What consequences should we expect in France after the epidemic rebound in China?

A 180 degree turn. And an epidemic that has gotten out of control. After almost three years of zero covid strategyChina lifted all of its very severe health restrictions on December 7, plunging the country a little further into an unprecedented epidemic outbreak of Covid-19.

A health situation that worries well beyond the Chinese borders. Health and home affairs experts from the Twenty-Seven thus met on Wednesday to develop a coordinated response from the European Union, and since Thursday, anyone from the Middle Kingdom must present a negative test. But will this answer be sufficient? What could be the repercussions in France of the wave of Covid-19 which is currently sweeping through China?

Chaos and info zero

Overcrowded hospitals, overwhelmed crematoriums: how China did she find herself overwhelmed by the Covid-19? After clinging to it firmly, Beijing had to “recognize the bankruptcy of its zero Covid strategy and abandon it”, recounts Professor Antoine Flahault, epidemiologist and director of the Institute of Global Health in Geneva. In practice, “the zero Covid strategy does not distinguish serious from mild infections. This partly explains why China has not taken a proactive approach to vaccinating the elderly” and at risk, the review abounds. The Lancet Yanzhong Huang, health issues specialist for the Council on Foreign Relations think tank.

Today, the health consequences of this epidemic outbreak are therefore “above all to be feared for the Chinese population, not immunized, especially vulnerable people, but the saturation of hospitals can also indirectly affect the health of all Chinese, indicates Antoine Flahault. If the population had been properly vaccinated, the authorities would today be calmly negotiating this transition between its zero Covid policy and the “living with” Westerners. The total lack of anticipation on the part of the authorities, when most Western experts considered this outcome inevitable, is appalling”.

A radical change of course which affects the monitoring of the epidemic in the country, which has put an end to its massive and regular screenings. “Visual navigation of the Chinese in this crisis gives the impression that the ship is drifting in the storm”, comments the epidemiologist. An alarming situation for the WHO: “The current figures published by China under-represent the real impact of the disease in terms of hospital admissions, admissions to intensive care and especially in terms of deaths”, s’ is worried Wednesday Michael Ryan, in charge of the management of health emergencies at the WHO.

“We must fear the emergence of new variants”

In this context, “we must of course fear the emergence of new variants, of which we still do not know what their characteristics might be”, warns Antoine Flahault. To protect against this, all people arriving in France from China must present a negative PCR or antigen test within 48 hours. And the EU “strongly encourages” its member states to supplement this with “random tests” on arrival on European soil. To the chagrin of Beijing, which deemed these measures “unacceptable”. But “with such a high circulation (of the virus) in China and in the absence of complete data, it is understandable that certain countries take measures” restrictive, estimates the director general of the WHO, Tedros Adhanom Ghebreyesus. As proof, in the context of a control operation carried out this week at a French airport “with the carrying out of passenger tests asymptomatic returning from China, one in three tests was positive, thus attesting to the need for the control measures that we are putting in place, ”government spokesperson Olivier Véran revealed on Wednesday.

“The objective of these controls is not to protect us from the introduction of variants on our territory, it has never worked anywhere in the world, underlines Antoine Flahault. The current crisis is even the demonstration that this cannot be effective with variants as transmissible as those of Omicron. On the other hand, this makes it possible to be better informed about the nature of the variants arriving from China. And puts healthy pressure on the Chinese government, which now provides more data. We must therefore continue to maintain this international pressure on Beijing”.

To better tighten the meshes of the surveillance net, random PCR tests are organized in French airports on the arrival of planes from China, each positive sample then being subjected to sequencing to detect a possible new variant. The EU is also calling on its member states to test aircraft waste water from the Asian giant with genomic sequencing.

A possible multiplication of drug shortages

In addition to the risk of new variants, another ripple effect is feared: “The possible economic and social consequences of the pandemic on production lines in China, a major factory in the rest of the world, due to absenteeism and the disorganization caused by the wave of Covid”, warns Antoine Flahault. France could thus face a increasing drug shortages, while many active ingredients are manufactured there, and several drugs have already been under severe supply pressure for months in France. Thus, 80% of the active ingredients of paracetamol and amoxicillin come from China. However, the Chinese government has banned the export of paracetamol.

Between the outbreak of contamination which disrupts the operation of factories and the requisitions of drugs by Beijing to treat its population, fewer active ingredients are exported. “We can hope that these supply disruptions will remain temporary, but the health crisis promises to be long in China, indicates the epidemiologist. The population has yet to catch up with our level of hybrid immunity [par vaccination et par contamination] to hope to start living with the virus without too much social and economic disorganization, as we are now doing in the West”.

In France, the risk is taken seriously. “The Internet sale of specialties composed exclusively of paracetamol is suspended until January 31, 2023”, decreed this Wednesday the government in a decree published in the Official Journal.

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