Recently, the health minister of the Seychelles—the world’s most vaccinated country against COVID-19—declared that the situation involving COVID-19 became critical again despite the fact that about 62% of the Indian Ocean nation’s population is vaccinated. In an intense spike, the number of active cases on the island nation went from 612 on April 28 to 1,068 on May 3. With 98,000 people, the country is highly dependent on tourism and hence the health ministry undoubtedly felt pressure to scramble for mass vaccination with an aim at herd immunity. In January, they announced a deal with Sinopharm via a donation from the United Arab Emirates. Bloomberg reported that 59% of the island population were inoculated with this vaccine and the remainder with the AstraZeneca/Oxford vaccine known as Covishield in India, produced by Serum Institute of India. As the world’s most vaccinated nation, again at about 62%, this compares to Israel’s 55.9%. But now the country’s health minister, Peggy Vidot, recently reported in a press conference that “Despite of all the exceptional efforts we are making, the COVID-19 situation in our country is critical right now with many daily cases reported last week.” This means tightening up rules involving eateries and businesses and potentially travel, which impacts the island’s main economic lifeline. Perhaps the lesson here is that vigilance must be kept at all times until this virus is contained. But this small island nation isn’t the only nation in Asia experiencing problems. A growing surge, led by the horrific situation in India, now centers attention on how the world can collectively overcome this pandemic—the problem is in fact global. SARS-CoV-2 infections are at a high in many nations across Asia except for one interesting anomaly: the world’s most populated country of China, which other than druing the pandemic’s onset, which occurred right in Wuhan, that Asian nation has avoided the economic, social and cultural upheaval that’s impacted pretty much everywhere else. TrialSite probes a little to explore what could be some possible explanations.
The Seychelles Situation
Apparently, the world’s “most vaccinated” status doesn’t imply that the virus won’t still spread as reports from various news agencies, such as Bloomberg, share news about the situation there. Officials at this beautiful Indian Ocean tourist destination aren’t sharing much detail, other than they suspected that relaxed vigilance (perhaps due to vaccination status) as well as lots of gatherings from the recent Easter celebrations could have been a factor behind the surge in infections. But also there are ties between Seychelles and India and the horrific crisis there, spurred in part by mutant variants, and this could be a factor on the islands.
TrialSite readers should also note that the two vaccines in use don’t have anywhere near 90%+ efficacy of Moderna or Pfizer/BioNTech. For example, 59% of the island’s population were vaccinated with the Chinese Sinopharm vaccine, which showed 79% efficacy according to an announcement by the state-owned company.
Critical Time in Asia…Except…
Generally. due to rapid mutations, new more transmissible strains of the virus swirl around Asia and beyond. India, of course, faces a devastating situation and even countries that have done well managing the contagion, such as Vietnam, now see spikes in the number of cases. Reports out of Thailand were stable for months but now that nation has experienced an incredibly steep ascension in number of cases, followed up with new restrictions on commerce and general movement. Cases in Japan spiked up starting in April. At 412 per day on March 6, they now report a 7-day average of 5,218, a disturbing increase, based on a review of data from Johns Hopkins University.
But What about China?
The amazing story that’s not covered much in American mainstream media is the China miracle. That is, despite the fact that this country’s city of Wuhan was at the genesis of the pathogen, due to confluence of factors and forces, the world’s most populous nation and second largest economy as measured by GDP has completely managed this pandemic like no other place given it’s size and growing influence.
While the pandemic clearly started in Wuhan—some might say suspiciously near the Wuhan Institute of Virology known for studying coronaviruses from bats—the world’s second most important economy has since thrived while the U.S., Europe, and much the rest of the world struggles to overcome and control the viral transmission.
In China, the government, which is notoriously guarded with meaningful data, started reporting cases for the outside world to review on February 11, 2020 with a recorded 6,905 cases. So this was a novel coronavirus and no one purportedly knew exactly what to do with this thing, how potent it was…its transmissibility levels… and the like. Yet cases immediately plummeted in just days, and while the rest of the world has been in utter and complete crisis, China’s seeming normalcy perplexes and frankly doesn’t get talked about much, at least by American media. With an average of 15 to 50 cases per day with so-called spikes totaling perhaps 100 cases for a day, the entire country appears to proceed with utter routine, almost boring regularity. Of course, this benefits the Chinese GDP growth, which thanks to this pandemic and its subsequent response and management, that country’s goal of surpassing the U.S. as the top economy is most certainly accelerated, reports CNBC.
Centralized Controls Utilized
Of course, China’s run by a different style of government, more authoritarian in nature with a central Communist Party completely running the show. Of course, it’s not quite that simple as China is a big place, with many regions, layers of political power and administration, and plenty of tensions and contradictions that at any given time could unfold in surprising and confounding ways. But make no mistake, this governmental regime has mastered this coronavirus. And part of the answer lies in the efficiency and effectiveness of a centrally controlled, and some might argue, authoritarian governing apparatus.
But again, China’s a complex place with many regions and layers and as this country embraced a new form of state-sponsored Capitalism, they’ve developed and continue to advance a very different kind of mixed economy than is known in the West.
The layers of political administration include the highest first-level administration, which includes 34 divisions, segmented by 23 provinces, four municipalities, and five autonomous regions. Each one of these administrative units or layers, which always have a tendency to align and protect local interests, happen to also include a Communist Party of China provincial committee, which is led by a secretary; apparently, this role is supposed to effectively run the province, with more authority than even the governor overseeing that provincial government.
But how are they Containing COVID?
While much of the world devolved into this public health crisis by the end of March, 2020, China had nearly full containment of the pandemic, which started in Wuhan. Well, at least that’s what the government there portrayed and there are data points backing the stance that they’ve managed this worst pandemic in modern history better than any other large government.
Although experiencing the occasional flare up here and there, apparently via a combination of aggressive public health oversight and control measures, such as ubiquitous contact tracing, hygiene and personal protective equipment policy, and a range of treatments, including Traditional Chinese Medicine (TCM), the people of the world’s most populated nation and second largest economy next to America have seemingly lived through this pandemic in relative normalcy.
But how could this be possible?
According to a report in The Lancet authored by Talha Khan Burki, China overcame COVID-19 via a confluence of factors from A) fast comprehensive and intense responses at pandemic onset, which included 1) what would be considered in the west a draconian lockdown of the people (freedom was taken away for over two months) in Wuhan, 2) the leveraging of manufacturing apparatus for personal protection equipment (PPE) production and methodical and targeted distribution, 3) specialized hospitals set up to isolate and contain those infected, and 4) leveraging of more authoritarian governing model to rapidly and comprehensively socially engineer behavior in those early days; B) its centralized epidemic response system; C) a shared collective experience with the first SARS epidemic prepared the people, culture and public health apparatus to fully respond; and D) efficiency and speed of general response and enactment of key public health policies.
What about Vaccination?
According to data from Our World Data, thus far while 279 million have been vaccinated in China by one of a few products authorized, this represents only about 20% of the population. The Chinese vaccines are generally of inferior quality to those of the West as measured by declared effectiveness rates. Clearly, vaccination has little to do with the success behind China’s management of this global pandemic. They started getting on top of this crisis by March 2020, long before any vaccine was available.
What about Treatments?
Could there be something here? Could the people be taking some form of prophylaxis or do they have treatments available when someone does get infected? TrialSite is aware that the China National Products Administration did accept a generic firm to produce Favipiravir, an antiviral medication from Japan that is also used in Russia and many other countries. TrialSite has been informed by multiple sources that Hydroxychloroquine is used by at least some in China.
According to a study led by researchers from Zhongshan Hospital Fudan University in Shanghai, the use of Hydroxychloroquine at early onset forms an important strategy in preventing SARS-CoV-2 disease progression. Of course in the West (North American, Europe), Hydroxychloroquine has been rejected due to concerns with adverse side effects and lack of efficacy. Although, TrialSite recently showcased plenty of research activity ongoing with the drug in relation to COVID. For example, recently the National University of Singapore had a study published revealing that the product may possibly be used for prophylaxis. A Yale researcher has advocated a review of the existing studies carefully for bias and furthermore is on the record that if used early on in the lifecycle of the disease that it can be effective. Are people in China using this therapy? We cannot be certain here at TrialSite.
TrialSite has accessed documents revealing China is by far the world’s largest producer of ivermectin. In fact, ivermectin is a derivative of avermectins and, according to a 2018 study authored by two researchers from China’s State Key Laboratory of Agrobiotechnology China, has become the world’s supplier of avermectins—ivermectin is simply a derivative of avermectins, and there is considerable data pointing to ivermectin as a possible treatment for COVID-19.
Of course, the U.S. FDA, EMA and the WHO refute such a claim, declaring more data is needed. TrialSite only has anecdotal data points of the use of ivermectin in China for the coronavirus, and only one actual clinical trial is documented in that nation involving the antiparasitic drug. But this country has enormous manufacturing capacity to produce the drug.
Evidence of Traditional Chinese Medicine (TCM) use for COVID-19 comes directly from CNN, who reported on March 4, 2021 that China’s National Medical Products Administration announced the greenlight for the use of three TCMs for COVID-19.
Apparently, the regulatory body approved a “special approval procedure” to make this happen as declared in a formal statement. Apparently, TCMs are even tested in clinical trials there purportedly evidencing superiority over standard of care, according to one report.
What about QR-Code-based Contact Tracing?
TrialSite interviewed a couple people in China, including a PhD and medical doctor there who spoke under condition of anonymity. We learned that the lockdowns are considerable, and made possible by intensive contract tracing activities there. So when SARS-CoV-2 does manifest in a community health authorities pounce, thanks to the ubiquitous contract tracing systems and processes this public health apparatus assembled. This facilitates rapid, agile activities including the management of small local outbreaks. Could this be a factor contributing to what appears to be near miraculous management of this highly contagious pathogen.
Last year, a British man living in Wuhan was the subject of an article demonstrating the Chinese COVID-19 contact tracing system in action. Based on the QR code system, just in November, 2020 China’s head, Xi Jingping at the G20 Summit called for a “global mechanism” based on the QR code system to “open up international travel.” The head of the government and Communist Party suggested, “We need to further harmonize policies and standards and establish ‘fast tracks’ to facilitate the orderly flow of people.” The implication for draconian government abuse was not lost on some key human rights advocates that reminded such a system could be used for “broader political monitoring and exclusion,” reported the BBC.
But what are QR-Codes?
These have actually been around for a long time. Little black and white square patterns used to scan with a person’s smartphone to pull up a website have apparently arrived in China in a big way. Even in America, they showed up in restaurants as a replacement to menus as no one wanted to touch a paper menu.
Actually called Quick Response Code, these are a type of matrix barcode (two-dimensional barcode) invented in 1994 by a Japanese automotive company called Denso Wave. Of course, a barcode simply is a machine-readable optical label that stores data about the item or element to which it is attached. QR codes often contain data for a locator, identifier or tracker that points to a website or application as shared in Wikipedia.
Of course, QR-codes showed up in North America and Europe during the pandemic as part of “Touchless” systems to display information such as a restaurant’s menu or a digital director of consumer information. QR codes support the use of contact tracing systems, reported ABC News of Australia at the end of 2020.
A Ways to Go
North America, Europe, India and now again the Seychelles are in the grip of the world’s worst human pandemic in a century. Despite a high vaccination rate, in fact the highest in the world next to Israel, the Seychelles public health minister has enacted more restrictions as the virus is now spreading there again at a rapid rate. In the United States, various experts tell that the pandemic will ultimately get under control via a combination of mass vaccination, development of therapeutics (both branded and low cost generic), proper hygiene, and public health measures—and unfortunately, all of this will take some more time. Advancing out of the COVID-19 pandemic grip represents at least a couple years’ effort and a number of investigations must occur, ranging from the origin of the pathogen to the effectiveness of taxpayer-funded national research programs. Those that don’t learn from the present crisis are doomed to experience even more problems in the future.