Mass COVID-19 testing 'not yield to' herd immunity
Global Times
By Zhao Yusha in Wuhan, Chen Qingqing and Liu Caiyu in Beijing Source:Global Times Published: 2020/4/24 0:38:41
Aims to understand outbreak magnitude, transmission patterns
As China is starting large-scale nucleic acid and antibody tests in a post-COVID-19 era with the epidemic appearing to have been brought under control, Chinese experts said that such a move cannot and should not be interpreted as the country's compromise to achieve "herd immunity," considering some Western countries have taken antibody tests as a major way of finding out how many people are immune to the coronavirus - something some politicians support as they struggle to strike a balance between abandoning the economy and giving up on lives, which is also why some of them are reluctant to take decisive action.
While some Western politicians, individuals, and groups raise doubts over China's strategy of containing the virus spread, accusing it of underreporting virus data, the upcoming massive virus testing in the country that has adopted the strictest restrictions and quarantine measures in slowing down the virus spread is aimed at understanding the magnitude of the outbreak and patterns of transmission, helping China get prepared for the possible resurgence and sporadic outbreaks, as the World Health Organization (WHO) warned the virus could coexist with human beings in the long run.
More importantly, China conducts those tests as part of the country's broader efforts to contain the epidemic, and it is fundamentally different from other countries, as China won't give up on any group of people and compromise to achieve "herd immunity" at the expense of certain groups, such as the elderly with underlying conditions.
There have been palpable changes in strategy among Western countries from the UK, calling for building "herd immunity," to France's passive battle and loose social distancing restrictions, to the US' lack of testing. China is doing its best to prepare for the worst, adhering to its core principle during this fight: Put people's lives above anything else, observers said, noting that though it might be reasonable for some Western countries to adopt a "herd immunity" strategy, even if more people in China are found out to have antibodies, it would not offset previous efforts of the country to reduce the mortality rate while containing the virus spread.
Purpose of testing
The Chinese central government's leading group on responding to COVID-19 in a Wednesday meeting called for expanding the testing scale and normalizing epidemic prevention and control work. Given sporadic cluster outbreaks in some places and local hospitals, full-scale tracking down and fixing of the loopholes are necessary, while massive nucleic acid and antibody tests could help identify patients as early as possible, fending off the risk of a resurgence of infections as the country accelerates work resumption.
"China's large-scale nucleic acid and antibody tests in the post-epidemic era are being conducted to understand the proportion of herd immunity in the country rather than a compromise on herd immunity," a Beijing-based immunologist told the Global Times on Thursday on condition of anonymity.
The antibody data from the Chinese population will offer a good reference for the government to adjust anti-epidemic measures accordingly, as the current strict "closed-loop" anti-epidemic policy is not conducive to economic recovery and work resumption.
In the long term, China may maintain a regular mechanism to monitor COVID-19, getting to know the incidence of the disease through certain networks, he said.
Some Chinese medical experts also noted that China and other Western countries are at different stages of conducting tests. While China has already reached its peak and flattened the curve of new confirmed cases, the large-scale tests would help understand the transmission patterns as part of epidemiological investigations to deal with the virus, while some Western countries continue to struggle to test for infections.
"Also, nucleic acid and antibody tests can help them identify the number of asymptomatic cases, and how many have antibodies while the situation remains severe overseas," Wang Peiyu, deputy head of Peking University's school of public health, told the Global Times on Thursday.
Some European countries and US states are planning to relax lockdowns and reopen businesses, while others have been pushing forward massive tests to find out whether a large number of people have antibodies and to help scientists decide if there is enough herd immunity to protect them from contracting COVID-19.
Given it's seen as a key factor to unfreeze their economies, countries like Sweden said it would reach "herd immunity" in weeks while Germany has launch nationwide antibody testing - the first one in Europe - media reported.
For instance, hardest-hit countries like the US and Italy are rushing to return to normalcy, though there is no evidence that suggests that antibodies guarantee long-term immunity. Some see antibody testing as crucial to deciding whether they could open up their economies. And medical experts in Sweden, which has been resisting a lockdown, said they have seen the effects of herd immunity. But the cost is a high death toll.
Anders Tegnell, the chief epidemiologist at Sweden's Public Health Agency, was quoted as saying by CNBC on Wednesday that sampling and modeling data indicated 20 percent of Stockholm's population is already immune to the virus, and "in a few weeks' time we might reach herd immunity."
Unfortunately, the mortality rate is high due to the introduction [of the virus] at elderly care homes, he told CNBC.
Herd immunity is a scientific matter, and varies in different countries, as it can be formed only when people who possess immunity reach a certain percentage, said Tong Zhaohui, the chief physician of the respiratory and critical medicine department at Beijing Chaoyang Hospital. Tong has treated severe and critical COVID-19 patients in Wuhan for three months.
"If China, which has a population of 1.4 billion, wishes to create herd immunity, it means we need to let 70 or 80 percent of our population get immune to the virus, which is very difficult task," he said, noting that herd immunity needs to be perceived wisely.
Different paths
Instead of the herd immunity adopted by Western countries, which is irresponsible and passive, China has taken the initiative to inspect herd immunity to make preparations for the reoccurrence of COVID-19 this winter, observers said.
Some of them are concerned that if more people have antibodies, aggressive prevention and control measures, including city lockdowns and freezing the economy, would be unnecessary. Unlike Sweden, China won't let people get immunity at the cost of lives.
Some hard-hit countries like Spain, which prides itself as a society which respects elderly people, have chosen to let people die in their beds, while in New York -- the world's top financial hub–people have been devastated as they see the US government fail them, especially the elderly.
Some elites in the US have also been weighing in as President Donald Trump supports the need for Americans to get back to work. California lawyer Scott McMillan tweeted in March that the fundamental problem is "whether we are going to tank the entire economy to save 2.5 percent of the population," which is generally expensive to maintain, and not be productive, who is considered a "right-wing nut," and even a "Nazi," the Washington Post said in an article published on March 25.
Countries like Belgium, France and the UK have mortality rates above 13 percent, while China maintained a relatively low rate of 5.5 percent, Johns Hopkins University data shows.
The US topped the list with 46,583 deaths so far, followed by Italy, Spain and France, with 25,085, 21,717, 21,373, respectively.
"Only when about 70 percent of the population has virus antibodies can herd immunity become effective, but not a single country in the West has reached such a level," the above-quoted immunologist said, noting that the percentage of herd immunity in countries such as Germany, the UK and the US stands at between 15 and 20 percent, the immunologist said.
Western politicians and elites would compare whether it is worth saving more lives or save the economy. For China, as life always comes first, its GDP growth has paid a heavy price to contain the virus, and is carefully seeking a balance in the post-epidemic era between resuming work and prevention and control work, which makes mass testing even more indispensable, as they would help scientists and epidemiologists understand how the virus transmits and what groups are more vulnerable to it, some observers said.
And for those who have hesitated to find a so-called perfect solution to protect both their citizens and the GDP, ambivalent and unclear policies won't save them when they embrace the next outbreak.
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