Europe is facing a new, fourth wave of Coronavirus infections. On the other side of the globe, Asia prepares to face the newly-emerged Omicron variant. The World Health Organisation (WHO) issued a warning on 3 December to countries in the East, urging them to increase and optimise their health and structural capacities as much as possible. The governments of China and India appear to be the primary targets of the warning. Despite a new decline in intercontinental travel and transit due to the Omicron variant, New Delhi and Beijing remain fixed points of contact and exchange with the western world.
According to the Chinese Centre for Disease Control and Peking University, if Xi Jinping's government decides to remove restrictions on international travel, it could find itself dealing with around 630,000 daily Covid-19 infections. However, this does not appear to be simply due to the arrival of the Omicron variant. China is fragile right now, due to the inefficient immune coverage provided by its own vaccine. Remember that last summer, the European Medicine Agency rejected authorisation of China’s Sinovac and Sinopharm vaccines because of the insufficient immunity coverage rates shown in clinical trials and rolling reviews.
Given the current situation, then, one can understand China's continued policy of zero tolerance towards the virus. If Beijing were to adopt the British strategy of seeking herd immunity, according to the EMA study, an average of 275,793 cases of infection per day would result. It is important to bear in mind, however, that the published study is based on mathematical calculations and algorithmic projections, and the study's authors indicate that their results should be cross-checked with more sophisticated analytical models for a more reliable picture of the situation.
In the Indian case, the context is somewhat different, with emergency situations potentially resulting more from human behaviour than from the arrival of the Omicron variant. According to the Indian Health Minister, the new variant is expected to have a lower incidence there. This is due to widespread vaccinations and the previous massive exposure of the population to the Delta variant (which infected about 70% of the entire country). The problem in India, rather, appears to be related to the organisation and structure of the national health system. The country is short of medical workforce for hospitals, while infections remain constant and show no signs of dramatic decline. That means they’re in a real race against time. Despite the words of the Indian Ministry, there is an urgent need to continue the inoculation cycle before the arrival of a new wave, the third for India.
Similar to what we saw in Europe during the most critical phase of the pandemic, there is a desire in India to allow newly-graduated doctors to practice. The request, made by both doctors and the students themselves, is not receiving a positive response from the government — which is having to contend with a strike triggered by some doctors in India's public health system not receiving their salaries. This reflects the difficult economic challenges the Indian government is facing. Although the strike involves more than 10,000 doctors in the national health service, for the moment they seem willing to continue to provide services for Covid and emergency departments. In light of the suspension of all routine and non-emergency health services, where patients are denied continuity of care and preventive medicine functions, there is a risk of a later flooding of the national health system. This puts chronic or rare disease patients at great risk. It is a situation that, through no fault of strikes, we in Italy experienced in 2020, in the early days of covid.
In the rest of Asia, the picture remains uniform. Many governments, such as Japan and Vietnam, have again restricted transit and intercontinental travel. South Korea has made vaccination passports compulsory for access to many public places. Only Singapore and Malaysia maintain their active transits, and only for vaccinated individuals.
This approach of extreme caution does not seem to be accepted by the World Health Organisation. Following their warning to Asian countries, the WHO has specified that the key to fighting the Omicron variant is in vaccinations and not in travel restrictions, which risk blocking the post-pandemic economic recovery phase that the region had effectively entered in November.