Should the World Worry About China’s New Mystery-Pneumonia Outbreak?

When you hear about a mysterious pneumonia outbreak occurring in northern China that is hospitalizing children, you cannot be faulted in this post-pandemic era if your mind immediately jumps to a novel pathogen or even something bioengineered.

But the more information about this outbreak that comes out, the more it appears this is not likely to be a repeat of COVID-19, thankfully — which is, of course, not to say that it couldn’t or hasn’t happened that same way.

Also, the fact that the Chinese have reported no “unusual or novel pathogens,” according to the World Health Organization (WHO), is not automatically reassuring when you consider that it was the WHO which declined to declare COVID a pandemic until March 2020, two months after spreading cases were reported, and which helped camouflage the extent of the problem while it had already erupted in Europe and on into the U.S.

Still, in this case I would tend to believe the WHO, not because it couldn’t be persuaded to carry water for China yet again but because its explanation makes the most sense: that the repeated lockdowns in China for COVID as late as 2022 helped to foster an environment where kids weren’t exposed to garden-variety respiratory infections like flu, RSV, and mycoplasma. Then when they were finally exposed, their immune systems responded in a delayed manner, known as an immune pause, because they hadn’t seen these pathogens over the past few years as a result of the shutdowns and restrictions.

This theory explains why we had an early and severe RSV and flu season here in the U.S. in 2022, because our lockdowns ended much earlier and our population was re-exposed to the common respiratory pathogens sooner.

Meanwhile, in China, with hospitals again being overwhelmed by clusters of pneumonia of various causes in children, with influenza-like illness reportedly on the rise at a higher rate earlier in the season than during the previous three years, the lack of widespread infections across all age groups also argues against this outbreak being due to a novel pathogen.

There are many news and social media reports of crowds of children at hospitals with “pneumonia,” without specifying the exact pneumonia that is at work. This inexactitude is worrying, if for no other reason than that China has a long history of underreporting infectious outbreaks. That official suppression of information drew worldwide scrutiny and heavy criticism in 2003 with SARS, before going on to become far more intense since 2020 and the SARS COV 2 pandemic. Many infectious disease leaders have told me they simply don’t believe any public health reports coming from China.

In the meantime, WHO is, of course, recommending staying home and wearing masks when you are sick, as well as updating vaccinations. Recent studies have shown a suboptimal vaccine uptake in influenza and other vaccinations in China, especially in groups that are not fully subsidized and have to pay for vaccines. This is a worldwide problem, not unique to China, but it contributes to large infectious outbreaks.

There are two major lessons here. One is that the public health consequences of extreme, prolonged restrictions lead to rebound effects that are just as real later on. And second, although not new, is that we can’t automatically trust medical information coming from China.

This may not be a new killer virus like COVID was — but the next one might be, and it could well emerge from a country like China with dense populations and limited or no information-sharing. We need a transparent worldwide system of surveillance that all countries adhere to or suffer marked economic sanctions if they don’t. Public health is a matter of international security, since a virus never obeys boundaries or borders.

Link to article: https://themessenger.com/opinion/china-children-respiratory-influenza-pneumonia-hospitals-who-information-concern