Travellers wearing face masks sit on rows of chairs with their luggage at Shanghai Hongqiao Railway Station

The government lifted a lot of restrictions in China. The credit is given to Qilai Shen.

According to some projections, up to one million people in China could die from carbon dioxide over the next few months.

James Wood, an infectious-disease modeller at the University of New South Wales, says that China is in for a bad few months.

The number of deaths could be reduced by giving most of the population a fourth vaccine dose, as well as high levels of adherence to masking and reimposition of temporary restrictions on social interactions when death rates surge, according to two studies. Hospitals could be helped by these measures.

An economist at Yale University who studies China's public-health system says it is never too late to flatten the curve.

The Chinese government has dismantled many of the restrictions it put in place to stop the spread of the virus. It lifted restrictions on travel within and between regions and allowed people with the disease to live in their homes. The number of people who have no symptoms will no longer be reported by the National Health Commission.

There are indications that infections in some regions are rising despite the fact that the number of reported cases has dropped. According to the Chinese state media agency, Beijing is facing a rapid increase in infections.

Fourth doses

One of the studies used data from Hong Kong and Shanghai to compare different scenarios in China. If infections rise as quickly as expected, hospitals will be overwhelmed. The study predicts that about one million deaths will occur over the next few months.

The estimates do not take into account excess deaths because of the delays in treating non-COVID-19 diseases.

The study suggests that if 85% of the population gets a fourth dose of a vaccine other than the in-activatedviruses vaccine, it could slow the rise in infections and deaths. It's possible to reduce deaths by up to 34% if you push fourth vaccine doses and give antiviral drugs to people who are at high risk of developing severe disease.

James Trauer, an infectious-disease modeller at Monash University in Melbourne, Australia, says that it is critical for China to achieve the highest vaccine coverage possible before a major epidemic. The impact of measures to slow the spread of the epidemic is still uncertain.

The government announced on December 13th that people over the age of 60 should get a fourth dose of vaccine. More than 260 million people in China older than 60 have not received a third dose.

It might be too late for China to benefit from fourth dose since there is already widespread transmission. He doesn't think an extra dose will make a big difference to transmission because the Omicron variant of the virus can evade the body's immune response.

Fewer deaths

China will face a death toll of half a million people by April, with 1.6 million deaths by the end of the year, according to a model. The model is developed by the Institute for Health Metrics and Evaluation at the University of Washington. According to Ali Mokdad, an epidemiologist at the institute, there could be as many as 9000 deaths in China by the end of the month.

The model predicts that the number of deaths could be reduced to around 290,000 if China takes certain measures. Reimposing restrictions, high rates of third- and fourth-dose vaccinations, and high antiviral drug treatment for at-risk groups are involved. Around 230,000 deaths could be reduced by widespread mask use. Adherence to masking is high in China and the easing of restrictions has led to changes in behavior. They will not allow it to be ripped.

Both studies agree on mortality estimates and the impact of interventions. herd immunity will only be achieved after a large, and difficult to contain, spread of transmission throughout the country.