What the deadly COVID outbreak in China means for the world in 2023 – Rolling Stone

There is new A form of SARS-CoV-2, the virus that causes it Corona virus disease. It’s called XBB.1.5 – and it sucks. XBB.1.5, commonly known as ‘Kraken’, is more infectious than previous sub-variants of the Omicron variant of the virus and also has a higher potential to evade antibodies than previous vaccines and infections.

Worldwide, there has been a rise in Kraken-related Covid cases. But that is not what epidemiologists are most worried about as the coronavirus pandemic begins its fourth year. number, China is what scares the experts. A country that, unlike the rest of the world, is now catching Covid in a big way for the first time.

That’s 1.4 billion people experiencing what the rest of us went through in early 2020, with some ups and downs. And what happens next in China could spill over to the rest of the world in frightening ways.

So far, judging by the monitoring of Chinese travelers arriving in Italy, China is picking up older forms of Covid. “There are no new variants, but simply the current circulating strains spreading rapidly in a population with low natural immunity,” says Paul Anantharajah Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection in Singapore.

But that could change.

Yes, Kraken is bad. But it evolved from earlier forms of the virus at a time when most of the world — China, of course, is the exception — has very strong immunity. Widespread vaccination was crucial early on, of course, but what really protects most people now, two years after the first vaccines became available, are natural antibodies from previous infections. That’s because natural antibodies are more potent and longer-lasting than antibodies from vaccines and boosters.

For all the controversy about lockdowns, masks, vaccines, and treatments, most of the world has ended up taking a reasonably smart approach to Covid. Many countries clamped down on businesses, schools, crowds and travel through 2020, helping to slow transmission of the virus until vaccines are available at the end of that year.

Then, as more and more people were fully or partially vaccinated – today most of the world’s eight billion people have had Covid at least once, and billions have been vaccinated. And Booster – Countries have gradually reopened.

People returned to a normal copy. Yes, that meant more viral spread which ultimately gave us the Omicron variant and its many sub-variants, which are still prevalent today. But vaccines mitigated the worst effects of these many infections. Case rates are up (and down again and then down again). But overall, hospitalizations and deaths have trended downward — a trend that continues today.

And all that infection fueled a virtuous cycle that began with mass vaccination. Covid hit us and we mostly survived – because millions of us have been vaccinated. This gave us natural antibodies that protected us from the worst outcome next one The time Covid hit us, a year or a half later as the vaccines started to wear off. And that Immunity seeding infection to next one Six, nine or 12 months.

and so on. Epidemiologists expect this cycle to continue unless SARS-CoV-2 makes some huge and sudden evolutionary leap that renders all existing antibodies ineffective.

But the longer the pandemic lasts, the less likely this nightmare will unfold. With each waning wave of infections, Covid begins to look more and more like the flu: a disease that we should take seriously, but not one that has the potential to end the world. “Within a few years, COVID-19 It would be a background risk alongside the seasonal flu, says Lawrence Gostin, a global health expert at Georgetown University.

This does not mean that Covid, like the flu, is not dangerous. Even a non-fatal infection with SARS-CoV-2 can have severe consequences. Long Covid, for example – a combination of long-term symptoms that are likely to include fatigue, confusion, sensory loss, and even heart problems. But even taking into account the long Covid, the overall risk of the worst outcome is decreasing in much of the world.

However, in China, things can get a lot worse before they get better. This is because China went into lockdown in early 2020 – and has remained closed for nearly three years as part of the country’s “Zero Covid” policy. Only on December 8th, after massive public protests in several major cities, did the ruling Chinese Communist Party finally Major restrictions lifted in most places.

“The situation completely changed on December 8th,” says Ben Cowling, a professor of epidemiology at the University of Hong Kong. The restrictions had bottled up SARS-CoV-2, preventing transmission and leading to what was, until a few weeks ago, one of the lowest rates of Covid cases of any country. But a lack of infection also means a lack of natural antibodies.

Yes, about 90 percent of China’s population is at least partially vaccinated. But the hundreds of millions of elderly Chinese, who are most vulnerable to contracting Covid, are also the least likely to be vaccinated — which experts attribute to misinformation in the Chinese media. And most of the Chinese We are He was vaccinated more than a year ago. So far, the protection from those early vaccines has eroded.

So when restrictions were lifted and more than a billion Chinese finally began to go out and travel, they did so without the protections the rest of the world got the hard way, through previous infections.

It should come as no surprise that China is really sick at the moment. “Almost everyone in the community is vulnerable to infection because there were so few infections before December 2022, and so few recent vaccine doses – which can provide temporary protection against infection,” Cowling explains.

Just How do It is difficult to say for sure, as the country’s authoritarian regime has stopped reporting reliable data. “Fortunately, there are some objective ways to assess what is happening in China besides drawing on the vibrant Chinese social media landscape, which primarily brought the pandemic to the world’s attention,” Tambia says.

More and more countries are testing travelers coming from China. Malaysian health authorities even test sewage in passenger planes flying out of Chinese airports. Based on these samples, experts can begin to track the outbreak in China, even without China’s help. “Ideally, this would include virus samples for genetic sequencing in order to see if an ominous new variant of concern has emerged,” says Peter Hotez, an expert in vaccine development at Baylor College.

It could be China around the year 2023 as it catches up in the beneficial cycle of infection and re-infection that shields most of the rest of the world and makes the pandemic “normal” for many of us. Many Chinese — potentially the majority of the population, according to Cowling — will have to contract the virus, and survive, before China achieves its new normal. Most of them will do so with less immunity.

Keep in mind that it cost the United States — a country with a population a billion smaller than China — more than 1 million deaths from Covid to build the important natural immunity it has today. “It’s a grim and tragic statistic,” says Eric Bortz, a University of Alaska-Anchorage virologist and public health expert. “China is looking at this barrel now.”

The danger, for the rest of the world, is that millions upon millions of severe Covid infections in China could act as a kind of incubator for new, more dangerous forms of the new coronavirus.

Every infection has an opportunity for the pathogen to mutate. It’s like a slot machine, says Nima Moshiri, a geneticist at the University of California, San Diego. Moshiri explains that each individual infection tends to cause two mutations every two weeks. In other words, the virus gets a couple of pulls of the lever twice a month, hoping to get a genetic prize that gives it some new feature. Greater portability. More ability to avoid antibodies.

“What if we had 50 million people pulling the levers of a slot machine at the same time?” Moshiri asks. “We expect at least one person to hit the jackpot very quickly. Now, replace the slot machine with a “clinically meaningful SARS-CoV-2 mutation,” and that’s the situation we’re in.”

It’s fair to say that even with the new Kraken variant rearing its evil little head, most of the world has Covid more or less under control. But China does not. And some new variant that developed from the outbreak in China could spoil 2023 for everyone else.