Three Fundamental Questions Posed by Decision to Test Chinese Arrivals

The re-introduction of tests for those travelling from China shows that nothing has been learned and authoritarianism is waiting around the corner. Tests are helpful only if they can identify contagious cases, which can be isolated and slow or interrupt transmission. If you have a few cases, that is. Not if you have 100,000 ‘positives’ daily and most of the population is vaccinated or had Covid, often more than once.

What evidence do we have that ‘test, test, test’ has made any difference in identifying the number of cases, i.e., transmission or mortality? Even the WHO considers travel bans are “usually not effective”, and that they may only be justified at the beginning of an outbreak, as they may allow countries to “gain time”.

Putting aside whether the strategy works (we will discuss that in a future post), the reintroduction of travel restrictions poses three contradictory questions.

1. If we now don’t trust Chinese data, why did we trust it so much at the beginning of the pandemic?

Chair of the Defence Select Committee Tobias Ellwood said, “We simply cannot trust Chinese data”, and Mark Harper, the Transport Secretary, wrote on Twitter, “China’s lack of reliable Covid data means these sensible, proportionate and temporary measures are needed ahead of their borders reopening”.

However, why are we just discovering this now? China does not report any figures for excess mortality, does not cooperate with data requests and reports implausible estimates for Covid deaths. As an example, Chinese public health authorities claim to have screened nearly 10 million residents in Wuhan over two weeks in the spring of 2020. New Zealand’s Covid deaths per population are 180 times that of China despite similarities in their approaches.

Therefore, why is Chinese data only now “unreliable” given we used it so much in 2020 to guide Covid policies? Up to March 2020, 39 of 42 reproduction number estimates were based on Chinese data, as was the Imperial College report that predicted 510,000 deaths in the U.K., but with “suppression” (evidence-free and ideological), these deaths would fall to somewhere between 8,700 and 39,000.

2. If we now don’t trust the data coming out of China, how can we trust the testing used to get on the plane?

Interpol reports illicit sales of false negative COVID-19 test certificates in Europe. In France, seven people were arrested for offering fake negative COVID-19 test certificates costing up to €300 (£271). Also, fraud and wrong Covid test results is a big problem in China. Testing is big business.

3. If we can bring back public health restrictions so quickly, what’s next?

U.K. legislation sets out legal obligations and Covid restrictions enforceable by law. The U.K. has had hundreds of laws during the pandemic: Parliament refers to these as “lockdown laws”, and there have been several travel restrictions enforced that lapsed on March 18th 2022.

The Government’s Living with COVID-19 guidance, published on February 21st 2022, stated it “will retain contingency capabilities and will respond as necessary to further resurgences or worse variants of the virus”.

The travel ban sees the reinstatement of lockdown laws, which begs the question – what’s next?

At some point, the policy setting will have to accept the endemic nature of the SARS-CoV-2 virus and move beyond panicked reactions that were the mainstay of policy throughout the pandemic. But, in the meantime, we have to keep paying the bill.

Dr. Carl Heneghan is the Oxford Professor of Evidence Based Medicine and Dr. Tom Jefferson is an epidemiologist based in Rome who works with Professor Heneghan on the Cochrane Collaboration. This article was first published on their Substack blog, Trust The Evidence, which you can subscribe to here.