U.S. and global health officials are worried about lack of transparency from China on Covid outbreak

US and global health leaders say Beijing is not sharing enough information about the spread of Covid-19 in China, leaving the international community in the dark about the scale and severity of the current wave of infection in the world’s most populous country.

The US Centers for Disease Control and Prevention said in a statement on Wednesday that a lack of transparency from China could delay the identification of new Covid variants that pose a threat to public health. China shares very few genomic sequences used to identify such variants, according to the CDC.

The CDC on Wednesday announced new testing requirements for airline passengers whose trips originate in China. All passengers, regardless of nationality or vaccination status, must be tested for Covid no more than two days before their flight to the US and present a negative result to the airline prior to departure. The requirements take effect on January 5.

India, Italy, Japan and Taiwan have also imposed Covid testing requirements on airline passengers originating in China. The Chinese government is battling a wave of infections after easing its strict zero-Covid policy in the wake of social unrest earlier this year.

A US federal health official speaking to reporters on Wednesday said the Biden administration has very limited information on the number of new Covid cases, hospitalizations and especially deaths in China. The reporting of tests and cases has also declined in the country, making it difficult to determine the true rate of infections, the official said.

China’s zero-Covid policy, which seeks to crush outbreaks through strict measures, means that much of the population has no immunity to the highly transmissible omicron variants, the official said. As a result, the Biden administration predicts that large numbers of people will be infected relatively quickly in China.

“What we are concerned about is a new variant that could actually emerge in China,” said the official, who declined to be named as a condition of press release. “Because so many people in China are affected in a short period of time, there is a chance, a possibility, that a new variant will emerge.”

The latest genome sequencing data shared by health authorities in China shows that the Covid variants circulating in the country are similar to those known in the rest of the world, according to a statement this week from GISAID, a public database based in Germany.

Over the past 180 days, China has sequenced and shared 412 Covid cases with GISAID, compared to more than 576,000 shared by the United States. Health authorities in China have shared less than 1% of reported and sequenced Covid cases, while the US has shared more than 4% and the UK almost 12%.

The World Health Organization has also called on China to share more information about what is happening on the ground as the virus spreads.

“The WHO is very concerned about the developing situation in China with increasing reports of severe disease,” Dr Tedros Adhanom Ghebreyesus, head of the global health agency, said at a news conference in Geneva last week.

“To make a comprehensive risk assessment of the situation on the ground, WHO needs more detailed information on the severity of the disease, hospital admissions and intensive care unit maintenance requirements,” Tedros said.

According to Dr. Mike Ryan, head of the global health agency’s emergencies program, the WHO has largely anecdotal reports of emergency rooms and, in some cases, intensive care units in China.

“We don’t have the full picture of the impact,” Ryan said of the Covid wave in China during a news conference in Geneva last week.

Dr Maria van Kerkhove, WHO’s Covid technical lead, said last week that omicron sub-variants BA.5, BQ.1, BF.7 and BA.2.75 were all circulating in China. XBB has also been discovered in China, which is one of the most immunized variants to date.

The Institute for Health Indicators and Evaluation said in a report published on December 15 that a massive wave of contagion in China is imminent as Beijing relaxes its zero-Covid policy. There will be a huge number of severe diseases among the elderly population and the number of deaths will be significant, according to the report.

China faces a difficult situation because its domestically developed vaccines are not as effective as Pfizer and Moderna’s mRNA injections. Vaccine coverage among China’s elderly population also lags behind other countries.

“One in seven people on the planet live in China, and accelerating vaccination, protecting the health system during this period, is in the interest of seven out of seven people on this planet,” Ryan said.

The US has offered China mRNA Covid vaccines and other support, but Beijing has rejected the offer, a federal health official said during the call on Wednesday.