Health in China: the situation in 2022

After the discovery of the highly contagious variant of incoming travelers in the southern province Guangdong, Hunan's provincial capital is now the latest victim. According to local health authorities, the infected individuals have not left closed-loop quarantine and are currently being treated in hospitals.

The governement has placed China's Covid zero strategy under severe pressure. However, no local transmissions have been reported. China's closed borders make it less vulnerable to the spread of Omicron, but there are increased risks.

In less than 50 days Beijing will host the Winter Olympics. 

Tens of thousands of foreigners are allowed to enter the country. 

Recent reports have shown that Chinese shotsgiven by the vast majority of China's highly vaccinated population do not provide enough antibodies against omicron.

China must ensure that ports and borders are secure before the Olympic events, Liang Wannian (an epidemiologist who heads China's special taskforce on the pandemic response) said at a press release.

China's rapid socioeconomic

China's rapid socioeconomic, and demographic change will have a profound impact on the wellbeing and health of its people. To fulfill its promise of a Healthy China 2030, it will be essential to prepare the health system and the public health response to new threats and challenges. This issue of The Lancet Public Health focuses on the health of China's 1*4billion citizens. It features the best Chinese research and highlights the most urgent public health issues.

Non-communicable disease is the main cause of death and morbidity in China today. An assortment of articles on cancer, stroke and injury show how it is important to address persistent disparities and reduce risk factors. Hongmei Zeng, along with colleagues, looked at five common cancers. They identified differences in diagnosis and reported large disparities between male and female patients. This has important implications for cancer awareness, screening and early detection. China is responsible for almost half of all new cases of stomach cancer worldwide. Ling Yang and his colleagues estimated that around 80% of non-cardiagastric cancer cases and 60% of cardia gastric carcinoma cases in China could be attributed to Helicobacter Pylori infection. They recommend that population-based H pylori screening be performed and that eradication be taken into consideration for gastric cancer prevention.

The Global Burden aof Diseases, Injuries, and Risk Factors Study (GBD), 2019 also appears in this issue. 

Qingfeng Ma and her colleagues discuss the risk factors and burden of stroke. The burden of stroke was high in 2019, with 3*94,000,000 new stroke cases. However, the age-standardised mortality and incidence rates have declined since 1990. 

This high burden can be reduced by effective prevention strategies against its major risk factors, such as high blood pressure, high blood sugar, high levels of air pollution, smoking, and diet. Pengpeng Ye, along with colleagues, report on the impact of falls among older adults. 

Falls are the leading cause for injury-related death in older adults. The incidence of falls among people 60 and older in China has increased significantly between 1990 and 2019. This highlights the need to invest in fall prevention strategies in order to reduce risks and address an increasing absolute burden with ageing.

 264 million old people in China

In China, there were 264 million people 60 and over in 2020. This number is expected to rise to 300 million by 2025, which would be nearly a fifth of the total population. This demographic shift could cause a major disruption to China's healthcare system. As Michael Ni and his colleagues have detailed in their thorough examination of the factors that led to Hong Kong's highest birth life expectancy, life expectancy is rising rapidly. Although life expectancy increases are a good indicator of health, it's important to distinguish it from healthy ageing. Also, consider the increased demand on social services and health care systems.

Climate change and its importance to our health and well-being is a key issue that requires much greater attention in China. The Lancet 2021 China Report Countdown to Health and Climate Change clearly reaffirms the dire climate-related threats to health in China and highlights opportunities for a post COVID-19 green recovery.

While COVID-19 has been a major event in the last 2 years, traditional infectious diseases have not been neglected. This is a good thing for China's public health. After decades of dedication and culturally-targeted approaches, China was declared malaria-free in June 2021 by WHO. The country is far from reaching WHO End TB targets. Qian Long and his colleagues, in their Health Policy, warned that the country is not yet at the right track.

China's healthcare system

China's healthcare system is still very disease-oriented. Junfang Wang and his colleagues discuss how China can improve its public health system in order to address both traditional and new public health problems. This year's China issue shows that equity in China's public healthcare approach is essential to address the social determinants and health of China (as discussed in Zhicheng Wang's and colleagues' comments); especially for transgender individuals (as Yezhe Lin and colleagues reviewed), and other minorities (as Lu Chen and Xin-fa Zhou discussed in their Comment). The Government should make a more inclusive and healthy China a priority.

Preliminary research is showing that the Covid vaccines in most countries offer little protection against the Omicron variant, which can be contagious.

All vaccines seem to offer significant protection from Omicron-related serious illness, which is the most important goal. Only the Moderna and Pfizer shots seem to be effective in stopping infections. These vaccines are not available worldwide.

Early research has shown that Omicron spreads far more quickly than the other shots, including those made by Johnson & Johnson, AstraZeneca and Johnson & Johnson. The gap is likely to have a significant impact on the spread of Omicron because many countries have built their vaccination programs around these vaccines. China

Globally, a surge in infections is a threat to the health of millions of people around the world. It also increases the chance of new variants emerging. This disparity in countries' ability to weather the pandemic is likely to get worse. The disparity in countries' ability to weather the pandemic will almost certainly grow.

The majority of evidence is based on laboratory studies, which don't capture the entire range of immune responses in the body, and do not track the effects on real-world populations. However, the results are quite striking.

Americans spend more on health care than any other country, leading to calls for lower reimbursement rates to providers. There is a risk that providers will respond to lower payments by limiting supply, preventing access to healthcare and resulting in worsening patient outcomes. Marcus Dillender, Anthony T. Lo Sasso, from DePaul University and Lu G. Jinks, from Analysis Group, examine the responses of providers to a 30% reduction in reimbursement rates in Illinois' workers' compensation system, which is one of the most-reimbursing workers’ compensation insurance systems in America. They examined data from more than 1.5million claims between 2009 and 2013, and found that the maximum reimbursement rates had a significant impact on annual costs. However, it did not have any effect on the care received by injured workers. They conclude that the authors could reduce healthcare costs by lowering reimbursement rates for high-reimbursing payers without requiring major changes to care.

US-CHINA TRADE WOES HELPED GLOBAL TRADE

In 2018 and 2019, the U.S. and China placed tariffs on imports from one another. Pablo Fajgelbaum from Princeton and his co-authors found that trade war increased global trade by 3% using bilateral trade data from top 50 exporting nations over the period 2014-2019. The U.S.-China Trade War lowered trade between these two countries but it also caused other exporting nations to trade more in products with higher U.S. tariffs. The authors also found that other countries had moved their exports away from China and toward the U.S. The differences in countries' export responses were due to the country's sensitivity to price changes and not its specialization in tariff-targeted products. The authors suggest that factors such as scale economies and pre-trade war reallocation capacity may have allowed the increase in exports. This ensured that the trade war did not simply reshuffle trade flows but created new opportunities in aggregate.

Data from a controlled trial in Cali (Colombia) was used by Felipe Barrera Osorio of Vanderbilt and Adriana D. Kugler at Georgetown. They found that workers who had received job training did not fare better during the pandemic. They find that participants randomly assigned to job training (primarily in the service sector) saw higher employment rates and monthly earnings initially. The differences disappeared when the pandemic struck, and both groups saw similar employment outcomes beginning in March 2020. These results may have been due to the fact that only service workers were affected by the pandemic. The training program was only 160 hours long and was completed less than a year before the outbreak. 

The lawyer jiwangassociate say Workers with longer tenures and longer training programs may have done better.

The rapid spread of Omicron coronavirus variants is looming across the globe, while the Delta variant remains dominant -- at least for the moment -- in other parts of the world. This means that the Covid-19 pandemic threatens holiday celebrations for millions.

Many European cities have already cancelled their 2022 firework displays, and other countries are imposing restrictions. Meanwhile, Chinese families may be forced to spend the third Lunar New Years apart.

Lunar New Year, which is celebrated in China on February 1, 2022, is China's largest holiday. Millions of Chinese people travel across the country to celebrate with their loved ones.

However, many of those plans were canceled after China's National Health Commission on Saturday announced travel restrictions. It doubled down on its "zero Covid" strategy in advance of the Beijing Olympics.

The city urged all residents with confirmed Covid-19 cases to avoid traveling during the New Year and Spring Festival holidays. This was in response to an epidemic of infections that occurred in recent weeks.

China will be required to use the facility as part of preparations for the partial reopening the border with the rest.

It will look similar to the one in China. 

The app will store a user's name and address, as well as their vaccination status. There is also a QR code scanner function that allows users to enter restaurants or other venues. Based on past check-ins, it assigns users an infection risk.

The government stated that Hong Kong's app will not track users' movements like China's. The app will only be available to Hong Kong residents who intend to cross the border. It will be available starting Dec. 10.

Alfred Sit, secretary of innovation and technology, stated that the app will be available for public testing and trials and would facilitate the gradual opening of the border.

Beijing has been a model for the global financial hub, and it has implemented some of the most restrictive travel restrictions in the world. It hopes that China, its primary source of economic growth will allow cross-border movement.

The two governments' delegations met last week in Shenzhen to discuss "good progress". However, the city authorities stated in a statement that Hong Kong must launch the app and set up boundary control points.

The government stated that cross-border travel will be allowed to resume initially, but with a restricted quota.

Omicron coronavirus variant, which caused anxiety worldwide last week, was discovered by mandatory testing of inbound travelers. However it has not spread from Hong Kong's quarantine hospitals into the wider community.

The 40-episode series has been called by Chinese media the first to concentrate on psychological counseling. It was adapted from the 2007 novel by Bi Shumin.

It was told by Xu Dingyuan a Zhejiang-based psychologist counselor that the show provides a plausible framework for counseling skills and procedures, but the TV-ready plots do not account for the slow pace required to provide real psychological treatment.

The process of counseling psychologically is slow and does not have many twists and turns. Xu said that counseling is often more difficult than it appears in dramas.

According to the 42-year old, many people are ashamed of visiting psychological counselors or having mental health issues. However, concerns about mental health have increased since the pandemic.

Xu stated that dramas can raise awareness about common mental disorders and the possibility of seeking psychological counseling to help. It also helps people feel less shame around the subject.