Tag Archives: Medical Conditions

China Weighs Zero-Covid Exit but Proceeds With Caution and Without Timeline

SINGAPORE—Chinese leaders are considering steps toward reopening after nearly three years of tough pandemic restrictions but are proceeding slowly and have set no timeline, according to people familiar with the discussions.

Chinese officials have grown concerned about the costs of their zero-tolerance approach to smothering Covid outbreaks, which has resulted in lockdowns of cities and whole provinces, crushing business activity and confining hundreds of millions of people at home for weeks and sometimes months on end. But they are weighing those against the potential costs of reopening on public health and support for the Communist Party.

As a result, they are proceeding cautiously despite the deepening impact of the Covid policies, the people said, pointing to a long path to anything approaching pre-pandemic levels of activity, with the timeline stretching to sometime near the end of next year.

The uncertainty around China’s Covid-19 strategy has led to a guessing game in the financial markets, with some looking for any sign that China would begin easing its Covid policies. China’s Communist Party congress last month, when Chinese leader

Xi Jinping

claimed a third term, had once been viewed as a potential turning point in its battle against Covid, but little has changed in the country’s approach to containing Covid.

China’s leaders are worried that a surge in Covid infections, hospital admissions and deaths could undermine confidence in the ruling Communist Party’s legitimacy.



Photo:

TINGSHU WANG/REUTERS

On Saturday, officials from China’s National Health Commission again reaffirmed their commitment to a firm “zero-Covid” strategy, which they described as essential to “protect people’s lives.”

Some progress is being made on relaxing border controls for inbound travelers from abroad. Beijing is likely to further cut the number of hotel quarantine days required of incoming travelers by early next year, to a total of seven days, say people involved in discussions, from a current policy of seven days in a quarantine facility followed by three days of home monitoring.

Domestically, officials have informed retail businesses that the frequency of PCR testing—a staple of China’s Covid regime—could be reduced as soon as this month, in part because of the high cost of mass testing, according to people familiar with the matter. The people said the government is planning to reduce the thousands of PCR testing stations that have been set up across the country as part of the campaign to institutionalize testing, citing the cost.

ECONOMIC IMPACT OF COVID IN CHINA AND CHINA’S ZERO-TOLERANCE APPROACH

Still, the leadership has found it difficult to enact broader relaxation measures this year, the people said. Many of the measures will remain. The country will still move aggressively to stamp out even small outbreaks, through mass testing and lockdowns. People will still need to use health codes on their phones to access public spaces, and travelers entering the country will face quarantines and rounds of Covid tests.

A combination of new viral variants, an underequipped public healthcare system and the impending approach of winter has left Beijing worried that a potential surge in Covid infections, hospital admissions and deaths could undermine confidence in the ruling Communist Party’s legitimacy.

Chinese health officials have been closely monitoring the fatality rates and public reactions in Hong Kong, Japan and South Korea, which share cultural roots with China and where governments had until recently imposed similar measures, the people said.

“The reopening in China will be carried out in an orderly manner. It will start gradually depending on the geographic areas and sectors, and it will be different from what we’ve seen in the West,” said one of the people involved in discussions. For example, the government could decide to implement less stringent measures in cities that are major business hubs.

Workers at the world’s biggest assembly site for Apple’s iPhones walked out as Foxconn has struggled to contain a Covid-19 outbreak. The chaos highlights the tension between Beijing’s rigid pandemic controls and the urge to keep production on track. Photo: Hangpai Xinyang/Associated Press

While some have questioned the accuracy of China’s official figures, health experts say the country’s Covid fatality rate has been much lower than in much of the West due to its strict measures. Officially, China has recorded roughly 5,000 Covid-19 deaths, a fraction of the U.S.’s more than 1 million deaths. China’s Communist Party has celebrated its lower official death count as evidence of the superiority of its governance model.

In recent months, Chinese officials have maintained close contact with the World Health Organization, focusing on the alert level that the Geneva-based body has assigned for the Covid-19 pandemic, according to people familiar with the matter.

The WHO’s emergency committee meets once every three months to assess whether the pandemic still constitutes a “public health emergency of international concern.”

A WHO shift in declaration would give China more wiggle room for policy changes. Beijing could start to push for more aggressive easing measures and adjust the domestic narrative on Covid, effectively declaring victory in containing the virus, according to people familiar with the matter.

The WHO first declared a public health emergency of international concern in January 2020, and decided during its latest meeting, held in October, that it is still too early to lift the status. The next meeting is slated for January.

A WHO official said the agency doesn’t comment on private discussions with member states.

One plan under consideration in Beijing, the people said, would be to begin treating Covid-19 as a “Class B” infectious disease following any change in the WHO’s designation. China has been treating it as a Class A disease, which calls for stricter public-health measures.

Even with such a move, it could take China a much longer time—perhaps a year, the people said—to return to pre-pandemic levels of activity. The government wants to continue to monitor new variants closely to ensure that they don’t become more dangerous, they said.

Any further loosening of measures would be contingent on a boost in the elderly vaccination rate. Beijing is planning to launch a vaccination campaign later this year for vulnerable groups, aiming for 95% of people aged 60 or above to receive two doses, some of the people said. The latest government data, from early November, shows 86% of the elderly population had received two vaccine doses, compared with 90% for the broader population.

Another condition for a full reopening of its economy is to boost access to oral antivirals to treat Covid, the people said. Earlier this year, China’s drug regulator granted approval for Azvudine, an HIV drug developed by Chinese drugmaker Henan Genuine Biotech Co., to be used for treating Covid. Drug regulators have also approved

Pfizer Inc.’s

Paxlovid drug.

Any further loosening of measures would be contingent on a boost in the elderly vaccination rate.



Photo:

CHINA DAILY/VIA REUTERS

The National Health Commission responded to a request for comment by referring to remarks made during its Saturday press conference.

There have been some signs of a shift in China’s posture on Covid in recent months. In September, Mr. Xi visited Central Asia, making his first trip outside the country since Covid began spreading in the central Chinese city of Wuhan in early 2020. The Chinese leader has also begun receiving foreign heads of state in Beijing and is expected to attend a summit of leaders from the Group of 20 nations in Indonesia next week.

Still, Beijing has been careful to rein in expectations of a rapid shift, including in the Saturday press conference. In a string of pointed commentaries last month, Communist Party mouthpiece the People’s Daily called for confidence and patience with Beijing’s zero-Covid strategy. Health officials have urged local governments to build quarantine hospitals to prepare for rebounding infections. Shanghai, for example, is building a quarantine facility that can house more than 3,000 people at a cost of just under $200 million, state media reported.

“All the signs are pointing to the beginning of preparation for an eventual reopening, especially given the rising cost of the ‘dynamic zero-Covid’ policy for the economy,”

Goldman Sachs

economists said in a Monday note. “The actual reopening is still months away as elderly vaccination rates remain low and case fatality rates appear high among those unvaccinated based on Hong Kong official data.”

 —Drew Hinshaw contributed to this article.

Write to Keith Zhai at keith.zhai@wsj.com

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Pig’s Heart Took Longer to Generate a Beat in Transplant Patient

A genetically modified pig heart transplanted into a severely ill person took longer to generate a heartbeat than those of typical pig or human hearts, research showed, another potential challenge for doctors aiming to conduct clinical trials of pig-organ transplants.

Doctors took daily electrocardiograms of

David Bennett,

a 57-year-old handyman and father of two who received a gene-edited pig heart in an experimental surgery at the University of Maryland Medical Center in Baltimore in January. Mr. Bennett died in March from heart failure, but doctors still aren’t sure why the pig heart thickened and lost its pumping ability.

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What do you think is the future for non-human organ transplants? Join the conversation below.

Doctors involved in the groundbreaking surgery have been studying data from Mr. Bennett’s case, which is being closely watched in the wider transplant community. Researchers reported in May that a common pig virus was detected in the pig heart transplanted into Mr. Bennett. They said there is no evidence the virus infected Mr. Bennett, but its presence in the pig heart could have caused inflammation that contributed to the cascade of events that led to his death from heart failure.

Researchers analyzed Mr. Bennett’s EKG data as part of efforts to understand his decline after the transplant, direct future research and determine a possible path toward opening clinical trials. Widely used tests that measure electrical signals that cause the heart to beat, EKGs can help diagnose heart attacks, irregular heart rhythms and other possible abnormalities.

Researchers reported unexpected findings in two aspects of Mr. Bennett’s EKG data: the time it takes electricity to travel from the top to the bottom chamber of the heart and across the bottom chambers, which pumps blood through the heart, and the time it takes the lower chambers of the heart to go through a full electrical cycle, which is associated with a heartbeat.



The surfaces of pig cells contain a sugar molecule that triggers the human immune system to attack the organs. Scientists are using the gene editing tool Crispr to overcome this obstacle.

Here’s one approach:

…and then insert the edited DNA into a pig egg cell whose nucleus has been removed. The egg cell is then transferred to the uterus of a sow. The sow gives birth to pigs whose cells—including those in their organs— contain the edited genes.

Crispr acts like scissors cutting DNA at a specific place

scientists edit troublesome genes in pig DNA…

…and sometimes add human genes…

ORGAN OPTIONS

Researchers are trying various techniques that might allow transplantation of gene-edited pig hearts, kidneys and livers into humans. Recent studies on pig organ transplantation in baboons and people have focused mainly on hearts and kidneys.

HEART TO HEART

Pig and human hearts have similarities—but also some differences.

Pigs can be bred to have hearts of similar size as human hearts.

Pig and human hearts each have four pumping chambers—two small ones known as atria and two large ones known as ventricles.

The wall of tissue separating the ventricles is thicker in pig hearts than in human hearts.

Pig and human hearts each are attached to a large artery known as the aorta as well as to a large vein known as the vena cava.

A pig’s inferior (lower) vena cava joins a pig heart’s right atrium at an angle. The vein is longer in pigs than in humans.

EASING ORGAN REJECTION

The surfaces of pig cells contain a sugar molecule that triggers the human immune system to attack the organs. Scientists are using the gene editing tool Crispr to overcome this obstacle. Here’s one approach:

Crispr acts like scissors cutting DNA at a specific place.

Scientists edit troublesome genes in pig DNA…

…and sometimes add human genes…

…and then insert the edited DNA into a pig egg cell whose nucleus has been removed. The egg cell is then transferred to the uterus of a sow. The sow gives birth to pigs whose cells—including those in their organs—contain the edited genes.

ORGAN OPTIONS

Researchers are trying various techniques that might allow transplantation of gene-edited pig

hearts, kidneys and livers into humans. Recent studies on pig organ transplantation in baboons and people have focused mainly on hearts and kidneys.

HEART TO HEART

Pig and human hearts have similarities—but also some differences.

Pigs can be bred to have hearts of similar size as human hearts.

Pig and human hearts each have four pumping chambers—two small ones known as atria and two large ones known as ventricles.

The wall of tissue separating the ventricles is thicker in pig hearts than in human hearts.

Pig and human hearts each are attached to a large artery known as the aorta as well as to a large vein known as the vena cava.

A pig’s inferior (lower) vena cava joins a pig heart’s right atrium at an angle. The vein is longer in pigs than in humans.

EASING ORGAN REJECTION

The surfaces of pig cells contain a sugar molecule that triggers the human immune system to attack the organs. Scientists are using the gene editing tool Crispr to overcome this obstacle. Here’s one approach:

Crispr acts like scissors cutting DNA at a specific place.

Scientists edit troublesome genes in pig DNA…

…and sometimes add human genes…

…and then insert the edited DNA into a pig egg cell whose nucleus has been removed. The egg cell is then transferred to the uterus of a sow. The sow gives birth to pigs whose cells— including those in their organs—contain the edited genes.

ORGAN OPTIONS

Researchers are trying various techniques that might allow transplantation of gene-edited pig

hearts, kidneys and livers into humans. Recent studies on pig organ transplantation in baboons and people have focused mainly on hearts and kidneys.

HEART TO HEART

Pig and human hearts have similarities—but also some differences.

Pigs can be bred to have hearts of similar size as human hearts.

Pig and human hearts each have four pumping chambers—two small ones known as atria and two large ones known as ventricles.

The wall of tissue separating the ventricles is thicker in pig hearts than in human hearts.

Pig and human hearts each are attached to a large artery known as the aorta as well as to a large vein known as the vena cava.

A pig’s inferior (lower) vena cava joins a pig heart’s right atrium at an angle. The vein is longer in pigs than in humans.

The time intervals are typically shorter in pig hearts that are in pigs. But they took longer in the gene-modified pig heart inside a human. The time for the electricity to travel through the heart’s electrical system and generate a heartbeat also took longer than what is typical for human hearts, said

Timm Dickfeld,

a professor of medicine and director of electrophysiology research at the University of Maryland Medical Center, who was the leader of the EKG study.

What that might mean in the future for doctors caring for patients with gene-modified pig heart transplants is uncertain, said

Paul Wang,

director of the Stanford Cardiac Arrhythmia Service and a professor of medicine and bioengineering at Stanford University, who examined the data but wasn’t involved in the study.

“It has only been done once,” Dr. Wang said. “It needs to be done many more times for us to understand what these differences mean.”

The EKG data haven’t been published or undergone an outside vetting process. They are being presented by the Maryland team at an American Heart Association annual meeting starting Nov. 5. The Maryland team said they are studying the significance of the findings and hope to gather more data in future studies.

The fact that the electrical signals traveled through Mr. Bennett’s heart more slowly than expected “did not appear to be associated with a pathological outcome,” said

Bartley Griffith,

co-director of the cardiac xenotransplantation program at the University of Maryland School of Medicine, who performed Mr. Bennett’s transplant surgery.

Dr. Griffith added that if Mr. Bennett had survived longer and the time intervals became even slower, a pacemaker might eventually have become necessary.

Researchers have tried for decades to develop the transplantation of organs between different species, or xenotransplantation, to address a chronic shortage of organs. More than 3,500 people are on the waiting list in the U.S. for a heart transplant, according to a 2022 update from the American Heart Association.

Megan Sykes,

director of the Columbia Center for Translational Immunology in New York, said that although pigs are similar to humans in organ size and physiology, the EKG data illustrate that there are differences that may only emerge after doing transplants into humans.

“We have reached the point where we need human studies as well as animal studies,” Dr. Sykes said.

The Maryland team and other groups have met with the Food and Drug Administration recently to discuss how to start small clinical trials of genetically modified pig organs. The FDA has requested additional data from the Maryland team in baboons, said

Muhammad Mohiuddin,

the scientific program director of cardiac xenotransplantation at the University of Maryland School of Medicine. Dr. Mohiuddin said they plan to gather additional EKG data as part of the research.

Write to Amy Dockser Marcus at amy.marcus@wsj.com

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Americans Take Ketamine at Home for Depression With Little Oversight

Startups are prescribing ketamine online to treat serious mental-health conditions, raising concern among psychiatrists about the safety of taking the mind-altering anesthetic without medical supervision, sometimes at high doses that raise risks of side effects.

Ketamine is approved by the Food and Drug Administration to anesthetize people and animals and has been used safely in hospitals for decades. The out-of-body, hallucinogenic sensations it produces made it popular as a party drug known as Special K. Some doctors prescribe ketamine off-label to treat patients with conditions including severe depression, suicidal thoughts and post-traumatic stress disorder.

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Is there enough support available for people taking ketamine at home because of mental-health concerns? Join the conversation below.

Generic ketamine isn’t approved for those conditions. Studies have shown it can rapidly alleviate symptoms of severe depression when other treatments have failed.

There is less data on ketamine’s effectiveness for other conditions including anxiety and PTSD, and little data on its long-term use.

The FDA has approved a chemically related version of the drug, called esketamine, from

Johnson & Johnson

for treatment-resistant depression with suicidal thoughts.

Clinics that are certified to administer J&J’s nasal spray must monitor patients for two hours afterward.

People taking generic ketamine at home aren’t subject to the same oversight.

Clinics specializing in ketamine treatment for depression and other mood disorders have popped up across the U.S. in recent years. WSJ visits a clinic to learn why some entrepreneurs are betting that demand for ketamine will continue to rise. Photo illustration: Laura Kammermann

Mindbloom Inc., Nue Life Health PBC and Wondermed LLC are among around a dozen companies now selling ketamine tablets or lozenges online, making use of relaxed restrictions on the prescription of controlled substances during the pandemic.

The companies work with clinicians who prescribe ketamine to patients based on a questionnaire and virtual evaluation. The generic ketamine pills or lozenges are mailed to patients’ homes. The companies say they instruct people to take the medication with someone nearby, among other safety measures.

Taking ketamine at home without medical supervision increases risks of patients falling and hurting themselves or taking more of the drug than prescribed, doctors said. Ketamine can be addictive, and patients might not get the help they need if they have a distressing experience while taking the drug, psychiatrists said.

“Places that are doing virtual ketamine are negotiating a compromise between accessibility and safety,” said Dr.

Benjamin Yudkoff,

medical director of the ketamine and esketamine program at Brigham and Women’s Faulkner Hospital in Boston.

Ketamine increases heart rate and blood pressure, raising the risk of rare complications including stroke or heart attack at the higher doses that some telehealth patients have been prescribed, medical experts said.

“Giving any drug like that has the potential to cause general anesthesia at home in a completely unmonitored environment,” said Dr.

Michael Champeau,

president of the American Society of Anesthesiologists.

The companies said prescribing ketamine-assisted therapy at home can help fill a need for people who don’t respond to existing medications or can’t reach or afford treatment in person. Ketamine blocks a receptor in brain cells important for brain adaptability, which researchers say might help facilitate changes in mood and mind-set.

Ketamine was prescribed for Leon New Valentine, who said it alleviated symptoms of treatment-resistant depression and PTSD.



Photo:

Tara Pixley for The Wall Street Journal

Mindbloom and Nue Life cited peer-reviewed research they published suggesting that many patients reported feeling better after taking ketamine and that few reported problems related to taking the drug.

Mindbloom, Nue Life and Wondermed said they decline to treat people who have symptoms that are too severe or histories of conditions such as substance-use disorder, psychosis or uncontrolled hypertension. Nue Life said it sometimes consults with a patient’s doctor before prescribing ketamine, and Mindbloom said it often asks for medical records. Wondermed said patients can choose to have their doctors work with the company during treatment.

‘Places that are doing virtual ketamine are negotiating a compromise between accessibility and safety.’


— Dr. Benjamin Yudkoff, Brigham and Women’s Faulkner Hospital

Nue Life said it starts patients at around 125 milligrams and prescribes at most 750 milligrams for a dose. Wondermed said it prescribes patients between 100 milligrams and 400 milligrams for a dose. Mindbloom said that it starts patients at around 400 milligrams and that some patients graduate to doses of around 1,000 milligrams.

Doses of around 1,000 milligrams heighten risks for severe side effects including rare seizures, hemorrhages or strokes, said

Ari Aal,

a psychiatrist in Boulder, Colo., who prescribes ketamine at lower doses to patients who take it under supervision at his clinic.

“That’s way too much of a dose to be doing at home and probably at all, and way too much without a practitioner watching you,” Dr. Aal said.

Mindbloom and Wondermed said they provide blood-pressure monitors for patients to use before and during treatment. Nue Life said it instructs patients with controlled hypertension to monitor their blood pressure.

A ketamine kit provided by Mindbloom for Courtney Gable.



Photo:

Courtney Gable

Timothy Mitchell,

a 40-year-old patient advocate from Ballston Lake, N.Y., said Mindbloom started him on an 800-milligram dose last year. He said he is undergoing his third course of a six-dose regimen with Mindbloom at 1,200 milligrams a dose. The treatment helped quiet suicidal thoughts, he said.

Wondermed said it charges $399 for a month of ketamine tablets or lozenges and telemedicine treatment. Mindbloom said it charges around $1,000 for around three months of ketamine and telemedicine care. Nue Life said it charges as much as $2,999 for ketamine tablets and telemedicine treatment over four months. Health insurers usually don’t reimburse people for the off-label treatments.

Amanda Itzkoff,

a psychiatrist and chief executive of Curated Mental Health, which administers ketamine in clinics, said she declined to be on Mindbloom’s advisory board in part because she was concerned that at-home use might not include enough patient supervision.

Making a comparison with a crackdown on psychedelic-drug research decades ago, she said that if companies recklessly prescribe ketamine for home use, they could set back adoption of a valuable treatment. “We could blow it again,” Dr. Itzkoff said.

A spokesman said that Mindbloom ended its relationship with Dr. Itzkoff and that she didn’t raise safety concerns. Mindbloom’s medical director, Dr.

Leonardo Vando,

said striking the right balance between expanding access to ketamine and safe prescribing practices is critical to Mindbloom.

Courtney Gable,

47, said her husband checked on her when she took ketamine that Mindbloom prescribed for her this year to treat chronic pain and depression. The 400-milligram dose was higher than initial doses prescribed at a clinic where she works in Philadelphia, she said.

“There’s a safety net, but the spaces between the net are a little wider,” Ms. Gable said.

Leon New Valentine,

a 32-year-old actor and videogame model in Los Angeles, was prescribed 100 milligrams of ketamine online last year by Peak Health Global Inc., and took the medication with someone nearby. Mx. Valentine, who uses they as a pronoun, said they graduated to 150-milligram doses and took that alone. Ketamine alleviated symptoms of treatment-resistant depression and PTSD, Mx. Valentine said.

“Things are joyful again even though I’m in pain,” Mx. Valentine said. Peak said it would close in November because it expects rules allowing controlled substances to be prescribed remotely to be tightened soon.

Write to Brianna Abbott at brianna.abbott@wsj.com and Daniela Hernandez at daniela.hernandez@wsj.com

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Inside a Chinese iPhone Plant, Foxconn Grapples With Covid Chaos

HONG KONG—

Foxconn Technology

2354 -0.76%

Group is scrambling to contain a weekslong Covid-19 outbreak at an iPhone factory in central China, trying to appease frightened and frustrated workers during a crucial period for smartphone orders.

In Foxconn’s main Zhengzhou facility, the world’s biggest assembly site for

Apple Inc.’s

AAPL 7.56%

iPhones, hundreds of thousands of workers have been placed under a closed-loop system for almost two weeks. They are largely shut off from the outside world, allowed only to move between their dorms or homes and the production lines.

Many said they have been confined to their quarters for days and that distribution of food and other essentials has been chaotic. Many others say they are too scared to carry on working because of the risk of getting infected.

Foxconn on Wednesday denied what it said were online rumors that 20,000 cases had been detected at the site and said that for “the small number of employees affected by the pandemic,” it is providing necessary supplies.

“A sudden outbreak disrupted our normal life,” Foxconn said Friday in a post to its workers on

WeChat,

a social-media platform. “An orderly progress in both pandemic prevention and output depends on the efforts of all staff,” it said. It outlined plans to ensure proper food supplies and mental well-being support and pledged to respond to workers’ concerns.

Asked about the workers’ details of the situation at the site, Foxconn didn’t respond. Earlier when asked about the situation, the company referred to its Wednesday statement as well as to its Friday post on WeChat.

Covid-19 lockdowns, corruption crackdowns and more have put China’s economy on a potential crash course. WSJ’s Dion Rabouin explains how China’s economic downturn could harm the U.S. and the rest of the world. Illustration: David Fang

“It’s too dangerous to go to work,” a 21-year-old worker who has been confined to his dorm told The Wall Street Journal, saying that he was skeptical about the company’s claim that there was a low level of infections at the plant.

The disruption at Foxconn is the latest example of the economic and societal toll from China’s rigid pandemic control policies—which include swift and sweeping lockdowns, mass testing and compulsory quarantines to crush the virus whenever it appears. While Beijing says the virus is too potent to allow any easing of its zero-Covid policy, businesses must convince their employees that there is little risk coming to work when there are signs of an outbreak.

Zhengzhou’s flare-up—95 cases recorded in the city the past four days—began in early October, after people returned from other parts of the country from a one-week national holiday. At the first signs of Covid in the city, officials locked down some districts and began rounds of mass testing to stamp out the virus before it gained a foothold among Zhengzhou’s 12.7 million residents. As a major employer, Foxconn joined the campaign.

When more infections emerged at Foxconn midmonth, the company sought to maintain output by creating a “bubble” around its operations to lower the risk of exposure, a practice now common among major manufacturers in China to continue their business during a local outbreak.

Foxconn says it employs as many as 300,000 workers in Zhengzhou. Analysts estimate that the company produces half or more of Apple’s smartphones in the city, making it vital for delivering iPhones to consumers, including for the coming winter holiday season when demand for the handsets typically spikes.

Foxconn, in its statement on Wednesday, said that production at the site is “relatively stable” and that it is sticking to its operating outlook for the current quarter as the impact from the outbreak is controllable. It is set to report quarterly results Nov. 10.

Apple, in its quarterly earnings release Thursday, didn’t mention Foxconn’s Zhengzhou plant. Its chief financial officer said that supply is constrained for the new iPhone 14 Pro models due to strong demand.

Apple didn’t respond to requests for comment about conditions at the Foxconn plant.

Some workers interviewed by the Journal said many colleagues had refused to go back to the production lines. Others had simply left, they said, sometimes abandoning their belongings.

On Sunday, a state-run newspaper in Henan published official notices from various parts of the province welcoming their people to return, with quarantine protocols laid out.

Over the weekend, videos geotagged near the Foxconn site went viral on China’s social-media platforms, recording groups of people walking on highways or through farm fields carrying suitcases and backpacks. Other footage showed makeshift stations set up by local residents offering bottles of water in front of handwritten signs to support migrant Foxconn workers leaving for home.

Foxconn said in a statement Sunday that the situation is coming under control with help from authorities. The company said it is organizing transportation for workers who wish to return home and is coordinating production capacity with its plants elsewhere to minimize disruption. There is no shortage of medical supplies or daily necessities at the facility, it said.

Earlier on Friday, the company had posted a video on WeChat urging people to return to work. “The company needs people,” said a woman’s voice over footage of workers stepping off a bus. “If nobody comes to work, how can the company run?”

Another Foxconn employee said most of his dozen-strong team of night-shift workers had either been taken to a quarantine facility or had refused to return to work. Every night, he said, he saw workers covered in protective gear waiting to be taken away by bus.

“I don’t know who around me is a positive case,” said the worker, who has been confined to his dorm for a few days. “I’d be better off staying in the dorm.”

With so many stuck inside their quarters, sent to quarantine centers or simply absent from work, the pace of production at some assembly lines has slowed, two of the workers said.

Foxconn has created incentives to maintain production, according to Friday’s company notice.

Anyone turning up for work will get free meals and a daily bonus, it said. Those turning up every working day from Oct. 26 to Nov. 11 will get an award of 1,500 yuan, or about $200.

The 21-year-old employee who spoke to the Journal and who worked on an assembly line making an older iPhone version, said he had been confined to his quarters since Oct. 17, along with thousands of others.

Over the following days, meal deliveries were delayed and garbage was left unattended in the hallways, piling up on the ground floor as more dorms were locked down, he said.

A daughter of one worker said her mother was placed in the same dorm as some who tested positive. Some other workers made similar complaints.

Around 10 days ago, almost 300 employees from Foxconn suppliers were asked to move out of their dormitories and sleep in the factory, one of them said.

In photos he shared with the Journal, people slept on bedding and pillows placed on metal bed frames, under white fluorescent lights suspended from the hangar-like roof. Hygiene has become a problem, he said. Still, he said he isn’t supposed to leave the plant—and has nowhere to go if he did.

“Where can I go? Barriers are everywhere,” he said. “There are people manning every checkpoint.”

Business and the Pandemic

Write to Wenxin Fan at Wenxin.Fan@wsj.com and Selina Cheng at selina.cheng@wsj.com

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A Possible Covid, Flu and RSV ‘Tripledemic’ Has Doctors Worried. What to Know

A possible convergence of flu, RSV and Covid-19 has doctors worried.

Flu cases are rising earlier than usual, and pediatric hospitals are seeing surges of respiratory syncytial virus, commonly known as RSV. There are also signs that Covid-19 cases are increasing in parts of the country as Americans head into the cooler months.

Covid-19 precautions earlier in the pandemic—and their near-disappearance lately—are a big part of the reason flu and RSV are staging a comeback, doctors say. Measures such as masking and social distancing suppressed rates of other viruses, too, leaving those of us who haven’t had a recent infection with lower levels of protection now.

“It’s very clear that because people are relaxing Covid precautions that it’s very likely we will also see an increase in influenza at the same time,” says

Jay Varma,

director of the Cornell Center for Pandemic Prevention and Response in New York City and a physician and epidemiologist at Weill Cornell Medicine. 

All three viruses share similar symptoms, such as cough, sore throat, runny nose and fever, making it hard to tell what you have without a test. You can test for Covid-19 at home, and most health professionals can test for flu and RSV.

Worries Ahead for Covid-19

Protection from vaccines and prior infection have dramatically reduced the severity of Covid-19 infections since earlier in the pandemic. Yet the virus remains dangerous, especially for people who are older or have certain health conditions. Less-severe cases can still make you feel ill for a week or more, and ripple through your household, disrupting work and school. And even mild infections can cause longer-term symptoms associated with long Covid-19, such as brain fog, extreme fatigue and racing heartbeat.

“Particularly for people who are over the age of 50 and who are immunocompromised, Covid remains a very real threat,” says

Celine Gounder,

a senior fellow at the Kaiser Family Foundation and an infectious-disease specialist and epidemiologist.

The most recent Centers for Disease Control and Prevention data show decreases in nationwide numbers of Covid-19 cases, hospitalizations and death. The 21-day average of new weekly cases decreased about 31% as of Oct. 19 compared with the previous 21-day moving average. The seven-day average for hospitalizations fell 4% to 3,156, and the 21-day moving average of new deaths declined 13% to 388.

However, it is difficult to accurately monitor Covid-19 cases as most people use at-home rapid tests, which are typically not reported. The CDC is also reporting Covid-19 cases less frequently, issuing weekly rather than daily updates as of October. The most reliable indicator of Covid-19 cases is hospitalization data, says Dr. Varma, but hospitalizations tend to lag behind cases by about two to three weeks.

“We think this is the calm before the storm,” says

Katelyn Jetelina,

an epidemiologist who writes the popular “Your Local Epidemiologist” newsletter. “We think in November it will really start taking off on a national level.” 

Newer Omicron subvariants are staking a claim around the world, with some driving surges in other countries. Weekly data from the U.S. CDC indicates that the BQ.1.1 and BQ.1 subvariants—descended from BA.5, the dominant Omicron subvariant in the U.S.—make up more than 16% of cases as of Oct. 21, up from 11% the week before. Another subvariant, XBB, is driving a surge of cases in Singapore. 

Case numbers and hospitalizations in some Western European countries are starting to rise, which often is a harbinger of what is to come in the U.S. Wastewater monitoring in the Northeast also indicates that cases are starting to climb. Doctors worry that few people so far have gotten the updated version of the booster shot.

The new bivalent vaccine might be the first step in developing annual Covid shots, which could follow a similar process to the one used to update flu vaccines every year. Here’s what that process looks like, and why applying it to Covid could be challenging. Illustration: Ryan Trefes
Flu Season Starts Early

At the same time, flu is rearing its head sooner than usual with the CDC citing increased activity in most of the country, particularly the Southeast and south-central states. 

Rick Zimmerman,

a professor of family medicine at the University of Pittsburgh, has been doing flu surveillance for more than a decade and says he hasn’t seen activity this early since the 2009 influenza pandemic. 

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Public-health officials recommend that everyone 6 months and older get a flu vaccine ideally by the end of this month, and say that it is safe to get a flu shot and Covid-19 booster at the same time. The dominant influenza strain is a H3N2 and appears to be well-matched to this year’s vaccine, says Dr. Zimmerman.

“It takes about two weeks for really good immunity postvaccination, so get your flu vaccine now because we’re seeing the start,” he says.

Last flu season, approximately half of people ages 6 months and older in the U.S. received the flu vaccine, the CDC estimates. Projections are similar for this year, according to a National Foundation for Infectious Diseases survey.

It remains unclear if the U.S. influenza season, while starting earlier, will be more severe in hospitalizations and deaths. The season was bad in some parts of the Southern Hemisphere such as Australia, which already had its winter, but not so bad in other parts such as South Africa.

RSV Rebounds

Rates of another common virus—respiratory syncytial virus—are also surging earlier than usual, filling beds in pediatric hospitals.

RSV is a virus that infects the respiratory tract. Typically a mild cold in healthy people, RSV can be dangerous and even deadly in the very old and young, particularly babies under the age of 1. 

The only way to get immunity to RSV is exposure because there is no vaccine, notes Dr. Gounder. RSV cases dropped during the first year of the Covid-19 pandemic. The respiratory virus that typically circulates in the fall and winter then resurged in the summer of 2021. Young children who haven’t been exposed to the virus over the past few years are getting hit now. 

Public-health experts say the same precautionary measures that protect against other respiratory viruses help prevent transmission of RSV: washing your hands thoroughly often, covering coughs and sneezes or wearing a mask, staying home if you’re symptomatic, and improving ventilation in indoor spaces.

Parents should seek medical attention if a child is having trouble breathing, gasping and wheezing or coughing so hard they can’t breathe, says Dr. Gounder. Difficulty feeding and sinking in of the soft tissues around the clavicles and between the ribs are also concerning signs.

Write to Sumathi Reddy at Sumathi.Reddy@wsj.com

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Monkeypox Outbreak Leaves Risks, Questions in Its Wake

As a global outbreak of monkeypox loses steam, disease researchers said they need a better understanding of how the virus spreads, and how well vaccination protects against it to predict whether it could come roaring back.

A global outbreak that gained momentum in May spread the virus much farther than it had been found previously. The virus might have reached new animal hosts, increasing the risk of future outbreaks, said epidemiologists and infectious-disease specialists. The extent to which vaccination has protected the most at-risk people from catching monkeypox is unknown.

“We can’t get lulled into this sense that monkeypox has disappeared,” said Jason Kindrachuk, an assistant professor at the University of Manitoba with a focus on emerging viruses.

Case numbers have been steadily declining since early August. Daily reported cases in the U.S. have fallen to around 40, from a peak of around 440. In Ontario, once a hot spot, health officials in the Canadian province said they are considering whether to declare the outbreak over.

The slowdown is attributed to a combination of a buildup of immunity and behavioral change, disease researchers said. The exact role each played hasn’t been determined. “They are working together in many cases,” said

David Heymann,

professor of infectious-disease epidemiology at the London School of Hygiene and Tropical Medicine.

Dozens of countries bet that Jynneos, a vaccine made by Denmark’s

Bavarian Nordic

A/S that had sat in stockpiles as a biodefense against a possible reintroduction of smallpox, could curb the spread of monkeypox, which is part of the same virus family. Studies on smallpox vaccines in Africa had found that they were around 85% effective at preventing monkeypox, but no such studies had been undertaken with Jynneos.

Early evidence from Jynneos’s use during the outbreak suggests the bet paid off. A recent study from the Centers for Disease Control and Prevention found that among men ages 18 to 49 in the U.S. who were eligible for Jynneos, case rates among the unvaccinated were 14 times higher than for those who had received at least one dose at least two weeks earlier. As of Oct. 18, around 647,400 people in the U.S. had received at least one dose of Jynneos, according to the CDC.

Immunity doesn’t fully explain the drop in cases, disease experts said. In the U.K., new cases started to fall before a vaccination campaign gained momentum, said Jake Dunning, senior researcher at the University of Oxford’s Pandemic Sciences Institute.

Early evidence indicates that use of the Jynneos vaccine has helped contain monkeypox.



Photo:

patrick t. fallon/Agence France-Presse/Getty Images

“Vaccine probably helped to bring things down and keep it as one curve, rather than more of a roller coaster,” he said.

Also driving down cases, disease experts said, was a reduction in sexual contact by men at the highest risk of catching monkeypox. In an August survey of around 800 men who have sex with men in the U.S., around half reported taking at least one measure in response to the monkeypox outbreak to limit their number of sexual contacts. Those measures included reducing one-time sexual encounters and cutting down the number of sex partners. A U.K. report published in September found that rates of two sexually transmitted diseases that also disproportionately affect men who have sex with men fell in August, suggesting that behavior change contributed to the decline in monkeypox.

Uncertainty regarding the precise roles played by immunity and behavior change mean that it is impossible to predict the trajectory of the virus, disease experts said. “If there’s a significant proportion that is attributed to behavior change, if that behavior change is not sustainable, will we see increases again?” said Anne Rimoin, professor of epidemiology at the University of California, Los Angeles, who has been researching monkeypox in the Democratic Republic of Congo for many years.

Even if the virus fades in some places, it is likely to be reintroduced through international travel because it is present in so many countries, said Emma Thomson, a professor of infectious disease at the University of Glasgow.

Testing sewage to track viruses has drawn renewed interest after recent outbreaks of monkeypox and polio. WSJ visited a wastewater facility to find out how the testing works. Photo illustration: Ryan Trefes

It hasn’t been determined whether the virus made its way into any new animal populations during the global outbreak. While monkeypox is mainly associated with forest-dwelling rodents in western and central Africa, it has been detected in other animals. An Italian greyhound in Paris caught monkeypox in June, likely from one of its owners, according to a case report in the Lancet.

“More human infections may arise because of that,” Geoffrey Smith, an expert on poxviruses at the University of Cambridge, said of potential animal reservoirs.

In 2003, around 50 people in the U.S. caught monkeypox from pet prairie dogs that had contracted the virus after sharing caging and bedding with small animals imported from western Africa. None of those cases went on to infect other people.

The global outbreak has prompted fresh calls for more research. A U.K. government-backed science funding group this week provided 2 million pounds, the equivalent of $2.2 million, for monkeypox research to 25 scientists spanning 12 universities. The researchers said their work would include detailed genomic sequencing, studies into the immune response to vaccination, developing new therapies and investigating the potential for animals to spread monkeypox.

Scientists said they want more research into monkeypox in central Africa, where a more-severe strain of the virus known as clade I circulates, to reduce transmission in countries there and to lower the risk of its sparking a more widespread outbreak. Dr. Dunning said that a global outbreak arising from the milder clade II virus raised the possibility that it could happen with clade I.

“That would be even more concerning,” he said.

Write to Denise Roland at denise.roland@wsj.com

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Biden Administration Pares Back Covid Fight as Funding Push Falls Short

The Biden administration has stopped paying to mail out free Covid-19 tests and expects to end free vaccines for Americans after Congress dropped billions of dollars for such efforts from a government funding bill last month.

People familiar with the matter said the administration’s Covid-19 task force will remain in place ahead of an expected uptick in cases in the coming winter months. But the team will shift focus from emergency response to longer-term issues, such as boosting domestic manufacturing of personal protective equipment, researching long Covid and supporting genomic sequencing to identify variants, the people said.

The shift means that health insurers and employers will likely pay for Covid-19 vaccines, drugs and tests, as they do for most medical products and services.

The administration on Tuesday released updates to the national biodefense strategy that it said would strengthen surveillance for risky pathogens and preparedness for future outbreaks or biowarfare attacks. Some of the planning is under way, officials said, and other aspects are dependent on $88 billion in funding for pandemic preparedness and biodefense the administration has requested from Congress.

Changes in the administration’s pandemic strategy come as Covid-19 cases are climbing in Europe, which is often a precursor to rising case numbers in the U.S. And the arsenal of available treatments for people infected with Covid-19 has dipped as mutations allow variants to evade them.

The White House had sought $22.4 billion from Congress for more Covid tests, vaccines and treatments.



Photo:

Kyle Mazza/Zuma Press

“Just because we’ve ended the emergency phase of the pandemic doesn’t mean Covid is over,” said

Eric Topol,

executive vice president of Scripps Research, a medical-research facility.

After the coronavirus hit, the federal government funded development of some Covid-19 vaccines and took control of the purchase and distribution of the shots, tests and other products to guarantee sufficient supplies and make sure they went where needed.

Federal officials planned to relinquish their control to the private sector after the emergency subsided.

Eli Lilly

& Co. said in August it planned to start selling its Covid-19 antibody drug after federal supplies ran out and without new appropriations from Congress.

The federal government has also wound down its program of providing free Covid-19 tests to people who ordered them online, though it is still distributing free tests in other locations, such as long-term-care facilities and rural health clinics.

The issue is tricky for the Biden administration. President Biden had campaigned on a promise to get the pandemic under control, and the White House has sought to show progress in combating the virus. Yet many Americans have stopped masking and taking other precautions, which administration officials worry will put them at risk if a new wave emerges during the winter.

The administration had sought $22.4 billion for the Covid-19 response from Congress, and it recently extended the pandemic’s status as a public-health emergency. The White House said the money was needed to pay for more tests, vaccines—including development of new, next-generation vaccines—and treatments.

The money wasn’t included in a must-pass government-funding bill last month.

To build support for new funding, Biden administration officials have been warning about the risks to people if cases surge in the cold-weather months and there aren’t sufficient supplies of Covid-19 products because the federal government lacks the money to buy them.

“We are going into this fall and winter without adequate tests because of congressional inaction,”

Ashish Jha,

the White House Covid-19 coordinator, said recently. “You can’t fight a deadly virus without resources.”

The new bivalent vaccine might be the first step in developing annual Covid shots, which could follow a similar process to the one used to update flu vaccines every year. Here’s what that process looks like, and why applying it to Covid could be challenging. Illustration: Ryan Trefes

Republicans, who opposed including the Covid funds in the spending bill, said there had not been a thorough accounting of how pandemic-relief funds had been spent. Congress had allocated about $4.6 trillion as of August, according to USASpending.gov, which tracks federal-spending information.

“You have been given astonishing amounts of money,” Sen.

Richard Burr

(R., N.C.) said at a recent congressional hearing.

Without a new appropriation, funds for the federal government to buy and supply Covid-19 vaccines are expected to run out by early next year. The administration now is looking into ways to guarantee that about 30 million uninsured people can access future boosters, treatments and vaccines. Foundations, companies and other groups have paid for non-pandemic medicines for some people who don’t have insurance.

The administration is also in talks with various stakeholders such as vaccine makers about how to transition from the government procuring vaccines to more traditional models, such as insurance coverage of shots or treatments.

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The administration is also figuring out how to move forward with efforts to develop a more durable, next-generation Covid-19 vaccine without the boost in funds. Without a vaccine that blocks both infection and transmission, the virus has been able to continue mutating to evade immunity. Members of the White House Covid-19 task force have said a nasal vaccine could be more effective because it targets immune responses where the virus first enters the body, though developing such a shot poses scientific challenges.

Anthony Fauci,

the president’s chief medical adviser, said the National Institutes of Health is giving grants totaling more than $60 million over three years to academic institutions for development of a broad coronavirus vaccine. But more funding will be necessary to finish that work, said Dr. Fauci, who leads the NIH’s National Institute of Allergy and Infectious Diseases.

Some public-health leaders and federal officials say the U.S. is falling behind countries such as China, which has introduced a vaccine that is inhaled through the nose and mouth.

“It’s a national-security risk,” said

Jennifer Nuzzo,

a professor of epidemiology and director of the pandemic center at the Brown University School of Public Health in Rhode Island. “Other countries have looked at how the U.S. is struggling.”

—Michael R. Gordon contributed to this article.

Write to Stephanie Armour at Stephanie.Armour@wsj.com

Corrections & Amplifications
The White House wants to show progress in combating the coronavirus. An earlier version of this article incorrectly said the White House wants to show progress in combating the vaccine. (Corrected on Oct. 18)

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China’s Xi Jinping Stakes Out Ambitions, With Himself at the Center

HONG KONG—Chinese leader

Xi Jinping

cast himself as the decisive helmsman his country needs in surmounting great adversity, pledging to build a more secure, powerful and egalitarian nation as he signaled plans to extend his decadelong rule.

In a Sunday speech, opening a Communist Party congress where he is set to defy recent norms and claim a third term as party chief, Mr. Xi issued a robust defense of his record, shaking off concerns over Covid-19, a sluggish economy and troubled ties with the U.S. He recalled his efforts to curb corruption, rally public support for the party and champion China’s political system as a counterweight to Western liberal democracy.

A campaign of “self-revolution,” marked by forceful crackdowns on corruption and political dissent, Mr. Xi said, has “ensured that the party will never change in quality, change its color, or change its flavor”—party parlance for threats to Communist rule in China.

In televised remarks delivered from Beijing’s Great Hall of the People, Mr. Xi also claimed significant successes in fighting Covid-19, enforcing order in Hong Kong and curtailing what he called separatist activism in the island democracy of Taiwan, which Beijing claims as its territory.

He reiterated that Beijing won’t renounce the use of force in unifying Taiwan, so as to deter outside interference and splittist elements. “The complete unification of the motherland must be realized, and it will be realized,“ he said, drawing loud applause.

Mr. Xi directed parts of his speech to addressing concerns about China’s ties to the rest of the world, amid rising geopolitical tensions and Beijing’s own Covid-imposed isolation, reaffirming his support for globalization and adherence to a decades-old national policy of “reform and opening up.”

While Mr. Xi warned of risks, challenges and “even dangerous storms” ahead, his report to the congress largely promised a continuation of his firm-handed rule at home and a more assertive exercise of power abroad, including by making the military combat-ready.

“The work report was unambiguously about continuity,” Joseph Torigian, a professor in Chinese politics and foreign policy at American University, said on Twitter. “Although historic, this Congress will almost certainly not signify fundamental new policy directions.”

In laying out his economic goals, Mr. Xi renewed his promise of a new era of “common prosperity,” in which the party exercises greater control over private capital and distributes China’s wealth more evenly. Such efforts have unnerved entrepreneurs at home and investors from abroad after sweeping regulatory crackdowns on Chinese tech giants and private businesses in recent years.

President Xi addressed several topics including Taiwan, Hong Kong and the fight against Covid-19 in his speech at the party gathering in Beijing.



Photo:

Mark Schiefelbein/Associated Press

Mr. Xi also trumpeted what he called “Chinese-style modernization,” doubling down on his program of party-led economic planning and development. He reiterated calls for ensuring China’s economic self-reliance, urging more indigenous efforts to develop high-end technologies that can serve the nation’s strategic needs—a demand that comes as the U.S. ramps up efforts to deny China access to critical components such as advanced semiconductors.

Since taking power in late 2012, Mr. Xi has assumed a degree of autocratic authority unseen since the Mao Zedong era and upended recent retirement practices to allow himself to stay in office indefinitely.

By taking a third term as party chief, the 69-year-old Mr. Xi would depart from the decadelong leadership cycle that his predecessor set and dismantle succession norms designed to prevent a return to a Mao-style dictatorship. Political analysts expect Mr. Xi to promote protégés and allies into senior party roles and thereby cement his political supremacy.

Mr. Xi devoted much of his speech to emphasizing how his party aligns itself with the Chinese people. “The country is the people, and the people are the country,” he said. The entire party must always “share its destiny and connect heart-to-heart with the people.”

The party has in recent years increasingly described Mr. Xi as renmin lingxiu, or “people’s leader,” a designation that echoes Mao’s title of weida lingxiu, or “great leader.” Party insiders say the congress could confer more tokens of power on Mr. Xi, such as by formally designating him renmin lingxiu and cementing his claim to being on par with Mao as China’s greatest statesmen.

Another possibility would involve shortening the label of Mr. Xi’s political philosophy, “Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era,” to simply “Xi Jinping Thought.” This would directly mirror “Mao Zedong Thought,” which the party exalts as a guiding ideology second only to Marxism-Leninism.

Chinese President Xi Jinping has used propaganda to extend his rule and set the stage for a third term. WSJ looks at three moments over his 10 years in power that trace his rise to become the country’s most powerful leader since Mao Zedong. Photo illustration: Adam Adada

Mr. Xi’s speech, lasting about 104 minutes, was roughly half the length of his remarks at the 2017 congress, where he spoke for more than 200 minutes. State broadcaster China Central Television said Mr. Xi’s address on Sunday comprised highlights from a full report that congress delegates will review over the coming week.

In the Sunday speech, Mr. Xi declared that the party had scored “historic victories” under his watch, citing the party’s centennial last year, its stewardship over a “new era” in Chinese socialism, and his campaign to eradicate rural poverty. He also reiterated long-term goals that he first laid out five years ago: ensuring that China achieves a degree of “socialist modernization” by 2035 and becomes a “modern socialist power” by the middle of the 21st century.

Some analysts have cited the 2035 target—when Mr. Xi believes China should have become a more equal and prosperous society with an innovative economy and a modernized military—as a possible timeline for his stint as paramount leader.

The party has pitched its twice-a-decade congress as a triumphant moment for China, even as it confronts wide-ranging challenges. Mr. Xi’s zero-tolerance approach to Covid-19 has throttled the domestic economy with repeated lockdowns and disruptions, exacerbated by a property-market slump.

Tensions with the U.S. and other Western powers have intensified as they challenge Beijing’s push for technological supremacy, territorial claims over Taiwan and continued support for Moscow following Russia’s invasion of Ukraine. Mr. Xi didn’t mention the war in Ukraine during his speech, which wasn’t expected to go into detail on foreign affairs.

Despite tightened security and censorship, frustrations with Mr. Xi’s policies boiled over into overt dissent on Thursday, when a protest took place on a highway bridge in Beijing. Dark smoke swirled over protest banners condemning Mr. Xi as a “traitorous dictator”—a rare display of defiance that was quickly snuffed out by local authorities.

More than 2,300 delegates were present at the Great Hall of the People, including retired party elders. Mr. Xi’s immediate predecessor,

Hu Jintao,

occupied a seat on the dais next to the incumbent’s. Notable absentees included

Jiang Zemin,

the 96-year-old former leader who served as general secretary for 13 years until 2002, as well as former Premier

Zhu Rongji,

who turns 94 this month.

Beijing’s Great Hall of the People, where the Chinese Communist Party’s twice-a-decade congress opened on Sunday.



Photo:

Mark Schiefelbein/Associated Press

The congress, which ends Saturday, will vote on the proposed changes to the party charter and elect a new Central Committee, which since 2007 has comprised more than 370 full and nonvoting alternate members, drawn from senior ranks of the party, government, military and state industry.

The new Central Committee will convene the day after to choose the next Politburo and its elite Standing Committee, the party’s top decision-making body. The Politburo has comprised 25 full members since 2007, while the Politburo Standing Committee has featured seven members since 2012, when it was reduced from nine.

The share of seats that Xi allies occupy in the next leadership would offer clues on how much clout the Chinese leader can exert in pursuing his priorities. Analysts say Mr. Xi isn’t likely to designate any potential successors, as doing so would undermine his own authority.

Top state positions, including the next premier and other ministerial roles, won’t be finalized until China’s annual legislative session next spring.

In his Sunday remarks, Mr. Xi didn’t say whether he plans to stay in power to fulfill the vision he outlined. Mr. Xi would turn 74 years old by the end of his third term, two years younger than Mr. Jiang was when he stepped down as party chief in 2002.

Write to Chun Han Wong at chunhan.wong@wsj.com

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Study finds Paxlovid can interact badly with some heart medications, and White House renews COVID emergency through Jan. 11

A new study has found that the COVID antiviral Paxlovid can interact badly with certain heart medications, raising concerns for patients with cardiovascular risk who test positive.

The study was published in the Journal of the American College of Cardiology and found the reaction involved such medications as blood thinners and statins. As patients who are hospitalized with COVID are at elevated risk of heart problems, they are likely to be described Paxlovid, which was developed by Pfizer
PFE,
-0.28%.

 “Co-administration of NMVr (Paxlovid) with medications commonly used to manage cardiovascular conditions can potentially cause significant drug-drug interactions and may lead to severe adverse effects,” the authors wrote. “It is crucial to be aware of such interactions and take appropriate measures to avoid them.”

The news comes just days after the White House made a renewed push to encourage Americans above the age of 50 to take Paxlovid or use monoclonal antibodies if they test positive and are at risk of developing severe disease.

White House coordinator Dr. Ashish Jha told the New York Times that greater use of the medicine could reduce the average daily death count to about 50 a day from close to 400 currently.

“I think almost everybody benefits from Paxlovid,” Jha said. “For some people, the benefit is tiny. For others, the benefit is massive.” 

Yet a smaller share of 80-year-olds with COVID in the U.S. is taking it than 45-year-olds, Jha said, citing data said he has seen.

On Thursday, the White House extended its COVID pubic health emergency through Jan. 11 as it prepares for an expected rise in cases in the colder months, the Associated Press reported.

The public health emergency, first declared in January 2020 and renewed every 90 days since, has dramatically changed how health services are delivered.

The declaration enabled the emergency authorization of COVID vaccines, as well as free testing and treatments. It expanded Medicaid coverage to millions of people, many of whom will risk losing that coverage once the emergency ends. It temporarily opened up telehealth access for Medicare recipients, enabling doctors to collect the same rates for those visits and encouraging health networks to adopt telehealth technology.

Since the beginning of this year, Republicans have pressed the administration to end the public health emergency.

President Joe Biden, meanwhile, has urged Congress to provide billions more in aid to pay for vaccines and testing. Amid Republican opposition to that request, the federal government ceased sending free COVID tests in the mail last month, saying it had run out of funds for that effort.

Separately, the head of the World Health Organization urged countries to continue to surveil, monitor and track COVID and to ensure poorer countries get access to vaccines, diagnostics and treatments, reiterating that the pandemic is not yet over.

Tedros Adhanom Ghebreyesus said most countries no longer have measures in place to limit the spread of the virus, even though cases are rising again in places including Europe.

“Most countries have reduced surveillance drastically, while testing and sequencing rates are also much lower,” Tedros said in opening remarks at the IHR Emergency Committee on COVID-19 Pandemic on Thursday.

“This,” said the WHO leader, “is blinding us to the evolution of the virus and the impact of current and future variants.”

U.S. known cases of COVID are continuing to ease and now stand at their lowest level since late April, although the true tally is likely higher given how many people overall are testing at home, where the data are not being collected.

The daily average for new cases stood at 38,530 on Thursday, according to a New York Times tracker, down 19% from two weeks ago. Cases are rising in six states, namely Nevada, New Mexico, Kansas, Maine, Wisconsin and Vermont, and are flat in Wyoming. They are falling everywhere else.

The daily average for hospitalizations was down 7% at 26,665, while the daily average for deaths is down 7% to 377. 

The new bivalent vaccine might be the first step in developing annual Covid shots, which could follow a similar process to the one used to update flu vaccines every year. Here’s what that process looks like, and why applying it to Covid could be challenging. Illustration: Ryan Trefes

Coronavirus Update: MarketWatch’s daily roundup has been curating and reporting all the latest developments every weekday since the coronavirus pandemic began

Other COVID-19 news you should know about:

• Federal Health Minister Karl Lauterbach has urged German states to reintroduce face-mask requirements for indoor spaces due to high COVID cases numbers, the Local.de reported. Lauterbach was launching his ministry’s new COVID campaign on Friday. “The direction we are heading in is not a good one,” he said at a press conference in Berlin, adding it’s better to take smaller measures now than be forced into drastic ones later.

• Health officials in Washington and Oregon said Thursday that a fall and winter COVID surge is likely headed to the Pacific Northwest after months of relatively low case levels, the AP reported. King County (Wash.) Health Officer Dr. Jeff Duchin said during a news briefing that virus trends in Europe show a concerning picture of what the U.S. could soon see, the Seattle Times reported.

Two banners unfurled from a highway overpass in Beijing condemned Chinese President Xi Jinping and his strict Covid policies, in a rare display of defiance. The protest took place days before the expected extension of the leader’s tenure.

• Kevin Spacey’s trial on sexual-misconduct allegations will continue without a lawyer who tested positive for COVID on Thursday, Yahoo News reported. The “American Beauty” and “House of Cards” star is on trial in Manhattan federal court facing allegations in a $40 million civil lawsuit that he preyed upon actor Anthony Rapp in 1986 when Rapp was 14 and Spacey was 26. Jennifer Keller’s diagnosis comes after she spent about five hours cross-examining Rapp on the witness stand over two days — a few feet away from the jury box without wearing a mask.

• A man who presents himself as an Orthodox Christian monk and an attorney with whom he lived fraudulently obtained $3.5 million in federal pandemic relief funds for nonprofit religious organizations and related businesses they controlled, and spent some of it to fund a “lavish lifestyle,” federal prosecutors said Thursday. Brian Andrew Bushell, 47, and Tracey M.A. Stockton, 64, are charged with conspiracy to commit wire fraud and unlawful monetary transactions, the U.S. attorney’s office in Boston said in a statement, as reported by the AP.

Here’s what the numbers say:

The global tally of confirmed cases of COVID-19 topped 623.9 million on Monday, while the death toll rose above 6.56 million, according to data aggregated by Johns Hopkins University.

The U.S. leads the world with 96.9 million cases and 1,064,821 fatalities.

The Centers for Disease Control and Prevention’s tracker shows that 226.2 million people living in the U.S., equal to 68.1% of the total population, are fully vaccinated, meaning they have had their primary shots. Just 110.8 million have had a booster, equal to 49% of the vaccinated population, and 25.6 million of those who are eligible for a second booster have had one, equal to 39% of those who received a first booster.

Some 14.8 million people have had a shot of the new bivalent booster that targets the new omicron subvariants.

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Tesla, BYD Break China Delivery Records as EV Rivalry Goes Global

HONG KONG—

Tesla Inc.

TSLA 0.17%

and its Chinese rival BYD Co. have each broken their monthly records for deliveries of electric vehicles in China as the global competition between the world’s biggest makers of new-energy autos intensifies.

Tesla, the world’s biggest EV maker, delivered more than 83,000 Model 3s and Model Ys from its recently upgraded Shanghai plant in September, data released Sunday by the China Passenger Car Association show. The American EV maker controlled by

Elon Musk

had been ahead of BYD in China before production was disrupted by Covid-19 outbreaks in the country.

BYD made almost 95,000 EV deliveries in September—a record high for the Shenzhen-based company. BYD’s sales, including hybrids, totaled 201,000 units in September, also a record.

The rivalry between the world’s leading EV companies intensified this year after BYD—which counts Mr. Musk’s fellow billionaire

Warren Buffett

among its key investors—abandoned the production of traditional gasoline-powered vehicles to fully focus on new-energy cars.

Production capacity at Tesla’s Shanghai plant was recently increased.



Photo:

Qilai Shen/Bloomberg News

BYD has dominated the Chinese domestic market this year, defying supply-chain disruptions and shortages of chips and raw materials for batteries that have plagued other manufacturers, including Tesla. The company’s monthly year-over-year sales of electric and plug-in hybrid vehicles have risen more than threefold on average this year.

Behind the growth is the company’s ability to produce its own batteries as well as many of the parts its vehicles use, ensuring stability along its supply chain.

Tesla, meanwhile, lost ground after suffering production hiccups from Covid-19 lockdowns in Shanghai earlier this year.

In July, Tesla suspended operations for several days to upgrade its assembly lines for increased production capacity. Its Shanghai plant can now crank out more than 750,000 units a year, the company said at the time.

Tesla said last week it delivered 343,830 EVs globally during the quarter ended Sept. 30. Vehicles from Shanghai made up about 54% of its global deliveries during this period, up from 44% in the second quarter, according to calculations based on the association’s data.

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While Tesla tussles with BYD in its home market, the Shenzhen-based auto maker is also expanding abroad. Last week, German rental-car company

Sixt SE

said BYD will supply its fleet with several thousand EVs by the end of this year. The initial commitment will pave the way for the German company to purchase a total of 100,000 EVs from BYD by the end of 2028, Sixt said.

BYD’s foray into Europe began with supplying electric buses for public transport in countries including the U.K., Sweden and Spain. Last year, it exported 100 Tang sports-utility EVs to Norway.

This past summer BYD announced partnerships with dealers in several European countries to distribute its vehicles. By September this year, BYD began selling its EVs to customers in Australia. It exported some 7,000 EVs or plug-in hybrids from China that month, according to company data.

The company announced European presale prices for three of its popular passenger EV models two weeks ago. They will be made available to customers in Scandinavian countries but also in Luxembourg and Germany, the home turf for legacy car brands such as Volkswagen AG. Sales will roll out to France and the U.K. by the end of this year, the company said.

And as it seeks to capture the global market for EVs, BYD is moving to produce more passenger cars overseas. Last month it secured a deal with Thai industrial-estate developer WHA Group to set up an overseas passenger EV factory on the east coast of Thailand. The plant is expected to deliver 150,000 passenger EVs in 2024, WHA said at the time.

Meanwhile, Mr. Musk weighed in on China’s thorny territorial issues during an interview with the Financial Times. Mr. Musk suggested that a special administrative zone should be set up for the self-governed island of Taiwan, similar to Hong Kong’s relationship with the Chinese mainland. His comments were welcomed by Chinese Ambassador to Washington Qin Gang, who on Sunday tweeted his thanks to Mr. Musk for the suggestion.

China regards Taiwan as an integral part of its territory, to be reunited with the motherland by force, if necessary.

Write to Selina Cheng at selina.cheng@wsj.com

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