Travel to China Zero-Covid : More than half the sky

quote from Mao Zedong about gender equality. With the adjustments to the circuit breaker mechanism and the addition of flights, international passenger traffic to China is expected to improve significantly while maintaining the tightness of the international arrivals process. The volunteer team of Solidarity Covid-Expats in China takes stock after a few weeks.

Planing in several stages

We feel ourselves growing wings in China since mid-June and the announcement of the reduction of quarantine for international arrivals. Another major concession follows on August 7 : the reduction of the scope of the cursed flight suspension mechanism.

This is not an exit of zero Covid, so it has been very little taken up by the international press, but for us Expats in China, this subject of connectivity is paramount, and occupies the bulk of the discussions...

From the list of measures detailed in the article "When China awakens" (https://lepetitjournal.com/shanghai/actualites/politique-zero-covid-quand-la-chine-seveillera-341895 visas, tests, transit, flights, quarantine….French only), the adjustments to the flight suspension mechanism were announced, and a few weeks later, the end of the intrusive questions in the departure to China questionnaire (about vaccines, past infection). Throughout the summer we also saw international air connections added to the schedule, in addition to the summer charter flights that enabled many foreigners to reunite with their families during the summer by braving the 7th wave of Covid.

Outbreaks of local infection "post quarantine" of international arrival since the announcement of the reduction of the quarantine, a droplet of water compared to the thousands of cases of other outbreaks of the summer which are themselves linked to contaminations by object / cold chain

Cautiousness has ruled this schedule of announcements spaced several weeks apart each time in order to be able to assess the resistance of the sanitary wall to each adjustment. First, the reduction of the quarantine from almost 3 weeks to 7+3 (7 days hotel + 3 days home). This reduction was motivated by the fact that Omicron has a shorter incubation period than previous variants and it was no longer necessary to isolate travelers (and the contact case for local clusters) for more than 7 days.

We apply and observe: a few cases in +3, a few cases in post-quarantine, but this remains low and controllable, especially in a context of permanent standardized screening?; few outbreaks linked to international arrivals because, with the rise of more contagious variants but also with a shorter incubation period, the time between landing and the positive PCR is reduced and fewer cases are counted in risky periods.

Reducing the duration of the quarantine makes it possible to free up places in quarantine hotels, and thereby accommodate more passengers: additions of flights as and when, and then on August 7, several criteria of the breaker circuit are slashed in: stop the counters from 7 to 5 days of arrival (already set up in June), duration of suspensions, trigger thresholds related to the proportion of infected passengers rather than a gross number of 5 cases on a flight, all this makes it possible to better consider the return of wide-body aircraft and lower the price of airline tickets. It was even thought for a while that the counting of cases would be limited to confirmed cases (确诊 mentioned in the notification) but in the end no, it did not make too much sense because some cities of arrival deliver almost only asymptomatic cases.?

It is interesting to study the rates of asymptomatic on imports by province, because we are in an ordinary situation compared to the fight triggered by each local outbreak, and even there we see that the definition is not at all homogeneous from one province (and even city) to another.

For provinces receiving only arrivals by plane (or sea freighter), we go from 15% asymptomatic in Fujian to 90% asymptomatic in Hubei with a tendency to increase this weight, and large differences per city within the provinces: Xiamen almost only confirmed, and Fuzhou: almost only asymptomatic who become confirmed,?between Guangzhou homogeneous distribution and Dongguan than asymptomatic people including a large proportion of "re-positives" from Hong Kong (known as Fuyang). It is impossible with these differences not to penalize more some Chinese cities and airlines (such as Sichuan Airlines in Chengdu, Xiamen airlines in Xiamen, China Eastern in Shanghai ...) that have their hub in some cities compared to others. So this element is finally maintained at the total number of positive cases per flight.

What impact on cases and flights of these adjustments?

It was first necessary to wait until August 21, i.e. 2 weeks later, to see the number of announcements of suspensions decrease, since the adjustment applied for flights arriving from August 7, and the suspensions are announced 14 days after arrival, knowing that at the same time the number of flights granted by the China Civil Aviation Administration (CAAC) was increased (+76 flights weekly international flights in July, +69 in September).?

Cases from imported cases recorded daily on provincial bulletins with a lot gaps (line "unprofiled" for provinces / cities that do not deliver all the information).

There is a jump in all regions of origin of imported cases in Q1 2022, it is the Omicron effect, which has generated many flight suspensions. In Q2 2022, drop in air entries with the shanghai lockdown (reduction of flight capacity to 40% for flights arriving in Shanghai, travel postponements), and it is also better in the former British colony. In Q3, China sounded by the shanghai lockdown promises more openness and many flights are added to the schedule, the capacity of flights arriving in Shanghai is raised from 40 to 60% in June, the number of suspensions drops from mid-August, some summer charters arrive, and there is a number of cases imported by air 17% higher than the level of Q1 2022.

The goal: living with zero Covid

On the matter of flight planning except for suspensions, we now find the level of flights of the pre-Delta era which has pushed many Asian countries (such as Thailand, Singapore, Australia but also Japan and Korea) into the era of living with it and therefore have seen their flights greatly reduced through the mechanism of the circuit breake. But with 308 weekly international flights as of September 16, we remain at a level of 3% of the flights before the pandemic. The goal of the Chinese authorities would be to bring it to 10%.

The increase in the number of flights granted by the Chinese civil administration is significant (+18.5% vs Q1 2022), the Chinese authorities still promise 3 times more international flights, enough to lower prices, we should be at +39% of international flights on October vs September.

For France for example, there was no an additional scheduled flight yet approved, but 2 charters of the Chamber of Commerce France China (total 730 passengers welcomed in Tianjin), suspended flights have been reinstated (Air France and Air China switched from Tianjin to Beijing) and a China Eastern flight from Shanghai in July which had delivered its quota of positive cases has not given rise to a suspension on the occasion of the return of the flight from Taiyuan to Shanghai. Thanks to this sleight of hand, France manages to reduce the suspension rate from 50% to 41% at the last count, still much higher than North America and Asian countries that have more flights on the schedule (and more added recently).

Flight suspension rates. The France dropped from 50 to 41% during the summer. 2 flights arrived end of September are expected to trigger the first "new formula" suspension from France (9 and 14 cases in Shanghai). Russia delivered a large number of cases as soon as the flights were added, in a scenario that resembled the evacuation of the Chinese from Ukraine in March.

Our team Covid Solidarity – French in China records CAAC flight schedules, suspensions and sources of imported cases for our daily point, so we are able to make an estimate of the number of actual incoming flights vs the number of imported cases. The scope of comparison must be reduced to cases imported by air and on routes subject to the breaker circuit, so we will remove land entries, and entries by air (or maritime yet negligeable) from the territories of Greater China which are subject to another schedule.

Major events will disrupt the trend from one quarter to the next: the Omicron BA.1 wave in Q1 2022 generating many suspensions, in Q2 2022, the Shanghai lockdown which has impacts on international arrivals, including flights cancelled in early April in entry and exit. In Q3 2022, the increase in flights generates an almost equivalent increase in the number of imported cases.

Global Incidence: Severe Fog forecast

And therefore, an increase in cases imported by air slightly higher than the increase in international traffic, while over the same periods (Q3 vs Q1 2022), the incidence of cases reported worldwide (excluding Greater China) decreased by 62% and 77% for deaths... Does this mean that the pandemic is not really over? Because all over the world, we have turned the page, the specter of saturation of hospitals and ICU has moved away because of infectious immunity, vaccination and the lower pathogenicity of successive Omicron variants, and therefore we no longer see the interest in making expensive screenings, press conferences, daily dashboards and quarantines on arrival (see Hong Kong which goes into 0+3).

Asia is the only continent to deliver the same proportion of imported cases as reported cases in the countries. Elsewhere it will depend on the level of trade between China and these countries, but for Europe (especially the UK which has alternative sources to the NHS) and Africa we are obviously under-screening.

This is perfectly understandable but it invites vigilance as regards travelers from China who have a return flight. It is difficult to estimate the circulation of the virus in the world from the cases imported into China, but it still raises questions ... because at the same time, 2nd test at 24 hours before departure.

We see little of this multiplier effect of the BA.5 variant on the global incidence due to the strong immunity acquired with BA.1 / BA.2 but we see it with these imported cases yet tested until the very day of departure, and also the local outbreaks of China on a population never exposed to the virus that very quickly exceeds 500 cases despite the lockdowns. This fact will necessarily weigh in the pursuit of the zero covid strategy.

A constantly increasing number of new outbreaks (new chain of transmission) and outbreaks of several thousand cases are no longer exceptional. As the September outbreaks are not yet closed, the data in shade are not significant.

Our volunteer research project is an initiative of the French Expat association of Shanghai (UFE-Shanghai), it requires a daily work that has become titanic with this strong epidemic pressure. Wherever you are, you can help us even if you can't commit to everyday tasks. Please contact [email protected]

And we invite you to encourage us on the URLs below : https://yoopay.cn/cf/10219

https://www.leetchi.com/c/solidarite-covid-wmvdemg5

Articles, CovidFlow interactive pages, video interview of 19/7, podcast of September 25, daily posts archived on www.solidaritecovid.com

To follow our daily update: contact UFE Shanghai, wechat ID Doozyben

Many thanks to Jean-Paul Danon for his help in translation, La?titia Bernard-Granger for the data curation and Bettina Al-Sadik Lowinski for the title inspiration.