As investors look keenly to China's expected economic recovery, it is useful to understand the evolving Covid situation there. With that in mind, we have again taken the liberty to republish Ho Ching's recent post on her Facebook page

Some 59,938 people in China died of Covid between 8 December 2022 and 12 January 2023. This number included over 50,000 who had other underlying conditions, and who would not have counted as a covid death under the previous reporting definitions.

And between 13 January and 19 January 2023, the week running up to the CNY on 22 January, an additional 12,658 covid deaths were reported.

And on 20-26 January, a further 6,364 covid related deaths were reported. This is about half of the previous week.

It is a great step forward that China has widened the covid death reporting to cover those who have other underlying conditions, and whose x-rays did not show the classical covid broken glass pattern of pneumonia in the lungs.

Most places in the world would just total numbers of anyone testing positive for covid.
 
HoChing1.23
But wait …

Wait! Wait! Wait!

Deaths outside hospitals are not included in the recent covid fatality reports in China.

And sure! The deaths have fallen in the hospitals across China during the CNY week when folks have travelled back to their home towns and villages for their CNY reunions and holidays.

True, the peaks in the major cities have also passed.

Activities have resumed and we can hear the collective sigh of relief that they have weathered and survived the re-opening.

But we know from pandemic spread patterns elsewhere, that the waves which start in major high density cities will cascade its way down to smaller cities, towns and villages.

"Factories are starting to hum again.

"Earlier plans to quarantine entire factories in some cities were scrapped when the tests showed some 70-80% infections, well above the quarantine activation limit of 30%.

"Like the dorms in Sg, fatality rates were very low, bcos most of the staff in the factories of coastal China were young. And a fairly good number were vaccinated too, albeit just 2 shots done well over a year ago."
And true, many with friends and relatives in China would have heard of folks dying at home, especially the older or elderly members, when they could not get admission into hospitals. These would not have been counted in their recent covid death numbers.

Hopefully, more of their elderly and chronic ill in the smaller towns and villages would have had a recent vaccine shot ahead of their CNY gatherings and festivities.

Some younger folks were trying to get infected in the cities so that they are recovered before they go back home for their CNY reunions. It’s a kind of folk remedy, to try not to carry infectious virus home.

Factories are starting to hum again.

Earlier plans to quarantine entire factories in some cities were scrapped when the tests showed some 70-80% infections, well above the quarantine activation limit of 30%.

Like the dorms in Sg, fatality rates were very low, bcos most of the staff in the factories of coastal China were young. And a fairly good number were vaccinated too, albeit just 2 shots done well over a year ago.

There are lessons that we can draw from from future pandemic responses among the younger population, for the coronavirus based infections.

Both SARS and MERS showed similar patterns as Covid - the risks go up exponentially with age, and touch the young very lightly.

This was why in Sg and most places in the world, vaccination started with the healthcare workers, before 2 parallel tracks were activated.

The first track was for the other essential services, including police abd armed forces, as well as folks manning essential services like water, power, ports and airports, ambulance, fire and rescue services and civil defence agencies, and so on.

The second track was for the general public, starting with the oldest before moving progressively down the lower risk younger age cohorts.

But even early during the start of the pandemic in Wuhan, it was quickly apparent that the biggest risks are with age, much like SARS and MERS.

Not all potential pandemic pathogens are like that.

Flu, for instance, has a bath tub shape, with high risks for the very young under 5, and very high risks for the older above 80.

So depending on the pathogen-age risks, we could be clear how best to manage the next pandemic in terms of non pharmaceutical prevention measures when we don’t yet have vaccines.

It is also clear that various underlying health conditions like diabetes, heart, kidney or respiratory conditions do accentuate the risks.

So it is worth reviewing based on experiences in the Sg dorms and the China factories where there are mostly young workers, to think through and prepare for a coronavirus type pandemic.

We can also think through and prepare for flu like and ebola like type pandemic pathogens for respiratory and body fluid contact infections. Other types of infections could be like measles, pox, and others.

And the last types of potential pandemic spread would include by insects like mosquitoes (think Malaria & dengue), by body waste, both fluid and non fluid like scabs, etc.
 
Meanwhile, we expect the successive waves into the smaller towns and rural villages to rise and fall within the next month or two.

This is likely faster than the spread elsewhere over the past 2 years for 2 reasons.

Firstly, the Omicron based BF.7 in China, and possibly the XBB.1.5 as a second smaller wave, are both much much more infectious than the earlier non-Omicron variants. So the speed of spread would be faster.

Second, the CNY break is a huge cross country migration in a short sharp burst of mingling.

So we should expect the China situation for Covid to normalise within the next couple of months.

Meanwhile, for folks above 50, do get your bivalent shot if you have not already done so, esp if your last shot was more than 6-12 months ago, and your covid infection was in first half 2022 or earlier.
 
Ho Ching was CEO of Temasek Holdings for 17 years and is the spouse of Prime Minister Lee Hsien Loong. She posts frequently on her Facebook page here.

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