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The Health 202

A newsletter briefing on the health-care policy debate in Washington.

China might relax its 'zero covid' policy amid widespread protests

The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Good morning, happy Thursday. Thanks to our colleagues’ intrepid reporting for helping us pull together today’s newsletter. 

Today’s edition: The Food and Drug Administration may ease some restrictions on blood donations for gay and bisexual men. The Centers for Disease Control and Prevention is expanding wastewater testing to detect polio. But first …

Three years of stringent covid policies have put the Chinese government in a bind

China offered the clearest sign so far that it may end its hardline pursuit of “zero covid” in the wake of the country’s most historic outpouring of protests in decades, The Post’s Lyric Li reports this morning.

Some major cities have begun loosening measures, such as relaxing some mass testing and allowing close contacts of infected people to quarantine at home.

At a meeting of health officials, Vice Premier Sun Chunlan, who heads covid response efforts, said the country faces a “new reality” with the less deadly omicron variant and an increase in vaccine coverage and health-care preparedness, Lyric writes, citing state media. It was a rare instance of a senior Chinese official — who has been linked to some of the harshest aspects of the “zero covid” policy — publicly acknowledging the virus’ risks are less severe than earlier on in the pandemic. 

The days of demonstrations had brought global scrutiny to China’s stringent covid measures — and Communist Party leaders are warning that they will “resolutely crack down” on the protests. 

The country is grappling with its worst coronavirus outbreak since the pandemic began, which comes as the Communist Party said in October that it would seek to reduce the burden of the virus on daily life, though without offering a concrete road map on how to do so. For nearly three years, China has been aiming to completely stamp out the virus, even as most of the world learns to live with it. 

The dynamic raises questions about what easing out of the “zero covid” policy could look like — and how long it could take — if officials ultimately decide to do so. 

Protests against China’s “zero covid” policy spread to cities around the country on Nov. 27. (Video: Julie Yoon/The Washington Post)

The weekend’s protests were triggered by an apartment complex fire that killed 10 people in Urumqi. Residents accused firefighters of being too slow to respond and faulted coronavirus restrictions. The city government denies there was a delay. 

That sparked the largest showing of discontent in the country since the 1989 Tiananmen Square protests. Thousands took to the streets in over a dozen cities. They called for the end to pandemic restrictions, with some going as far as demanding President Xi Jinping resign, “a sentiment deemed so sensitive in China that it is seldom uttered publicly,” writes The Post’s Christian Shepherd.

Demonstrations largely fizzled out with the cold temperatures and beginning of the workweek, though a video making the rounds on social media Wednesday showed protesters throwing what appeared to be glass bottles at security officers in the southern city Guangzhou. 

Chinese authorities are responding by quietly trying to quell protests through tactics like showing up at homes in the middle of the night, stopping residents and searching their phones for restricted apps, and holding people at police stations for more than 24 hours, our colleagues Lily Kuo, Pei-Lin Wu and Theodora Yu reported yesterday. Officials are also expected to impose tighter censorship measures and issue propaganda in an effort to prevent escalating public backlash. 

Protestors in Guangzhou, China, clashed with police on Nov. 29 over frustration with China’s “zero covid” restrictions. (Video: The Washington Post)
What’s next?

There are signs this week of easing some covid-19 restrictions.

Beijing, Chongqing and Guangzhou will now allow some close contacts of people infected with covid-19 to quarantine at home (it’s unclear if this policy will spread across the country). Meanwhile, in Chengdu, the construction of a facility that could quarantine more than 10,000 people was called off. And in Urumqi, public transportation partially restarted Monday.

But the move raises serious questions, considering how long the country has been under the tight restrictions. 

Vaccine uptake has been low in China. Roughly two-thirds of Chinese citizens over age 80 have received two vaccine doses, and only 40 percent of that age group have been boosted. The National Health Commission is encouraging local governments to identify elderly people who haven’t gotten shots and if they refuse, obtain a reason.

There are also questions over whether China’s health-care system can handle a sudden and stark reversal in the “zero covid” policy. In addition to the low booster rate among the elderly, the country’s population has low natural immunity, which means cases of severe illness could spike and potentially overwhelm the system.

  • “For China, estimated coronavirus cases are chilling, based on the Hong Kong, Taiwan and South Korean experiences of opening up after tight restrictions,” Jeremy Wallace, an associate professor of government at Cornell University, wrote yesterday in The Post. “Some estimates project well over 1 million covid deaths within a few months if China completely removed restrictions — and China’s health system is much more threadbare than those of their East Asian neighbors.”

Agency alert

FDA appears poised to ease blood donation restrictions for gay and bisexual men

The Food and Drug Administration is considering shifting away from a blanket ban on blood donations from sexually active gay and bisexual men in favor of a more individualized approach, the Wall Street Journal reports. 

The change would be a major win for advocates who have long argued that the policy, which originated in the 1980s during the AIDS epidemic, is discriminatory and lacks scientific justification. 

Federal rules prohibit all men who have had sex with men in the past three months from donating blood. Previously, men who had sex with men were banned from donating blood altogether, a prohibition that was lifted in 2015.

Under the potential new policy, which is still under debate and is expected to be released in the coming months, all potential donors would be required to complete a questionnaire about their recent sexual activity. People who say they haven’t had any new sexual partners in the last three months would likely be permitted to donate. 

Rep. Greg Stanton (D-Ariz.), who advocated for the prohibition to be lifted:

CDC expands wastewater testing for polio to Michigan, Pennsylvania

The Centers for Disease Control and Prevention will begin testing wastewater to detect polio in the Philadelphia and Detroit area in an effort to target communities at highest risk for the life-threatening illness, our colleague Lena H. Sun reports.

The testing will last for at least four months and occur in places with low vaccination rates. The Michigan and Philadelphia health departments are working with the CDC to identify undervaccinated communities that also have wastewater sampling locations. 

The expansion comes amid growing pressure to bolster strategies to fight the disease after the first U.S. polio case in nearly a decade was discovered this summer in Rockland County, N.Y. The virus has since been detected in wastewater samples from nearby areas. 

Other news from around the agencies …

The Biden administration is eyeing winding down the public health emergency for mpox, the virus called monkeypox until it was renamed this week, Politico’s Adam Cancryn reports. Officials may issue a notice later this week that the declaration will end in 60 days.

The FDA paused the emergency use authorization of Eli Lilly’s coronavirus drug bebtelovimab because it isn’t likely to be effective at neutralizing dominant omicron subvariants BQ.1 and BQ.1.1. The drug was the only remaining monoclonal antibody treatment cleared for use, according to Stat

Deaths related to alcohol consumption and drug use increased among older adults in the United States in the first year of the pandemic, with drug overdose deaths more than tripling in people age 65 and over during the past two decades, according to data published yesterday by the CDC’s National Center for Health Statistics.

State scan

California courts to weigh free speech and medical misinformation

Two lawsuits in California have preemptively challenged a first-of-its-kind law that would punish doctors for spreading misinformation about covid-19, the New York Times reports. 

The legal challenges test what steps, if any, states can take to remedy a problem that has divided the country.

At issue is a law signed by Gov. Gavin Newsom (D-Calif.) in September that empowers the Medical Board of California to designate the spread of false or misleading information about the coronavirus to patients as “unprofessional conduct.” Punishments range from fines to the suspension or revocation of a physician's license to practice in the state. The law is set to take effect Jan. 1. 

The view from supporters: Proponents of the measure argue it's necessary to safeguard patients against doctors who fueled skepticism about vaccines and mask mandates or encouraged the use of drugs like ivermectin and hydroxychloroquine, neither of which have been proven to be effective against the coronavirus, the New York Times’s Steven Lee Myers writes. 

The view from opponents: Plaintiffs in the case view the law as an unconstitutional infringement of free speech that is both vague and intrusive. Doctors involved in the legal challenges, some of whom have spoken out against the government and its pandemic recommendations, warn that the measure could stifle a physician’s ability to honestly advise their patients about the risks and benefits of coronavirus treatments and prevention methods.

ACLU of Northern California:

In other health news

  • ProPublica and Vanity Fair are defending their story published last month about an interim report on the origins of covid-19 that concluded that the pandemic was “more likely than not, the result of a research-related incident,” following an internal review of the story after it received sharp criticism over its translations.
  • Indiana’s Republican attorney general asked the state’s medical board to discipline a doctor who performed an abortion on a 10-year-old rape victim from Ohio over allegations that she failed to immediately report the child abuse to authorities.
  • Swiss drugmaker Roche will mostly end testing of its experimental Alzheimer’s drug gantenerumab after it failed to slow the progression of the memory-robbing disease in a pair of late-stage clinical trials, Reuters reports.

Health reads

Poison pill: How fentanyl killed a 17-year-old (By Devlin Barrett | The Washington Post)

Yale accused of discriminating against students with mental illness (By William Wan | The Washington Post)

New York’s Plan to Address Crisis of Mentally Ill Faces High Hurdles (By Emma G. Fitzsimmons and Andy Newman | The New York Times)

Sugar rush

Thanks for reading! See y'all tomorrow.