they proclaimed that the youngest generation had simply accrued an “immunity debt” during months or even weeks of lockdowns in 2020 and limited mitigation measures through 2021. Significantly, this baseless right-wing term “immunity debt” is now circulating on social media in China.

At the time, immunologist Dr. Anthony Leonardi debunked this unscientific claim, writing, “We mustn’t delude ourselves into thinking infections actually confer a benefit or are a debt that must be paid. They are more like a tax we make the children pay for our civilization not being developed enough to prevent viral illnesses that hospitalize thousands of children per year.”

Dr. Leonardi drew attention to the large body of research demonstrating that COVID-19 can cause significant damage to one’s immune system.

The Chinese Communist Party (CCP) abruptly lifted Zero-COVID in China in November-December 2022, in response to a ruthless offensive by US and European corporations, including Nike and Apple, who threatened to shift production to India and other countries. Serving as the guarantor of cheap labor for world capitalism and determined to maintain its own vast profits, the capitalist CCP regime sacrificed the health of the Chinese population to ensure that its relations with the West were not severed.

Every corporate media outlet, as well as those of the pseudo-left political parties which falsely claim to be socialist, propagandized on behalf of the Western imperialist powers in agitating for the lifting of Zero-COVID. Only the World Socialist Web Site and the International Committee of the Fourth International opposed this reactionary policy, calling for the expansion of a global elimination strategy utilizing all available public health measures to stop the pandemic once and for all.

The consequences of ending Zero-COVID were horrific, as the country’s 1.4 billion people were subjected to a catastrophic wave of mass infection and death, with estimates that nearly the entire population was infected by late December and between 1-3 million perished by late January.

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]

Since then, China experienced a second wave of mass infection in April-July 2023. After this, cases plateaued at a very high baseline, similar to that seen in the rest of the world after the second wave of mass infection with the Omicron BA.2 subvariant in spring 2022.

COVID-19 reinfections have now become ubiquitous in China. On October 15, the keyword “a fourth [COVID] infection” increased by a staggering 707,621 percent. Social media posts about fourth, fifth and even sixth infections are now increasingly common across the country. Every day, one can find multiple posts of new Long COVID patients suffering from often debilitating conditions, including extreme fatigue, neurological disorders, heart conditions, difficulty breathing and more.

In response to an online poll asking how many times people have been infected with COVID-19, 38 percent replied “once,” 38 percent replied “twice,” 15 percent replied “three times or more” and only 9 percent replied “never.” Given that this poll was conducted by a blogger who advocates strict protection against COVID-19, the percentage of people who have never been infected or only infected once is likely much higher than in the general population.

With what is known about the damage that COVID-19 can cause to the immune system, the mass infection and reinfection of the entire Chinese population is undoubtedly a contributing factor to the present spike in child hospitalizations.

Fundamentally, what is required is the prevention of disease transmission, including that of SARS-CoV-2, mycoplasma pneumoniae, influenza, adenovirus, RSV and all other infectious diseases, both within China and internationally.

Significantly, all of the diseases identified so far as spreading in China are respiratory pathogens known to spread through airborne transmission. Thus, the modernization of ventilation systems and the universal use of N95 masks in indoor public places would rapidly reduce the present disease burden. Combined with mass testing, contact tracing and other public health measures, these viruses could quickly be eliminated in China and throughout the world.

Such a global elimination program, for all of these pathogens and more, requires a vast expansion in public health funding and resources. The experience of the COVID-19 pandemic has proven that nothing short of the socialist reorganization of global society will ensure that such resources are provided. The ICFI is the only political party in the world fighting for such a socialist public health program, and we urge all those in China and globally who support this program to contact us today.