Chinese and international airlines are reviewing schedules and coping with a flood of inquiries about travel to China following this week’s announcement that strict quarantine requirements for arriving travelers will be dropped early next month.

According to the Chinese state-run media the Beijing News and Cailian Press, data from the Chinese travel website “Ctrip” shows that searches for popular cross-border destinations, including Macau, Hong Kong, Japan, Thailand, South Korea and the United States, increased tenfold within a half-hour after Monday’s announcement.

Searches related to outbound and group tours during the Spring Festival have increased sixfold.

According to Bloomberg, Hong Kong residents also rushed to the internet to search for flights to key mainland cities, with Shanghai, Beijing and Hangzhou being the most searched cities.

The decision to drop quarantine rules for inbound travelers comes after three years of strict international travel control as part of the country’s signature zero-COVID campaign.

The Chinese National Health Commission announced that the new measures will start on January 8.

“Those who come to China should undergo a nucleic acid test 48 hours before their departure, and those with a negative result can come to China without applying for a health code from our embassy or consulate abroad,” according to a document from the NHC. Arrivals into China with negative nucleic acid tests will be able to “enter society.”

The new order also requires all localities to “orderly resume Chinese citizens’ outbound tourism.”

In response, U.S. carrier United Airlines; European airlines company Lufthansa Group, which includes SWISS and Austrian Airlines; and Philippine Airlines announced they are looking into resuming additional flight operations to mainland China.

A staffer at Lexiang travel agency in the Flushing neighborhood of Queens in New York City, told VOA Mandarin that she has seen about a 30% increase of the number of travel inquiries to China. She provided only her family name, Wang, because she doesn’t want to attract attention from the Chinese authorities.

She said dozens of people have contacted her since the announcement to inquire about getting a Chinese visa or booking a flight to China.

A staffer at another Flushing travel agency who doesn’t want to reveal his identity because he doesn’t want to draw attention, told VOA Mandarin that more than a dozen people have reached out to the agency for information about getting a Chinese visa or COVID-related information for traveling in China since Monday’s announcement. He said there were barely any such inquiries in the past three years.

He said that most of the people who reached out to the firm are considering traveling to China to visit sick family members, rather than to celebrate the upcoming Lunar New Year.

He said that since the airlines haven’t started to add more flights, fares are still high and China hasn’t resumed issuing multi-entry visas, so people who want to travel still can’t just pack and go.

Reactions vary

China’s decision has been met with mixed reactions from Chinese netizens on social media.

Some celebrated the end of the quarantine rules, which clears the way for them to travel overseas.

“A long, long nightmare, I finally woke up,” one commented.

“A ridiculous era has finally come to an end,” said another commenter.

However, some commenters doubt whether easing regulations will repair the damage done in the past three years.

“There is no such thing as ‘everything goes back to the way it was.’ The lives of countless people have been completely changed, and they can only bite the bullet and live in this parallel timeline. It’s like they broke a mirror and then glued it back together, it’s not the same mirror as before,” said one comment on Weibo, the Chinese version of Twitter.

Three years of Chinese government propaganda insisting on zero-COVID and highlighting the dangers of the virus have made many netizens feel uncomfortable with the sudden “opening up.” They worry that the move will worsen the current outbreak.

“A smorgasbord of strains is coming,” wrote one commenter.

Some consider virus a biological weapon

Many nationalists have bought into a conspiracy theory that the coronavirus is a biological weapon developed by the United States to attack China; they fear that opening China will make it easier for the U.S. to attack again.

“It’s time to come to China to poison,” said one comment.

Others seem to look forward to a move that could spread the virus from China to other countries.

“Spread the virus all over the world!! No one gets left behind!” said one comment. “Europe, America, Japan, South Korea and India! Every single one! Don’t even think about running away!”
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India’s pharmaceuticals regulator has begun inspecting some drug factories across the country, the health ministry said on Tuesday, as it tries to ensure high standards after an Indian company’s cough and cold syrups were linked to deaths in Gambia.

India is known as the “pharmacy of the world” and its pharmaceuticals exports have more than doubled over the past decade to $24.5 billion in the past fiscal year.

The deaths of at least 70 children in Gambia has dented the industry’s image, though India says the drugs made by New Delhi-based Maiden Pharmaceuticals Ltd were not at fault.

“Joint inspections are being conducted all over the country as per standard operating procedures,” the Ministry of Health and Family Welfare said in a statement. “This will ensure high standards of quality compliance with respect to drugs manufactured in the country.”

The ministry said it was inspecting “drug manufacturing units” that were at risk of making non-standard, adulterated, or spurious drugs but did not name any company.

Some health experts say India’s drug regulations are lax, especially at the level of states where thousands of factories operate.

The government in October suspended all of Maiden’s production, based in the state of Haryana, for violation of manufacturing standards.

But India’s main drugs officer told the World Health Organization this month that tests of samples from the same batches of syrups that Maiden sent to Gambia were compliant with government specifications. Maiden too said its drugs were fine.

The WHO said labs contracted by it in Ghana and Switzerland found excess levels of ethyleneglycol and diethyleneglycol contaminants in the Maiden syrups.

A Gambian parliamentary committee said last week that Maiden was responsible for the deaths of at least 70 children from acute kidney injury and called on the government to pursue legal action.
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Artificial intelligence technology has tripled the number of U.K. stroke patients recovering to a point where they can perform daily activities, according to new research released Tuesday.

Early-stage analysis of over 111,000 suspected stroke patients whose care included use of the technology found it reduced the time between being seen by a doctor and treatment beginning by more than 60 minutes, leading to improved results.

The proportion who were able to resume day-to-day activities increased from 16 to 48 percent, the analysis of the Brainomix e-Stroke imaging platform found.

The technology, developed by the UK’s med-tech solution firm Brainomix, is being used across 11 stroke treatment networks in the UK’s state-funded National Health Service (NHS) to diagnose strokes and determine the best treatment.

The platform helps doctors in the interpretation of brain scans and allows them to share the images with specialists worldwide who can access them remotely.

“AI has the potential to transform our NHS — delivering faster, more accurate diagnoses and making sure patients can get the treatment they need, when they need it,” the U.K.’s health secretary Steve Barclay said in a statement.

“Brainomix is an incredible example of how this can be achieved, using the power of AI to shave lifesaving minutes off one of the most time-sensitive diagnoses in medicine.”

Patient Carol Wilson, a teaching assistant, said the prompt diagnosis and treatment she received as a result of the technology meant she was sitting up and texting her family later the same day.

The grandmother who has since returned to work said she was “back home and able to walk around two days after having a stroke.”

Over 85,000 people suffer a stroke in the U.K. each year.

NHS England director of Transformation Dr. Timothy Ferris said the treatment was “harnessing the potential that AI has to support expert staff in delivering life-changing care.”

“Every minute saved during the initial hospital assessment of people with stroke-like symptoms can dramatically improve a patient’s chance of leaving hospital in good health,” he said.

Brainomix launched as an Oxford University spin-out in 2010. Its e-stroke platform is now used in more than 330 hospitals in more than 30 countries.
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A British historian, an Italian archaeologist and an American preschool teacher have never met in person, but they share a prominent pandemic bond.

Plagued by eerily similar symptoms, the three women are credited with describing, naming and helping bring long COVID into the public’s consciousness in early 2020.

Rachel Pope, of Liverpool, took to Twitter in late March 2020 to describe her bedeviling symptoms, then unnamed, after a coronavirus infection. Elisa Perego in Italy first used the term “long COVID,” in a May tweet that year. Amy Watson in Portland, Oregon, got inspiration in naming her Facebook support group from the trucker cap she’d been wearing, and “long hauler” soon became part of the pandemic lexicon.

Nearly three years into the pandemic, scientists are still trying to figure out why some people get long COVID and why a small portion — including the three women — have lasting symptoms.

Millions of people worldwide have had long COVID, reporting various symptoms including fatigue, lung problems, and brain fog and other neurological symptoms. Evidence suggests most recover substantially within a year, but recent data show that it has contributed to more than 3,500 U.S. deaths.

Here’s some of the latest evidence:

Women more at risk?

Many studies and anecdotal evidence suggest that women are more likely than men to develop long COVID.

There could be biological reasons.

Women’s immune systems generally mount stronger reactions to viruses, bacteria, parasites and other germs, noted Sabra Klein, a Johns Hopkins professor who studies immunity.

Women are also much more likely than men to have autoimmune diseases, where the body mistakenly attacks its own healthy cells. Some scientists believe long COVID could result from an autoimmune response triggered by the virus.

Women’s bodies also tend to have more fat tissue and emerging research suggests the coronavirus may hide in fat after infection. Scientists also are studying whether women’s fluctuating hormone levels may increase the risks.

Another possible factor: Women are more likely than men to seek health care and often more attuned to changes in their bodies, Klein noted.

“I don’t think we should ignore that,” she said. Biology and behavior are probably both at play, Klein said.

It may thus be no coincidence that it was three women who helped shine the first light on long COVID.

Pope, 46, started chronicling what she was experiencing in March 2020: flu-like symptoms, then her lungs, heart and joints were affected. After a month she started having some “OK” days, but symptoms persisted.

She and some similarly ill colleagues connected with Perego on Twitter. “We started sort of coming together because it was literally the only place where we could do that,” Pope said. “In 2020, we would joke that we’d get together for Christmas and have a party,” Pope said. “Then obviously it went on, and I think we stopped joking.”

Watson started her virtual long haulers group that April. The others soon learned of that nickname and embraced it.

Mono virus

Several studies suggest the ubiquitous Epstein-Barr virus could play a role in some cases of long COVID.

Inflammation caused by coronavirus infection can activate herpes viruses, which remain in the body after causing an acute infection, said Dr. Timothy Henrich, a virus expert at the University of California, San Francisco.

Epstein-Barr virus is among the most common of these herpes viruses: An estimated 90% of the U.S. population has been infected with it. The virus can cause mononucleosis or symptoms that may be dismissed as a cold.

Henrich is among researchers who have found immune markers signaling Epstein-Barr reactivation in the blood of long COVID patients, particularly those with fatigue.

Not all long COVID patients have these markers. But it’s possible that Epstein-Barr is causing symptoms in those who do, although scientists say more study is needed.

Some scientists also believe that Epstein-Barr triggers chronic fatigue syndrome, a condition that bears many similarities to long COVID, but that also is unproven.

Obesity

Obesity is a risk factor for severe COVID-19 infections and scientists are trying to understand why.

Stanford University researchers are among those who have found evidence that the coronavirus can infect fat cells. In a recent study, they found the virus and signs of inflammation in fat tissue taken from people who had died from COVID.

Lab tests showed that the virus can reproduce in fat tissue. That raises the possibility that fat tissue could serve as a “reservoir,” potentially fueling long COVID.

Could removing fat tissue treat or prevent some cases of long COVID? It’s a tantalizing question, but the research is preliminary, said Dr. Catherine Blish, a Stanford infectious diseases professor and a senior author of the study.

Scientists at the University of Texas Southwestern Medical Center are studying leptin, a hormone produced by fat cells that can influence the body’s immune response and promote inflammation.

They plan to study whether injections of a manufactured antibody could reduce leptin levels — and in turn inflammation from coronavirus infections or long COVID.

“We have a good scientific basis together with some preliminary data to argue that we might be on the right track,” said Dr. Philipp Scherer.

Duration

It has been estimated that about 30% of people infected with the coronavirus will develop long COVID, based on data from earlier in the pandemic.

Most people who have lingering, recurrent or new symptoms after infection will recover after about three months. Among those with symptoms at three months, about 15% will continue to have symptoms for at least nine more months, according to a recent study in the Journal of the American Medical Association.

Figuring out who’s at risk for years-long symptoms “is such a complicated question,” said Dr. Lawrence Purpura, an infectious disease expert at Columbia University.

Those with severe infections seem to be more at risk for long COVID, although it can also affect people with mild infections. Those whose infections cause severe lung damage including scarring may experience breathlessness, coughing or fatigue for more than a year. And a smaller group of patients with mild initial COVID-19 infections may develop neurologic symptoms for more than a year, including chronic fatigue and brain fog, Purpura said.

“The majority of patients will eventually recover,” he said. “It’s important for people to know that.”

It’s small consolation for the three women who helped the world recognize long COVID.

Perego, 44, developed heart, lung and neurologic problems and remains seriously ill.

She knows that scientists have learned a lot in a short time, but she says “there is a gap” between long COVID research and medical care.

“We need to translate scientific knowledge into better treatment and policy,” she said.

Watson, approaching 50, says she has “never had any kind of recovery.” She has had severe migraines, plus digestive, nerve and foot problems. Recently she developed severe anemia.

She wishes the medical community had a more organized approach to treating long COVID. Doctors say not knowing the underlying cause or causes makes that difficult.

“I just want my life back,” Watson said, “and it’s not looking like that’s all that possible.”
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China said Monday it would scrap mandatory quarantine on arrival, further unwinding years of strict virus controls as the country battles a surge in cases.

Having mostly cut itself off from the rest of the world during the pandemic, China is now experiencing an unprecedented surge in infections after abruptly lifting restrictions that torpedoed the economy and sparked nationwide protests.

And in a sudden end to nearly three years of strict border controls, Beijing said late Monday it would scrap mandatory quarantines for overseas travelers.

Since March 2020, all passengers arriving in China have had to undergo mandatory centralized quarantine. This decreased from three weeks to one week this summer, and to five days last month.

But under new rules that will take effect January 8, when COVID-19 will be downgraded to a Class B infectious disease from Class A, they will no longer need to.

“According to the national health quarantine law, infectious disease quarantine measures will no longer be taken against inbound travelers and goods,” the National Health Commission (NHC) said.

The move is likely to be greeted with joy from Chinese citizens and diaspora unable to return and see relatives for much of the pandemic.

But it comes as China faces a wave of cases that studies have estimated could kill around one million people over the next few months.

Many are now grappling with shortages of medicine, while emergency medical facilities are strained by an influx of undervaccinated elderly patients.

“At present, COVID-19 prevention and control in China are facing a new situation and new tasks,” President Xi Jinping said in a directive Monday, according to state broadcaster CCTV.

“We should launch the patriotic health campaign in a more targeted way… fortify a community line of defense for epidemic prevention and control, and effectively protect people’s lives, safety and health,” he said.

‘Impossible’ to track

Hospitals and crematoriums across the country have been overflowing with COVID patients and victims, while the NHC on Sunday announced it would stop publishing daily nationwide infection and death statistics.

That decision followed concerns that the country’s wave of infections is not being accurately reflected in official statistics.

Beijing has admitted the scale of the outbreak has become “impossible” to track following the end of mandatory mass testing.

And last week, the government narrowed the criteria by which COVID-19 fatalities were counted — a move experts said would suppress the number of deaths attributable to the virus.

The winter surge comes ahead of two major public holidays next month, in which millions of people are expected to travel to their hometowns to reunite with relatives.

Authorities are expecting the virus to hit under-resourced rural areas hard, and on Monday called for the guaranteed supply of drugs and medical treatment during New Year’s Day and late January’s week-long Lunar New Year holiday.

In recent days, health officials in the wealthy coastal province Zhejiang estimated that one million residents were being infected per day.

The coastal city of Qingdao also predicted roughly 500,000 new daily infections and the southern manufacturing city of Dongguan eyed up to 300,000.

Unofficial surveys and modelling based on search engine terms suggest that the wave may have already peaked in some major cities like Beijing and Chongqing.

A poll of over 150,000 residents of the southwestern province of Sichuan organized by disease control officials showed that 63% had tested positive for COVID, and estimated that infections peaked Friday.

Only six COVID deaths have been officially reported since Beijing unwound most of its restrictions earlier this month.

But crematorium workers interviewed by AFP have reported an unusually high influx of bodies, while hospitals have said they are tallying multiple fatalities per day, as emergency wards fill up.

The main funeral service center in the southern metropolis of Guangzhou postponed all ceremonies until January 10 to focus on cremations due to the “large workload,” according to a notice published online Sunday.

China’s censors and mouthpieces have been working overtime to spin the decision to scrap strict travel curbs, quarantines and snap lockdowns as a victory, even as cases soar.
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China’s Zhejiang, a big industrial province near Shanghai, is battling around a million new daily COVID-19 infections, a number expected to double in the days ahead, the provincial government said Sunday.

Despite a record surge of cases nationwide, China reported no COVID deaths on the mainland for the five days through Saturday, the Chinese Center for Disease Control and Prevention said Sunday.

Citizens and experts have called for more accurate data as infections surged after Beijing made sweeping changes to a zero-COVID policy that had put hundreds of millions of its citizens under relentless lockdowns and battered the world’s second-largest economy.

Nationwide figures from China had become incomplete as the National Health Commission stopped reporting asymptomatic infections, making it harder to track cases. On Sunday the commission stopped reporting daily figures, which the China CDC then published.

Zhejiang is among the few areas to estimate their recent spikes in infections including asymptomatic cases.

“The infection peak is estimated to arrive earlier in Zhejiang and to enter a period of elevated level around New Year’s Day, during which the daily new infection number will be up to two million,” the Zhejiang government said in a statement.

Zhejiang, with a population of 65.4 million, said that among the 13,583 infections being treated in the province’s hospitals, one patient had severe symptoms caused by COVID, while 242 infections of severe and critical conditions were caused by underlying diseases.

China narrowed its definition for reporting COVID deaths, counting only those from COVID-caused pneumonia or respiratory failure, raising eyebrows among world health experts.

The World Health Organization has received no data from China on new COVID hospitalizations since Beijing eased its restrictions. The organization says the data gap might be due to the authorities struggling to tally cases in the world’s most populous country.

‘Most dangerous weeks’

“China is entering the most dangerous weeks of the pandemic,” said a research note from Capital Economics. “The authorities are making almost no efforts now to slow the spread of infections and, with the migration ahead of Lunar New Year getting started, any parts of the country not currently in a major COVID wave will be soon.”

The cities of Qingdao and Dongguan have each estimated tens of thousands of daily COVID infections recently, much higher than the national daily toll without asymptomatic cases.

The country’s health care system has been under enormous strain, with staff being asked to work while sick and even retired medical workers in rural communities being rehired to help grassroots efforts, according to state media.

Bolstering the urgency is the approach of the Lunar New Year in January, when huge numbers of people return home.

Visits to Zhejiang fever clinics hit 408,400 a day — 14 times normal levels — in the past week, a Zhejiang official told a news conference.

Daily requests to the emergency center in Zhejiang’s capital, Hangzhou, have recently more than tripled on average from last year’s level, state television reported Sunday, citing a Hangzhou health official.

The eastern city of Suzhou said late Saturday its emergency line received a record 7,233 calls Thursday.
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Three years ago, scientists in Wuhan, China first reported infections from a novel coronavirus. Since then, the world has developed and delivered 13 billion shots against COVID-19. It is an unprecedented achievement, but it has been tarnished by unequal access. The global program aimed at improving vaccine equity has announced it will narrow its focus to the poorest countries. VOA’s Steve Baragona has a look at the global COVID vaccine drive as a pandemic blamed for more than 6.5 million deaths enters its fourth year.
Video editor: Steve Baragona
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World Health Organization Director-General, Tedros Adhanom Ghebreyesus gave a grim assessment of the many health challenges and threats people around the world have faced this year.

Topping the list was the COVID-19 pandemic that has sickened and killed millions of people for a third year. He noted a global outbreak of monkeypox, now known as mpox, an Ebola outbreak in Uganda, and cholera outbreaks in multiple countries as other health crises.

He said these emergencies were compounded by wars in Ethiopia and Ukraine, as well as climate disasters, including drought and flooding in the greater Horn of Africa and the Sahel, and flooding in Pakistan.

And yet, as 2022 draws to a close, he said there were many reasons for hope.

“The COVID-19 pandemic has declined significantly this year, the global monkeypox outbreak is waning, and there have been no cases of Ebola in Uganda for more than three weeks,” he said. “We are hopeful that each of these emergencies will be declared over at different points next year.”

While the pandemic is not over, Tedros said great progress has been made in containing its spread. He noted that one year ago, COVID-19 was killing 50,000 people a week. This now has dropped to fewer than 10,000 deaths a week.

Despite the significant decline, he cautioned the virus is here to stay and people have to learn how to manage the disease. He urged vigilance, masking, social distancing and, above all else, vaccinating.

2023

Looking ahead to next year, he said the WHO’s focus will be on health promotion and disease prevention.

“Instead of focusing on sick care like we do, we focus on health care, meaning keeping people healthy,” said Tedros. “And we will do everything to make that happen. But for that to happen, we will also focus on pushing for universal health coverage, especially with a shift to primary health care as a foundation.”

The WHO chief cited emergency preparedness and response as another priority. With new virus strains emerging, he emphasized the importance of doing everything possible to prepare the world for future pandemics.
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An arctic blast has brought extreme cold, heavy snow and intense wind across much of the U.S. — just in time for the holidays. 

The weather system, dubbed a “bomb cyclone,” is disrupting travel and causing hazardous winter conditions. Where is this winter weather coming from, and what’s in store for the coming days? 

What’s happening? 

A front of cold air is moving down from the Arctic, sending temperatures plunging. 

Much of the U.S. will see below-average temperatures, said Bob Oravec, lead forecaster for the National Weather Service in College Park, Maryland. 

Temperatures may drop by more than 20 degrees Fahrenheit (11 degrees Celsius) in just a few hours, the National Weather Service predicts. 

Wind chill temperatures could drop to dangerous lows far below zero — enough to cause frostbite within minutes. In parts of the Plains, the wind chill could dip as low as minus 70 degrees Fahrenheit (minus 57 Celsius). 

Those in the Plains, the Upper Midwest and the Great Lakes were cautioned to expect blizzard conditions as heavy winds whip up the snow, according to the National Weather Service. 

Who will be affected? 

Pretty much everyone east of the Rockies — around two-thirds of the country — will see extreme weather, said Ryan Maue, a private meteorologist in the Atlanta area. 

Though much of the West Coast will be shielded from the cold, the Arctic front is expected to pass east and south all the way through Florida. 

Heavy snowfall and intense winds could be bad news for air travel, Oravec said. 

And for those planning to hit the road for the holidays, “you’re going to have pretty serious whiteout conditions,” Maue cautioned. 

How long will it last? 

This weather system is expected to bring some major “weather whiplash,” said Judah Cohen, a winter storm expert for Atmospheric Environmental Research. 

The cold isn’t going to stick around for long. After the dramatic plunge that will keep temperatures low for about a week, “everything will snap back to normal,” Cohen said. 

Shortly after Christmas, temperatures are expected to start to warm up again, moving from west to east. They are likely to remain near normal through the end of the year in most of the U.S. 

Why is this happening? 

It all started farther north, as frigid air collected over the snow-covered ground in the Arctic, Maue said. 

Then the jet stream — wobbling air currents in the middle and upper parts of the atmosphere — began pushing this cold pool down into the U.S. 

As this arctic air is pushed into the warmer, moister air ahead of it, the system can quickly develop into serious weather — including what’s known as a “bomb cyclone,” a fast-developing storm in which atmospheric pressure falls very quickly over 24 hours. 

These severe weather events usually form over bodies of water, which have lots of warmth and moisture to feed the storm, Maue said. But with the huge amount of cold air coming through, we could see a rare bomb cyclone forming over land. 

Is this normal? 

The storm is a strong one, but “not unheard of for the winter seasons,” Oravec said. 

It’s pretty normal to have cold air build up in the winter. This week, though, shifts in the jet stream have pushed the air more to the southeast than usual, Oravec said — sweeping the freeze across the country and making storm conditions more intense. 

The U.S. probably won’t reach record-breaking lows, like those seen in the cold snap of 1983 or the polar vortex of 2014, Maue said. 

Still, “for most people alive, this will be a memorable, top-10 extreme cold event,” Maue said. 
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Hong Kong is forecast to grow economically next year after the city’s leader announced the removal of nearly all COVID-19 restrictions on international arrivals and said it would reopen its border with China.

But experts say the coronavirus pandemic and geopolitics have hampered Hong Kong’s international status after nearly three years of global isolation.

Last week, Hong Kong Chief Executive John Lee announced that people arriving in Hong Kong are free from COVID-19 restrictions.

International passengers can now travel freely upon arrival. Previous requirements meant arrivals were not allowed to enter places such as restaurants and bars for the first three days, monitoring their health as a precaution against catching the coronavirus. The government also scrapped its COVID-19 tracking media app that granted users access to venues such as restaurants, gyms and salons, although some designated venues will still require vaccination records for those who wish to enter.

Gary Bowerman, a tourism analyst based in Kuala Lumpur, said Hong Kong’s arrivals could still be hesitant to enter.

“Removing most entry restrictions is a big step forward, but as experience proved in Southeast Asia and South Korea, it is not until on-arrival testing is eliminated that confidence will return for inbound travel,” Bowerman told VOA. “Hong Kong is on a holding pattern, where travelers will likely wait until testing is removed before committing to travel to Hong Kong.”

COVID-19 background — China reopening

Arrivals must still be subject to a mandatory COVID-19 PCR test on arrival and one on Day Two, while the city’s face mask mandate is still in place.

Hong Kong initially closely followed China’s “zero-COVID” strategy, implementing strict policies such as vaccine passes, curfews and bans on group gatherings. But the territory has gradually eased restrictions as the spread of the highly transmissible omicron variants has been difficult to control.

Despite cases roaring in China, Lee announced Saturday that by mid-January Hong Kong’s border with the mainland would reopen.

“Hong Kong relies heavily on tourism from mainland China — which accounted for 78% of its visitors in 2018, so it would need China to reopen the border for any significant uplift to occur,” Bowerman previously told VOA.

Visitor numbers low

Hong Kong first opened borders to non-residents May 1 and then, in September, removed quarantines for arrivals. But with much of the world opening completely, Hong Kong hasn’t seen anything close to the number of arrivals it would welcome in pre-pandemic times.

This year has seen arrivals into Hong Kong remain low in comparison to before the pandemic, with only 330,223 visitors through the end of October. The city usually enjoys tens of millions of arrivals per year, with more than 65 million arrivals in 2018.

Alicia Garcia-Herrero, chief economist for the Asia Pacific region for Natixis, a French investment bank, said the removal of remaining restrictions for arrivals is a “game changer.”

“The announcement [removing] “0+3” is a game changer for Hong Kong. We are going to revise our growth projection. We are at -3 [%] this year at least. We’re going to see a rebound of at least 3%, possibly 4%. So, I can see about 3.5% [economic] growth [for 2023]. That’s to these measures,” Garcia-Herrero told VOA.

But trade wars and political differences between the U.S. and China in recent years have affected Hong Kong’s status as a global financial center. Relations also have  soured between Washington and Beijing after Hong Kong authorities cracked down on pro-democracy protests in 2019.

Garcia-Herrero said geopolitics means investors and businesses are relying less on Hong Kong as an investment hub.

“There is also export ban sanctions, even if Hong Kong is a different jurisdiction, the U.S. also applies these sanctions,” Garcia-Herrero said. “Companies in the light of Hong Kong are being perceived much more like the mainland [China] and not only by observers, this affects investors’ positions. Some are leaving for Singapore. I wouldn’t say financial institutions are just shutting and leaving, but they are reducing operations and finding what they can do elsewhere is less risky. It is a geopolitical risk not a competitive risk.”

Hong Kong’s international status “is a different ballgame,” Garcia-Herrero said. “To me, a global financial center like London, New York — the point is there is a vast variety in these two stock exchanges. That’s not the case in Hong Kong anymore and I doubt it will be. For me, Hong Kong will remain increasingly this offshore center for the mainland.”

Long time coming

Business owners, residents and foreign expatriates in Hong Kong have criticized Hong Kong’s long-winded COVID-19 rules, complaining the city would lose its competitiveness and status as a global city.

The city has already seen an accelerated exodus of a number of businesses and expatriates. Data shows Hong Kong’s population has declined significantly, with more than 113,000 residents leaving the city in the past year alone, the biggest-ever drop since record keeping began more than 60 years ago.

Health perspective

But Dr. David Owens, a family physician and honorary assistant clinical professor at Hong Kong University, argued the city could have moved to open earlier to prevent further damage.

“Hong Kong border restrictions, along with other COVID policies have had no grounding in science or evidence for many months,” he told VOA. “With other COVID regulations, Hong Kong border policies will actively harm public health due to the damage to both the economy and trust in public health institutions.

“I see no impact on Hong Kong from opening the international border,” he said. “This was always a political, not medical, decision, which could have been made months ago.” 
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Shanghai authorities urged residents to stay at home this weekend, seeking a toned-down Christmas in the nation’s most populous city as COVID-19 rages nationwide after tough curbs were lifted.

A branch of the Shanghai Municipal Health Commission on Saturday urged young people in particular to avoid crowded gatherings, due to the ease of spreading the coronavirus and low temperatures.

Christmas is not traditionally celebrated in China, but it is common for young couples and some families to spend the holiday together.

The omicron variant is surging weeks after the authorities abruptly ended their zero-COVID policy, lifting strict testing requirements and travel restrictions as China becomes the last major country to move toward living with the virus.

While many have welcomed the easing, families and the health system were unprepared for the resulting surge of infections. Hospitals are scrambling for beds and blood, pharmacies for drugs and authorities are racing to build clinics.

Shanghai typically hosts a large Christmas-themed market in a luxury shopping area along Nanjing West Road, and restaurants and retailers offer promotions to drum up business.

But the spread of Omicron is dampening celebrations.

Many Shanghai restaurants have canceled Christmas parties normally held for regulars, while hotels have capped reservations due to staff shortages, said Jacqueline Mocatta, who works in the hospitality industry.

“There’s only a certain amount of customers we can accept given our manpower, with a majority of team members who are unwell at the moment,” she said.

Skepticism about official data

People lamented on social media that they will be staying inside as most of their friends have tested positive for COVID.

“I originally planned to go to Shanghai for Christmas but now I can only lie in bed,” a person wrote on Weibo, China’s Twitter-like social network.

Infections in China are likely more than a million a day with deaths at more than 5,000 a day, in “stark contrast” to official data, British-based health data firm Airfinity said this week.

China’s national health authority Saturday reported 4,128 daily symptomatic COVID-19 infections, and no deaths for a fourth consecutive day.

Bloomberg News reported Friday that nearly 37 million people may have been infected with COVID on a single day this past week, citing estimates from the government’s top health authority.

The emergency hotline in Taiyuan in the northern province of Shanxi was receiving over 4,000 calls a day, a local media outlet said Saturday.

Taiyuan authorities urged residents to call the number only for medical emergencies, saying guidance about COVID “does not fall within the scope of the hotline.”

A health official in Qingdao said the port city was seeing roughly 500,000 daily infections, media reported Friday.

In Wuhan, the central city where COVID emerged three years ago, media reported Friday that the local blood repository had just 4,000 units, enough to last two days. The repository called on people to “roll up their sleeves and donate blood.”
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Half a million people in a single Chinese city are being infected with COVID-19 every day, a senior health official has said, in a rare and quickly censored acknowledgement that the country’s wave of infections is not being reflected in official statistics.

China this month has rapidly dismantled key pillars of its zero-COVID strategy, doing away with snap lockdowns, lengthy quarantines and travel curbs in a jarring reversal of its hallmark containment strategy.

Cities across the country have struggled to cope as surging infections have emptied pharmacy shelves, filled hospital wards and appeared to cause backlogs at crematoriums and funeral homes.

But the end of strict testing mandates has made caseloads virtually impossible to track, while authorities have narrowed the medical definition of a COVID death in a move experts have said will suppress the number of fatalities attributable to the virus.

A news outlet operated by the ruling Communist Party in Qingdao on Friday reported the municipal health chief as saying that the eastern city was seeing “between 490,000 and 530,000” new COVID cases a day.

The coastal city of around 10 million people was “in a period of rapid transmission ahead of an approaching peak,” Bo Tao reportedly said, adding that the infection rate would accelerate by another 10% over the weekend.

The report was shared by several other news outlets but appeared to have been edited by Saturday morning to remove the case figures.

China’s National Health Commission said Saturday that 4,103 new domestic infections were recorded nationwide the previous day, with no new deaths.

In Shandong, the province where Qingdao is located, authorities officially logged just 31 new domestic cases.

China’s government keeps a tight leash on the country’s media, with legions of online censors on hand to scrub out content deemed politically sensitive.

Most government-run publications have downplayed the severity of the country’s exit wave, instead depicting the policy reversal as logical and controlled.

But some outlets have hinted at shortages of medicine and hospitals under strain, though estimates of actual case numbers remain rare.

The government of eastern Jiangxi province said in a Friday social media post that 80% of its population — equivalent to around 36 million people — would be infected by March.

More than 18,000 COVID patients had been admitted to major medical institutions in the province in the two weeks up to Thursday, including nearly 500 severe cases but no deaths, the statement said.

‘No historical precedent’

There were signs that medical resources remained under stress as the weekend began, as some regional health officials warned that the worst was yet to come.

The southern manufacturing hub of Dongguan said Friday that outbreak modelling indicated up to 300,000 new infections per day, adding that the rate was “accelerating faster and faster.”

“Many medical resources and personnel are enduring severe challenges and huge pressure with no historical precedent,” read a statement issued by the health bureau of the city of 10.5 million.

The bureau also published a video showing patients connected to intravenous drips queuing outside a clinic, and a doctor sleeping on his desk after working late into the night for several days straight.

A senior health official in Hainan said Friday the island province would reach peak infections “very soon,” while in the eastern megacity of Shanghai more than 40,000 patients were treated for “fevers,” the state-run People’s Daily newspaper reported Saturday.

Authorities in Chongqing launched a campaign to inoculate residents with inhalable vaccines as the central megacity grapples with a significant outbreak.

AFP journalists in the city of 32 million this week witnessed hospitals overflowing with mostly elderly COVID-positive patients, and dozens of bodies being unloaded at crematoriums.
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The combination of the COVID-19 pandemic and high levels of opioid overdose deaths drove life expectancy in the United States down for the second consecutive year in 2021, with a child born in that year expected to live 76.4 years, the lowest figure since 1996, according to data from the U.S. Centers for Disease Control and Prevention.

By comparison, Americans born in 2019, the year before the pandemic took hold, could expect to live 78.8 years.

In 2019, the U.S. experienced 715.2 deaths per 100,000 people. In 2021, that rate had climbed by 23%, to 897.7.

While most countries in the world experienced a decrease in life expectancy during the pandemic, it was particularly pronounced in the U.S. And while many advanced economies, including France, Belgium, Switzerland and Sweden saw their life expectancy rates recover to pre-pandemic levels in 2021, death rates in the U.S. continued to climb.

Heart disease, cancer and COVID-19 remained the top three causes of death in 2021, unchanged from the preceding year. In 2021, the U.S. also recorded 106,699 deaths attributed to drug overdoses, or more than 30 per 100,000 people.

Since 2001, when the rate was below 10 per 100,000, the rate has increased every year.

Overdose deaths have an outsized effect on average life expectancy because victims are disproportionately young.

Differences by gender, race

Women in the U.S. have a higher life expectancy than men, on average. In 2021, a girl born in the U.S. could expect to live 79.3 years, while a boy could expect to live 73.5 years.

An American who turned 65 in 2021 could expect to live another 18.4 years on average, while women could expect to live 19.7 years longer — for men the number remained unchanged from 2020 — at 17 years.

Dividing the population by sex, race and Hispanic origin highlights stark disparities in death rates. Among men, American Indian and Alaska Native men had the highest rate of deaths per 100,000 people in 2021, at 1,717.5

The next-highest death rate was for Black men, at 1,380.2. White men experienced 1,055.3 deaths per 100,000, Hispanic men experienced 915.6, and Asian men just 578.1.

Among females, death rates were highest for American Indian and Alaska Native women, at 1236.6 per 100,000, followed by Black women, at 921.9. White women experienced 750.6 deaths per 100,000, followed by Hispanic women at 599.8. Asian women had the lowest death rate of any subgroup, with 391.1 per 100,000.

International comparison

Compared to other wealthy industrialized nations, particularly in Europe, U.S. life expectancy is not only lower, but also is getting worse.

A study published in the journal Nature Human Behavior in October charted the stark differences between the U.S. and many European nations. While almost all countries in Europe experienced a sharp decline in life expectancy in 2020, the first full year of the pandemic, many had returned to 2019 levels by the following year.

Among them, Sweden, Switzerland, Belgium and France all saw life expectancy rebound to near pre-pandemic levels in 2021. Other countries, including the U.K., Portugal, Austria, Italy, the Netherlands, Spain, Slovenia and Iceland had all recovered some, but not all the lost life expectancy.

Alone among wealthy European countries in posting two back-to-back declines was Germany, though its combined fall in life expectancy, less than one year in total, was far smaller than in the U.S.

Other European countries, mostly former Soviet states, also saw consecutive yearly declines, including Croatia, the Czech Republic, Estonia, Hungary, Lithuania and Poland, though none of those saw a decline as sharp as in the U.S.

The only European countries with a steeper drop in life expectancy than the U.S. from 2019 to 2021 were Bulgaria and Slovakia.

The differences in life expectancy between the U.S. and other wealthy countries is even more stark when compared with industrialized countries in the Asia-Pacific region.

Data collected by the World Bank shows that a child born in wealthy countries in that region, including Hong Kong, Japan, Singapore, Australia and New Zealand had a life expectancy of 82 years or more in 2020.

Public health failure

Life expectancy declines in the U.S., particularly regarding deaths related to COVID-19, is especially frustrating to experts, who note the widespread availability of vaccines and the fact that medical professionals have far more knowledge about how to fight the disease than they did at the beginning of the pandemic.

“It is absolutely a public health failure and a political failure,” Noreen Goldman, the Hughes-Rogers professor of Demography and Public Affairs at the Princeton University School of Public and International Affairs, told VOA.

“It’s certainly due, in part, to a lack of public health infrastructure, a lack of any kind of national coordination of our strategies during the pandemic, high politicization of vaccination and higher [vaccine] refusal rates in the U.S. than most other high-income countries,” she said.

Goldman said there are other complicating factors, not the least of which is the lack of universal health care, which is present in all other wealthy nations. Other factors play a role as well, including the high prevalence of other medical conditions, such as obesity and diabetes, which are associated with poorer COVID-19 outcomes.
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