BEIJING: China is dealing with a surge in respiratory illnesses that is straining its healthcare system and sparking global concern over a possible new pandemic threat, four years after COVID-19 first emerged in the country.
What do we know about the outbreak?
A nationwide increase in respiratory diseases, mainly affecting children, was first reported by China’s National Health Commission on Nov 13, according to the World Health Organization (WHO).
Patients have reported symptoms such as fever, fatigue and cough. No deaths have been reported.
China reported 205 influenza/flu clusters for the week starting Nov 13, compared with 127 the week before that.
The rising caseload has led to long queues and gruelling waits at children’s hospitals in cities like Beijing, Tianjin and Liaoning.
The National Health Commission attributed the increase in infections to the circulation of known pathogens – primarily influenza, but also mycoplasma pneumonia, respiratory syncytial virus (RSV), rhinoviruses, adenoviruses as well as COVID-19.
Another contributing factor cited was the arrival of winter and China’s first full cold season since it lifted its zero-COVID policy nearly a year ago.
An increase in respiratory illnesses in winter is not uncommon.
In the US, for instance, RSV cases were on a sharp upward trend in the middle of October, according to the Centers for Disease Control, with weekly infection numbers at their highest since the last winter.
Related:
China's respiratory illness surge not as high as pre-pandemic: WHO official
China says respiratory disease surge driven by range of pathogens
What’s China doing about it?
The government is pushing for a coordinated effort to fight the spread.
The National Health Commission has called for “effective epidemic prevention and control measures” to be implemented in locations such as schools, childcare institutions and nursing homes.
Hospitals have been told to ramp up their capacity and to improve their ability to grade patients by the severity of infection, to better identify the seriously ill.
The commission has also called for more fever clinics to be opened, for service hours to be extended and more the supply of medicines to be increased. It is also encouraging children and elderly people to get vaccinated.
People have been advised to take children with less severe symptoms to clinics and other facilities, to ease the load on hospitals.
What does the WHO have to say?
The WHO said there was limited detailed information to fully identify the overall risk of the reported cases of respiratory illness in children in China.
It recommended that people in affected areas follow the normal rules to avoid respiratory illnesses.
These include getting vaccinated, isolating if symptoms emerge, and getting tested or wearing masks if necessary.
As of Nov 27, the WHO is not recommending any specific measures for travellers to China.
It is also advising against any travel or trade restrictions involving China.
Why has the outbreak drawn global attention?
On Nov 22, an alert by global outbreak surveillance system ProMED described “clusters of undiagnosed pneumonia in children in northern China”. Its source was a report by Taiwanese media outlet FTV News.
“Undiagnosed pneumonia” was the exact phrase used in a Dec 30, 2019 alert for what would become COVID-19 and an ensuing pandemic that consumed the world for much of the next three years.
As global media outlets picked up on this term, the WHO stepped in, and assessed that “the reported symptoms are common to several respiratory diseases”.
Both the WHO and China faced questions over transparency during the early days of COVID-19. The WHO eventually criticised Beijing for not being forthcoming with data.
Has it spread beyond China?
There have not been specific reports, but other jurisdictions are taking precautions.
Taiwan on Sunday (Nov 26) issued an alert instructing the local medical community to be on guard against the spread of mycoplasma pneumonia from China, according to local media reports.
Doctors have reportedly been told to be diligent in getting patients’ travel and contact history, in order to prevent cluster infections in hospitals.
And India on the same day put out an advisory instructing all states and union territories to review public health and hospital preparedness measures.
Related:
China holds the key to understanding COVID-19 origins: WHO chief
WHO chief pushes China for ‘full access’ to determine COVID-19’s origins: Report
What do the experts say?
The end of COVID-19 restrictions and a lack of prior immunity in children are likely factors behind the infections, according to analysts cited by AFP.
“Since China experienced a far longer and harsher lockdown than essentially any other country on Earth, it was anticipated that those ‘lockdown exit’ waves could be substantial in China,” said Professor Francois Balloux of University College London.
Unless there is new evidence suggesting otherwise, “there is no reason to suspect the emergence of a novel pathogen”, he added.
Professor Paul Hunter of the UK’s University of East Anglia also said it did not seem like an epidemic caused by a novel virus, even as he emphasised the lack of information at this point to make a “definitive diagnosis”.
“If it was, I would expect to see many more infections in adults. The few infections reported in adults suggest existing immunity from a prior exposure,” he added.
Writing on The Conversation platform, Australian researchers from the University of New South Wales noted that the threat of new viruses was nevertheless increasing.
“Pandemic potential is greatest for viruses spread by the respiratory route and which are severe enough to cause pneumonia,” they said.
“There is no indication that the current situation in China is a new pandemic, but we should always identify and pay attention to undiagnosed pneumonia clusters. Early warning systems give us the best chance of preventing the next pandemic.”