Testing Chinese Visitors to the U.K. Would be Foolish

China’s sudden pivot away from zero-Covid is striking, to say the least. Less than three months ago President Xi Jinping declared, at the Communist Party’s quinquennial conference:

We have adhered to the supremacy of the people and the supremacy of life. We are committed to putting people and lives first and adhere to dynamic zero-Covid.

Now, following protests and a growing failure to contain outbreaks, the CCP has dictated a 180-degree turn to ‘Let it rip’. Mass testing is gone, along with quarantine hostels. Borders have been opened, both for incoming and outgoing travel. Infection rates have spiralled as a result, with estimates of c. 250 million cases in the first three weeks of December, or a little more than a sixth of the Chinese population. This is massive, to say the least, compared with last spring’s omicron spikes elsewhere in the Far East. Half the travellers on incoming flights from China to Italy have proved to be infected, supporting the view that cases have increased explosively.

If anyone believes that masks – still worn everywhere in China – have merit, these numbers should disabuse them. There are no data on the vaccination status of the infected, but it’s likewise clear that the locally used vaccines – classical inactivated virus preparations – have failed to prevent mass transmission and circulation of SARS-CoV2.

Hong Kong’s omicron wave showed that these Chinese vaccines reduced short-term COVID-19 mortality among the over-80s compared with the unvaccinated, though less than for those given mRNA products. Whether a reduction will be achieved or maintained in China is anyone’s guess: many of those vaccinated received their shots months ago and any protection is likely to have diminished markedly.

We’ll likely never know: China has helpfully stopped publishing daily figures for infections and deaths. The only useful signal is that crematoria are unduly busy. Even with a mortality rate of 0.1%, 250 million cases translates to 250,000 deaths.

The West is, or should be, a spectator at this fiasco. We should merely hope that the long-suffering Chinese recognise the futility of what that has been inflicted upon them – mandatory testing, vaccine passports to enter shops and offices, or to catch the train; being quarantined or sealed in their own apartments if they have the misfortune to test positive; having their infected children taken for lonely separate isolation; having their pets slaughtered.

We must hope that, in time, the Chinese have the opportunity repay Xi Jinping and the CCP for its callousness. Particularly for persisting with this cruel insanity through 2022, even when every other country in East Asia had recognised that omicron was milder and unstoppable.

Unfortunately, China’s infection spike is causing a recrudescence of folly in her neighbours and in the West. Japan, Taiwan, India the U.S. and Italy have all taken to testing incoming visitors from China for Covid. This list looks set to grow. Lord Bethell, a former U.K. Health Minister, is calling for the U.K. to follow, and the Telegraph tells us that Rishi Sunak has the topic ‘under review’, as does the EU.

The ‘logic’ is that China’s surge may generate new SARS-CoV-2 variants and that import of these might “put us back to square one”. Assorted academics have been wheeled out to support this claim. Shares in Novacyt and Genedrive, who manufacture Covid tests, have surged. But the ‘logic’ is nonsense, and should be called out as such, for two reasons.

First, experience shows that, even in a time of strict international restrictions, the global spread of major SARS-CoV-2 lineages cannot not be stopped. New variants will continue to emerge. If they have an advantage, they will disseminate worldwide. We can’t do much to prevent this, and should stop trying.

Second, there is no good reason to suppose that China will prove an especially fertile ground for the proliferation of new variants. Mutants gain traction where they have an advantage. That is how Darwinian evolution works.

Advantages comes when spread of the established type is limited but the mutant evades the limitation. An example is if non-pharmaceutical restrictions constrain the established type but have less effect on its more-transmissible mutant – for example, one with a lower infective dose. The alpha variant’s initial rise to prominence during the U.K.’s second (November 2020) lockdown, provides a plausible example. A second case is when existing immunity – from vaccination or infection – constrains the established type, but not its variant. The briefly-protective adenovirus vector and mRNA vaccines used in the West (and Russia) solely target the virus’s highly mutable Spike protein. As immunity wanes, this creates selective conditions favouring partly or substantially evasive types – e.g. omicron – with an altered Spike protein.

These conditions don’t look to apply in China, where the already-very-transmissible omicron variant is ripping into an infection-naïve population, poorly protected with inactivated-virus vaccines. Since these are based on the whole virus, not just the Spike protein, they might provide a broad selective pressure if they were effective. But the sheer speed of omicron’s expansion shows that they aren’t effective at all, and therefore they will not advantage any mutant.

There is much to blame the Chinese Government for. The virus most probably escaped from a lab in Wuhan. The CCP have done their utmost to prevent and confuse investigation of this topic. They provided the terrible lockdown model, causing massive collateral damage to the rest of the world, as well as to themselves. Chinese twitter bots encouraged panic in the West, pumping out clips of plague victims dropping in the Wuhan streets. China’s own citizens have been treated appallingly.

But suggesting that China is now the likeliest source of new variants, simply owing to its infection surge, is to misunderstand how evolutionary pressure works. And imagining that we can stop new variants, wherever they come from, is to disregard everything we should have learnt these past three years.

Dr. David Livermore is Professor of Medical Microbiology at the University of East Anglia.