'A cascade effect': Leading Spanish virologist explains why China’s COVID-19 surge is 'worrisome'

30 December 2022

Three years have passed since what came to be known as COVID-19 was first reported in Wuhan, China. Since those initial reports in December 2019, COVID-19 has killed more than 6.6 million people worldwide — including, according to Johns Hopkins University in Baltimore, over 1 million in the United States.

Much has changed with the COVID-19 pandemic since 2020. Millions of people have been vaccinated, and while COVID-19 is still highly contagious, fewer people are dying from it. The U.S., Europe, Canada and other parts of the world have long since abandoned the strict social distancing policies of 2020. Some businesses in the U.S. and Europe are still encouraging masks but aren’t requiring them.

But Mainland China only recently ended its lockdown policies, and it has been experiencing a COVID-19 surge. Dr. Luis Enjuanes, a well-known Spanish virologist, discussed this development with El País reporter Oriol Güell and offered his insights on possible implications for the rest of the world. Enjuanes serves as director of Spain’s National Center for Biotechnology (or Centro Nacional de Biotecnología in Spanish).

On Wednesday, December 28, El País published Güell’s interview with Enjuanes in Spanish. And the following day, an English-language translation of the interview was published. Both versions were published in a Q&A format.

Enjuanes sounded the alarm during the interview, stressing that Mainland China has lower COVID-19 vaccination rates than Europe. And he told Güell that in Mainland China, “there has been no middle ground” when it comes to COVID-19 policies.

According to the Spanish virologist, “They have gone from isolating all the residents in a building because of a (single) positive case to virtually letting the virus run rampant in a population that is not well-immunized…. The result is that, according to some sources, about 35 million people are infected a day. That’s a huge number, which can only be explained if we take two things into account.”

Enjuanes continued, “The first is that the restrictions (that China has) imposed over the past three years mean that very few people have spread the disease naturally. The second is that China’s vaccination coverage rates are lower than (they are) in Europe… and their vaccines are less effective as well. All of that means that the population is poorly protected against the virus.”

When Güell asked Enjuanes how “worrisome” Mainland China’s COVID-19 surge is for “the rest of the world,” the virologist responded, “It is worrisome” but added that “we are much better prepared” going into 2023 than three years ago.

“There are many contagions, which means that there will be many more mutations, and new variants will emerge,” Enjuanes told Güell. “This will have a cascade effect on the rest of the world. More infections always lead to more serious cases and more deaths, and that implies additional risks. However, it is also true that the new variants tend to be more attenuated forms of the virus.”

Enjuanes pointed out that COVID-19, like the flu, is an RNA virus rather than a “more stable” DNA virus. RNA viruses, according to Enjuanes, are more likely to “mutate” than a DNA virus like the measles or smallpox.

Enjuanes explained, “Being vaccinated (for a DNA virus) or having had the disease once means you are protected for life. I was vaccinated against smallpox over 60 years ago, and I am still protected against it. Coronaviruses and influenza viruses are RNA and mutate much more.”

COVID-19 infections are affecting people in a variety of ways. Some people test positive for COVID-19 but are totally asymptomatic; others die from it. And non-fatal symptoms can resemble anything from a mild cold to a bad cold to the flu. Most COVID-19 infections, at this point, are not fatal.

When Güell asked Enjuanes if COVID-19 will “become milder” and “end up being like a cold,” the virologist responded, “Not necessarily. It could be like the flu, which for many people, is not mild — and every year, they have to get vaccinated again. There are things we don’t know yet.”

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