Thread by @BallouxFrancois

The Covid situation in China is not looking good right now. The authorities have trapped themselves into a situation from which there's no obvious escape strategy. Whatever they choose - or will be forced - to do next will be very costly.
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China has managed to suppress SARS-CoV-2 with brutal restrictions. Those are becoming increasingly untenable as the population is suffering. A major surge seems largely inevitable in the short term unless the authorities chose to enforce even more ruthless measures.
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A major Covid-19 surge in China would lead to a dramatic death toll. Current SARS-CoV-2 Omicron lineages in circulation are 'milder' than Alpha or Delta, but the associated morbidity / mortality is in line with early pandemic SARS-CoV-2 lineages for those with no immunisation.
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China is extremely poorly prepared for a major Covid surge. Very few people have acquired immunity to the virus through prior exposure and vaccination rates in the elderly are dismally low.
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asia.nikkei.com/Spotlight/The-…

China's population is not particularly young nor healthy and its healthcare system is fragile, in particular outside major cities. It would be easily overwhelmed by any significant surge in Covid-19 cases.
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researchgate.net/publication/33…

Hong-Kong faced a similar set of challenges in early 2022, and despite far better fundamentals, it fared poorly when Omicron spread.
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ft.com/content/6e610c…

The most plausible scenario to me is that China will experience a major Covid surge in the near future leading to massive morbidity and mortality, which could be amplified by a collapse of the entire healthcare system.
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Beyond the immediate death toll, the failure of a zerocovid strategy would be difficult to handle by Chinese authorities, given the immense political capital they invested into it since early 2020.
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