Tuesday, March 15, 2022

Glenn Greenwald is mostly right, and the COVID-19 situation in China

Greenwald is nearly 100% correct in his assessments of the recent political and media climate in the US (https://greenwald.substack.com/p/romneys-treason-smear-of-tulsi-gabbard?s=w), as his arguments are well rounded and supported by historic records and facts.  

There are two blemishes, however, going along with his other writings.  The first and most damning is that he implies that the neocons were the only GOP pro-war fraction while Dems are mostly pro-war where neocons now belong.  In reality, both Dem and GOP are pro-war, with minor variations depending on who is in the WH at the time.  For example, in the 1990s GOP was less supportive of Clinton’s wars, then in 2000s more Dems were against Bush’s.  But there has almost always been enough and broad support for wars at DC.  Is there a war WH really liked but stopped by the Congress in the last 30 years?  Don’t we all have the impression that the Congress appears more belligerent than WH?  If there is any distinction, it is that overall more Dems or the left are anti-war than the right.  Thus, among the GOP Senators favored by Greenwald, like Cotton, Rubio, Hawley, who has said or done anything sensible lately?  Some, plus Tucker Carlson, may be less enthusiastic about war with Russia, but they are all in for cold or hot war with China, Iran, etc, and have been poisoning the water for years.  You can’t be for peace if you want to substitute one war for another.    

Another is Greenwald wrote “the U.S. has funded the work of Chinese scientists to manipulate coronaviruses to make them more contagious and lethal”.  Not sure if Greenwald even understands what he read or wrote, or maybe he just wants to scare people?  From everything reported, WIV made point mutations in bat CoVs and infected mice, nothing unusual or inconceivable in the research community.  While some mutations made more viruses at first, at the end of the experiment a few days later, all CoVs had the same outcome.  So “more contagious” at first maybe but not at the end, and surely not lethal, since CoVs don’t kill mice.  And never any human studies, and nothing to do with COVID-19.  Greenwald can be excused for lacking a scientific background, but harping on something with little knowledge is tiresome. 

Turning to COVID-19, mainland China is experiencing the most serious situation and is enacting the most restrictive policies since March 2020.  There are, however, important differences then and now.  The recent daily record is ~5000, even higher than Wuhan.  A caveat is that during early 2020 testing was limited, so the actual infections were much higher than recorded, whereas currently it is carpet testing.  In early 2020 only the Wuhan city and Hubei province was severely impacted, with other places only a few hundred cases total at most.   But in Mar 2022 it is more widespread, including economic heavyweights like Shanghai and Guangdong (Shenzhen).  The Jilin province now has a lockdown, not like the Wuhan one, but a lockdown nevertheless, Shanghai and Shenzhen have a slowdown, and many cities have closed schools and others.  On the other hand, the vast majority of infections are asymptomatic or very mild, and out of the 20K+ cases, maybe only 10 need any meaningful care so far.  This is likely due to the effects of vaccination and the less pathogenic Omicron. 

All these resuscitate the long-vexing question: is lockdown or slowdown really necessary, at least in certain cities?  Sure, something has to be done, but using largely the same old strategy from 2020 is lazy at best, suicidal at worst for economic destruction with diminishing returns in saving lives in 2022.  Virus kills people.  So does lockdown.  So does bad economy.  A recent Lancet paper examines global excess death from Jan 1, 2020 to Dec 31 2021(https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02796-3/fulltext), typically representing underreported COVID-19 deaths in most countries.  But in countries with fewer COVID-19 cases, it is likely that most excess deaths are related but not due to COVID-19, e.g., due to lockdown-induced stress, limited medical access or care, or economic hardship.   For mainland China the Lancet paper estimates 13K excess death in the two year period, including 7K in areas outside Hubei where only 40-50K infections were reported.  Compare that to an earlier paper (https://doi.org/10.1136/bmj.n415) looking at excess deaths in China from Jan 1 to March 31 2020, when COVID-19 was the most deadly, which reveals 2K excess deaths in Wuhan but nothing elsewhere.  So maybe 11K extra deaths from April 1, 2020 to Dec 31, 2021?   Few if any of 11-13K were due to COVID-19 since only 50K infections were identified under constant surveillance including the city-wide, multi-round testing scheme.  It must be noted that 20 million people die in China every two years, so 11K or 13K might well be a rounding error, but it is probable that some of those 11-13K die due to COVID-19 related policies.  It is true that without those policies many, many more people would have died from COVID-19.  Still, the issue at hand is 2 years into COVID-19 and with widespread vaccination, why is the blunt instrument still applied, and why isn’t there a better approach to deal with COVID-19 in China?

The new development is clearly not towards the direction of returning to normalcy.  A hope is that after weathering this wave, including the much worse one in HK, China should gain enough experience and learn a new way to manage COVID-19.  A glimmer of light emerges when China just updates its COVID-19 medical policy (https://news.sina.com.cn/o/2022-03-16/doc-imcwiwss6227003.shtml), the first one in almost two years.  The new policy allows COVID-19 patients to be discharged more early and easily, and also reserves important resources for the severe cases.  This is in line with what many countries are doing.  So China is moving to a more reasonable endpoint, even though there will be detours and seems too slow at times.

Both Chinese and international media often discuss “zero COVID” vs “living with COVID”.  The framing of the choices is simplistic.  We are all living with COVID, and the real question is how.  China’s so-called dynamic zero policy can never ensure absolute zero COVID, but suppresses it to zero or almost zero whenever a case is identified.  In countries “living with COVID”, measures are still in place that limit and treat COVID-19.  Hence never black and white, or all or nothing.  It is likely that China’s eventual policy will be a middle ground: won’t be zero, and allows COVID-19 at a level as high as the locals can tolerate, a moving target, before strict measures kick in.