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Current Covid wave may lead to new variants, warn Chinese health experts

By K J M Varma
December 21, 2022 20:30 IST
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Chinese health experts have warned that a new wave of coronavirus infections that have hit China may result in new variants, prompting authorities to set up a nationwide network of hospitals to monitor mutations of the deadly virus.

IMAGE: A medical worker administers a dose of a vaccine against coronavirus disease to an elderly resident, in Zhongmin village on the outskirts of Shanghai, China December 21, 2022. Photograph: Brenda Goh/Reuters

Wang Guangfa, a respiratory expert from Peking University First Hospital, warned that Beijing may experience a spike in severe COVID-19 cases over the next fortnight.

Engulfed by the latest wave, medical resources in the capital city are facing additional stress. The city is set to soon face peak caseload, Wang told state-run Global Times.


Wang said ensuring there is no breakdown in medical resources is a key factor in raising success rates in treating critical COVID-19 cases.

"We must act quickly and prepare fever clinics, emergency and severe treatment resources," he said, adding that the primary action for hospitals is to expand ICU beds.

According to health officials, Chinese cities are currently hit by highly transmissible Omicron strains, mainly BA.5.2 and BF.7, which are spreading like wildfire.

Beijing is hit by the BF.7 variant of the Omicron virus, stated to be the fastest spreading coronavirus, causing havoc in the capital whose hospitals are overcrowded.

Reports also highlight the increasing rush at crematoriums in Beijing and other cities. Beijing has acknowledged seven deaths in the last few days.

Many Chinese pharmaceutical companies are operating at full capacity to meet rocketing demand for cold and fever medicines, and thanks to various measures taken by the government and firms, the shortages are easing, according to official media reports.

Also, public health experts, including top respiratory disease expert Zhong Nanshan, have warned that waves of Covid-19 infections in China over a short period of time might give rise to new variants of the virus.

After relaxing the zero-COVID policy restrictions following protests, China has stopped testing people.

Till early this month people needed to test almost every day to visit public places with negative test results.

With no testing now, concerns have been raised about whether it is possible to track any changes as the country battles a surge in cases at the same time as testing requirements have been scaled back.

To keep track of the emergence of new variants, the Chinese centre for disease control and Prevention has established a data-gathering network made up of one hospital in each city, and three cities in each province.

Xu Wenbo, director of the China CDC's National Institute for Viral Disease Control and Prevention, said each hospital is expected to collect samples from 15 patients in the outpatients and emergency room, 10 from patients with severe illnesses, and all fatalities.

Genomic data from the samples will be uploaded to the national database within a week for analysis and sequencing, laying out the distribution of any sub-lineages that may develop across the country, Xu was quoted as saying by Hong Kong-based South China Morning Post.

"This will allow us to monitor in real-time the dynamics of the transmission of Omicron in China and the proportion of its various sub-lineages and new strains with potentially altered biological characteristics, including their clinical manifestations, transmissibility and pathogenicity," he said.

"This will provide a scientific basis for the development of vaccines and the evaluation of diagnostic tools, including PCR and antigen tests."

Xu said more than 130 Omicron sub-lineages had been detected in China in the past three months, including several from the BQ.1 and XBB strains which have been circulating in the US, Britain and Singapore, among other countries, since October.

These are known to be highly evasive from immunity built from past infections or vaccination but do not increase disease severity. The World Health Organisation (WHO) has said the potential impact of the BQ.1 and XXB sub-lineages 'is strongly influenced by the regional immune landscape'.

While BA5.2 and BF.7 remain dominant in China, BQ.1 and its sub-lineage have been found in 49 cases in nine provinces, while XBB sub-lineages have been found in 11 cases in three provinces, Xu said.

There had been no increase in the rate of severe cases and no significant increase in the number of deaths as a result of these sub-lineages, he said.

Xu predicts that the spread of new sub-variants -- including BQ.1 and XBB -- will increase over time and mutations will continue. "As long as it circulates in the crowd, when it replicates, it will mutate."

But the possibility is low that a highly transmissible variant with a high disease severity will emerge, as none of the 700 Omicron sub-lineages has caused a significant increase in severe cases and death rates, he said.

"We will monitor changes in disease severity, whether the genome mutates," Xu said.

Leading Chinese epidemiologists say the epidemic will peak in January and February, although the number of infections will continue to increase in the short term.

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K J M Varma in Beijing
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