The worst of all possible approaches?

For all of the complaint and infighting about how many Western countries responded to Covid, can we at least agree that China has dealt with it in a way in which is pretty much "the worst of all possible worlds":

Most scientists believe China’s decision to end its zero-COVID policy was long overdue. But now they have a new worry: that the country is collecting and sharing far too little data about the rough transition to a new coexistence with the virus.

China abruptly dropped virtually all controls a month ago, after protests, a sagging economy, and the extreme transmissibility of the virus’ latest variants made clinging to zero COVID untenable. Now, “SARS-CoV-2 has an open goal in front of it: a population with very low levels of standing immunity,” says evolutionary biologist Edward Holmes of the University of Sydney. But how the epidemic is unfolding is a mystery because the country has practically stopped collecting basic epidemiological data.

And more:

As to the death toll, China’s reporting had long been inconsistent, Huang says, with some regions reporting all fatalities in which SARS-CoV-2 was a factor, as most countries do, and others excluding people who died from other conditions, such as heart attacks, even if they had COVID-19. In early December, China’s government decided the narrower definition should be used nationwide.

Even then, the official count is astonishingly low: just eight deaths for the entire last week of December, which is “not matching media reports and what is being seen on social media,” says Louise Blair, who tracks China’s COVID-19 outbreak for Airfinity, a London-based health analytics firm that estimates about 9000 people were dying of COVID-19–related causes every day in late December. Also missing are data on case fatality rates, the average number of new infections stemming from each case, and hospital and intensive care admissions. “These are critical data” that would help health authorities get a handle on the surge and further the world’s understanding of the pandemic, says Xi Chen, a public health scientist at the Yale School of Public Health.

A major worry is that the wave will breed a new and even more troublesome SARS-CoV-2 variant. “It’s possible that something might be emerging, because there is such a big population in China,” says George Gao, who in July 2022 stepped down as head of China CDC but is now helping track circulating variants. But, he told Science, “There are no novel mutants—yet.” At a 20 December press briefing, Xu Wenbo, head of the National Institute for Viral Disease Control and Prevention, explained that the BA.5.2 and BF.7 Omicron subvariants, which are now causing most infections globally, are also dominant in China. BQ.1 and XBB, which have recently been spreading in Europe and North America, have turned up in limited numbers in several provinces.

Experts are split on whether China is looking closely enough. Three designated sentinel hospitals in different cities in each of China’s 31 provinces, municipalities, and regions are supposed to sequence and analyze samples from 15 outpatients, 10 severe cases, and all deaths every week. “I’m afraid [that] sample size is too small,” Chen says. A stronger plan would consider province size and population density, instead of picking three cities in each, and adopt other sampling approaches, says Elizaveta Semenova, an epidemiologist at the University of Oxford. Semenova is a co-author of a study of how well 189 countries have detected new variants, published in November 2022. It concluded that effective surveillance requires sequencing about 0.5% of cases, with a turnaround time of less than 21 days. China’s plan is unlikely to come close to that percentage.

In light of this article, I find it difficult to understand our Chief Medical Officer's decision to not endorse our government following other countries in requiring Chinese arrivals to have a negative Covid test, at least for now:

Professor Kelly advised in the absence of any "specific threat" from a COVID-19 variant and with high vaccination rates in the country, any restrictions or additional requirements on China were unnecessary. 

But, as explained above, there is a lot of doubt as to how long it would take China to find and report a new variant.