Omicron’s Real Threat to the NHS May Be Shutting Its Chinese Supply Line

If the last two years have taught us anything, it’s that the world never pays enough attention to things that happen in inland China in December.

The whole metropolitan region of the Chinese city of Xi’an, home to the terracotta warriors, has just been put under a hard lockdown, with residents to stay home except for one person from each household allowed out to buy groceries every two days. Thirteen million people confined at home because of a Delta outbreak of just 127 cases. Factories are not exempt from the lockdown.

I processed this news as I opened the latest brand of Lateral Flow Devices I got from Boots the other day – made in the Zhengzhong Road industrial area in another historic Chinese tourist city, Hangzhou. The previous box was “Orient Gene’s” from an hour up the road from there in Houzhou. What happens to the supply of these lateral flow tests and other vital goods if factories start shutting all over China in the face of hard lockdowns caused by Omicron outbreaks? A huge proportion of the equipment we need to manage Covid-19’s spread comes from China. A huge proportion of everything we need to make modern life possible comes from China.

Outbreaks of Delta in other East Asian countries causing factory and port shutdowns were a big part of this autumn’s worldwide supply chain problems.

China is still pursuing a rigid Zero Covid strategy, the only country in the world to be able to do so in the face of Delta’s very high transmissibility. Given the case curves we’ve seen in Gauteng, London, Denmark, and now Paris, Omicron has a big transmission advantage over even Delta.

There are good reasons for thinking China will continue to pursue a hard Zero Covid strategy for at least the next two months. Firstly, the Chinese New Year, the biggest travel event on the planet when people trek across the country to visit families, is on 1 February. Banning travel during the festival would be terribly unpopular – and very cruel to scattered families; but if Omicron were spreading in the community by then, it would become a mega-spreading event. Then, the Winter Olympics will take place in Beijing from 4-20 February.

Based on experience in, e.g., Chile, while China’s Sinovax vaccine is a lot better than nothing, it’s the least effective of the Covid-19 vaccines in use. Chile boosted it with Astrazeneca which made a highly effective combination, but I haven’t heard of that being tried in China. And, of course, China’s Covid-suppression operation has been so effective – and genuinely impressive – over the last 21 months that few Chinese have any immunity via infection. So Omicron will spread like wildfire if there is any community transmission in China. In fact, it will almost certainly make Zero Covid impossible, even there, for very long: the question is whether the authorities will try and hold on for two months until the Olympics.

I know it’s Christmas and everyone is going to have a few days off and nobody important is going to read an article by a clergyman on an obscure blog from, of all places, Northern Ireland. But I needed to get out there that the authorities in every capital in the world need to be seeking cast-iron supply guarantees from Beijing at the moment while also preparing for the prospect that they won’t ultimately be honoured. Especially as factory shutdowns will cause domestic supply problems in China too, when it might be facing its first big wave of cases since February 2020 – remember that in early 2020 Chinese officials restricted exports and even quietly reimported PPE previously sold to other countries. In genuinely big crises, countries do look after themselves first.

I appreciate why NHS managers feel the need to plan for 2 million cases a day and treating people in hospital carparks and all that; but I haven’t seen any hard data showing this is likely. Even in London, there are still fewer Covid patients on ventilators than there were at the end of August, and barely more than at the start of December. It’s the same story in Denmark.

But I think a collapse of NHS supply chains and many others is a real possibility if all those factories on the Zhenzhong Road start shutting down. I hope clever people are being tasked to plan how the worst consequences of that can be managed as soon as everybody comes back after the break. It feels like “call Kate Bingham” time.

Oh, and our toilet roll mostly comes from Scotland and Scandinavia, not China, so you don’t need to panic buy.

Merry Christmas!