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Health

Flu, RSV and Covid-19 Add to Crunch on Pediatric Hospitals

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Flu activity continued to rise across the U.S. in the past week, adding to a crunch on emergency departments and pediatric hospitals from an early surge in respiratory viruses.

Flu has caused an estimated 4.4 million illnesses, 38,000 hospitalizations and 2,100 deaths so far this season including seven pediatric deaths, the Centers for Disease Control and Prevention said Friday. The highest flu hospitalization rates are among adults ages 65 and older, followed by children under the age of 5, the CDC said.

Pediatric hospitals across the U.S. have been under strain for weeks from a rush of patients with RSV and other respiratory viruses. RSV amounts to a cold in most people, but the virus can be dangerous for younger children and older adults, especially those with other health concerns. 

“You have flu that is starting to surge in other areas where they’re trying to deal with the RSV surge, and you also have Covid,” said Tina Tan, vice president of the Infectious Diseases Society of America. “It’s one after the other after the other.” 

RSV cases appear to be plateauing or declining in parts of the U.S., doctors said. Within the CDC’s RSV-surveillance network of 12 states, the hospitalization rate for RSV remains higher than the most recent prepandemic peak.  

Some 76% of pediatric inpatient beds are occupied across the U.S. and occupancy of pediatric intensive-care beds is just above 80%, according to the Department of Health and Human Services. That’s up from 65% of pediatric beds and 70% pediatric ICU beds occupied in early August.   

States including Massachusetts, Nevada, Pennsylvania and Texas have more than 90% of their pediatric intensive-care beds occupied, the data show. The data doesn’t specify why patients are in the hospital. 

Researchers say the coronavirus is having a persistent effect, keeping millions out of work and reducing the productivity and hours of millions more.



Photo:

Neeta Satam for The Wall Street Journal

“We really maxed out all the space we have,” said Kristina Deeter, physician-in-chief at Renown Children’s Hospital in Reno, Nev., and specialty medical officer for pediatric critical care at

Pediatrix Medical Group.

Pediatric patients at Renown Children’s are backed up into the waiting room, some teenagers have been sent to the adult floor and a list of kids from nearby emergency departments are waiting for a bed, she said. 

Other respiratory viruses, including Covid-19, and high demand from pediatric mental-health patients are contributing to the strain at pediatric hospitals, doctors said. Nursing shortages and a decrease in pediatric beds have compounded the crunch. 

From 2008 to 2018, the number of pediatric inpatient beds in the U.S. decreased by 12%, according to a 2021 study in the journal Pediatrics. Declines in rural areas were steeper than average, and pediatric specialty care has been increasingly concentrated at large children’s hospitals. The pandemic exacerbated those trends, doctors said. 

“When we combine that decrease in beds with a surge in the need for those beds, I certainly think we feel it,” said Anna Cushing, lead author on the study and a pediatric emergency medicine physician at Children’s Hospital Los Angeles. Children’s Hospital Los Angeles hasn’t had space to accept all the transfer patients looking for a bed, said chief medical officer James Stein.

At Rady Children’s Hospital-San Diego, emergency department wait times have fluctuated between two and six hours. In October, the hospital started sending administrative staff to volunteer there, freeing up the regular workers to focus on the sickest patients. 

The staffers give kids blankets and alert a triage nurse if patients get sicker, said Nicholas Holmes, chief operating officer at Rady Children’s. A trained pediatric urologist, Dr. Holmes said he worked in the emergency room several times last week. 

“Handing out a coloring book and giving a kid a Popsicle, it helps them feel a little bit better,” Dr. Holmes said.  

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How are you protecting your kids from RSV and the flu? Join the conversation below.

People should wash their hands, stay home if they’re sick, consider wearing masks indoors and while traveling and get vaccinated against Covid-19 and the flu, doctors and health officials said. They said people should be particularly conscious of risks to infants and older adults during Thanksgiving gatherings. 

There are no specific treatments for RSV, but over-the-counter medication can help with fever and patients should stay hydrated. Parents should consult pediatricians if a child is having trouble breathing, having trouble staying hydrated or appears lethargic, doctors said. 

The American Academy of Pediatrics said eligible high-risk infants could receive more than the standard five consecutive doses of the monoclonal antibody palivizumab to protect them during this unusually early and long RSV season. Hospital referrals should be reserved for children who need a higher level of care, to avoid overcrowding and extended wait times, the academy said. 

—Jon Kamp contributed to this article.

Write to Brianna Abbott at brianna.abbott@wsj.com

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Business

China Dials Back Property Restrictions in Bid to Reverse Economic Slide

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For much of the past year, China’s economy has been reeling under Xi Jinping’s dual campaigns to rein in soaring property prices and to stamp out any traces of Covid-19 within the country’s borders.

Now, as he moves to loosen pandemic restrictions, China’s leader, Mr. Xi, is signaling a reversal of his real estate crackdown, too, a tacit acknowledgment of the economic pain and public frustration that the two policies have engendered.

China’s central bank and top banking regulator issued a wide-ranging series of measures aimed at bolstering housing demand and supply, according to a notice circulated on Friday to the country’s financial institutions and officials involved in policy-making. The authenticity of the document was confirmed by people close to the central bank.

The new policies, which were signed off on by Mr. Xi, according to the officials involved in policy-making, unwind some of the previous restrictions aimed at curbing property developer debt and give lenders permission to extend loans to home builders in financial trouble.

“These property measures, on top of announcements of Covid loosening, are a clear indication that Beijing’s efforts to support growth are intensifying,” said

Michael Hirson,

head of China Research at 22V Research, a New York-based firm focused on investment strategy.

While local governments across China have taken more modest measures to ease some of the pressure facing real-estate companies, the new bundle of 16 measures represents the single biggest step yet to rescue a sector that has for decades been a key pillar of growth for the world’s second-largest economy.

The property measures had led to falling home sales, hurting overall growth in the real-estate sector.



Photo:

Cfoto/Zuma Press

Chinese home prices for decades outpaced the rate of broader economic growth.



Photo:

Anthony Kwan/Bloomberg News

The new measures are “massive in scale” and amount to “targeted credit easing for the property industry,” said

Dan Wang,

chief economist at

Hang Seng

Bank China, who drew a contrast with previous rounds of incremental support measures.

As developers face looming loan repayment deadlines, regulators are eager to avoid any systemic risks in the financial sector triggered by a wave of potential defaults, Ms. Wang said. Even so, she added, “demand for home purchase remains weak,” with any reversal in housing-market sentiment likely to depend on the longer-term outlook for the economy.

The easing of real estate and Covid restrictions comes just weeks after Mr. Xi secured another five years in power at a closely watched Communist Party congress. With Mr. Xi having consolidated political control, he now faces the prospect of a third term in office facing the country’s worst prolonged economic slowdown in decades.

Much of the economic weakness is a direct product of his campaign-style clampdowns to crush Covid and, starting last year, tame a four-decade-old property market boom that officials have warned may be a bubble.

The property measures led to increased defaults by property developers, rising bad debts for banks, falling home sales and investment—all of which have weighed heavily on overall growth in recent quarters.

China’s gross domestic product expanded just 3.0% in the first nine months of 2022, well below the government’s official full-year target of about 5.5%, set in March.

China Evergrande Group, long the country’s largest developer, is now its biggest debtor.



Photo:

ALY SONG/REUTERS

Chinese home prices have for decades outpaced the rate of broader economic growth, driving more credit into real estate speculation and further pushing up property values. Authorities in recent years have repeatedly tried to break the vicious cycle with various tightening measures, only to loosen them whenever growth appears threatened.

By 2019, the total value of Chinese homes and developers’ inventory was $52 trillion, according to

Goldman Sachs Group Inc.,

twice the size of the U.S. residential market.

As Beijing tightened the screws on developers last year—and then reaffirmed their commitment to the tougher rules—several private developers began to teeter on the brink of crisis. Among the most prominent was

China Evergrande Group,

long the country’s largest developer and now its biggest debtor, though the concerns have spread to other large private players.

More than 30 developers have defaulted on their dollar-denominated bonds. International investors have dumped their bonds, driving price levels to new lows and leaving even the strongest private developers struggling to sell new debt.

Shares of Chinese property developers surged on Monday following the news.

Country Garden Holdings Co.

, one of the country’s largest real-estate companies by contracted sales, jumped 40% in early trading in Hong Kong, taking its gains this month to more than 200%. A Hang Seng subindex of property stocks rose 7%.

Prices of dollar bonds of developers that haven’t defaulted on their debt—including

Agile Group Holdings Ltd.

and

Longfor Group Holdings Ltd.

—also rose sharply from deeply distressed levels, as investors placed bets on their potential recovery. 

As the broader economic pain mounted this year, regulators and regional governments moved only modestly to try to avert a full-blown housing crisis, introducing limited measures such as tax rebates, cash rewards and lower down payments, as well as providing banks with window guidance to increase property lending. But those piecemeal moves have so far failed to reverse sentiment and lift the sector.

In October, sales at the country’s 100 largest property developers fell to the equivalent of $76.7 billion, down 28.4% from a year earlier and the 16th straight month of year-over-year declines, according to China Real Estate Information Corp., an industry data provider.

As foreign investors and home buyers lose confidence in China’s property market, developers are offering cars and pigs to boost sales. WSJ examines ads and policies to see how the country’s real estate turmoil could ripple out into the global economy. Photo composite: Sharon Shi

Now, with a new leadership team in place after the party congress—one packed with party members loyal to Mr. Xi—the top leader is moving toward a more concerted approach to shoring up the economy, part of a broader effort to brace for greater competition with the U.S.

“It seems that room for policy easing has widened post-party congress,” said

Larry Hu,

a Hong Kong-based economist at Macquarie. “After the impact of previous efforts turned out to be muted, policy makers are giving a big push now to get credit to flow to the property sector.”

Credit has been a particular headache for developers, since many had relied on heavy borrowing to build new projects and stay afloat. In the first nine months of this year, funds raised by China’s property developers dropped by 24.5%, according to data from the National Bureau of Statistics.

The new notice, jointly issued by the People’s Bank of China and the China Banking and Insurance Regulatory Commission, doesn’t represent a total reversal of Mr. Xi’s earlier efforts to tamp down exuberance in the sector.

“‘Policy makers are giving a big push now to get credit to flow to the property sector.’”


— Larry Hu, a Hong Kong-based economist at Macquarie

The notice, which has been billed as a package aimed at ensuring the sector’s “stable and healthy development,” still underlines the need to curb speculative real estate buying, repeating Mr. Xi’s mantra that “housing is for living in, not for speculating on.”

Under the new measures, developers’ outstanding bank loans and some types of nonbank credit due within the next six months can be extended for a year. Repayments on developers’ bonds can also be extended.

In addition, banks are encouraged to offer financing to unfinished housing projects and negotiate with home buyers on extending mortgage repayment, an apparent effort to help defuse growing resentment among those who have boycotted mortgage payments since the summer.

Banks are also encouraged to offer financing to support acquisitions of real-estate projects by financially sounder developers from weaker ones.

The new policies require financial institutions to treat state-owned developers and private developers equally, a measure that appears aimed at addressing banks’ reluctance to lend to private developers, according to

Yan Yuejin,

research director at Shanghai-based E-House China R&D Institute, a research firm.

“Regulators are making all-round efforts to target a soft landing for the property sector,” said

Bruce Pang,

chief China economist at Jones Lang LaSalle. Still, with the measures’ heavy skew toward improving liquidity for cash-strapped developers, he said, “these measures likely aren’t enough to avert the slowdown in the physical market.”

—Rebecca Feng contributed to this article.

Write to Lingling Wei at Lingling.Wei@wsj.com, Cao Li at li.cao@wsj.com and Stella Yifan Xie at stella.xie@wsj.com

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Health

How Does Flu Spread Compared With Covid? What to Know as Flu Cases Surge

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When my 14-year-old son tested positive for flu recently, questions ran through my mind that didn’t occur to me before the coronavirus pandemic. Should we run for our masks? Pump up the air purifier? Remind our 9-year-old to time her hand-washing to “Happy Birthday”?

Covid-19 has given us all a crash course in viral transmission and prevention. We know far more than we ever wanted to about how the virus that causes Covid spreads, how long it can incubate in the body and what kind of masks are most effective. That new awareness has made some of us ask similar questions about other viruses now that respiratory illnesses like flu and RSV are surging.

So how much do we really know about how flu spreads and how it compares with the virus that causes Covid? Here’s what scientists say.

How flu spreads

One of the big questions at the beginning of the Covid pandemic was how the virus transmits. Was it mainly through contact with contaminated surfaces? Was it droplets spreading when you’re close to an infected person? Or was transmission largely through aerosols, smaller particles that can be emitted and inhaled through talking and breathing, and which can linger in the air even after a contagious person has left?

We eventually learned that tiny aerosol particles are a major way Covid spreads, which is why indoor spaces are so much riskier than outdoor ones—because the particles fill up and linger in the air. 

What about flu?

Most scientists agree that influenza is transmitted most commonly through the air, but there is disagreement about whether the main vehicle is aerosols or droplets. 

Some scientists who study aerosol particles say flu mainly transmits through these tiny particles rather than through the larger droplets. That would mean you can get infected just by being in the same room with a contagious person—even far away—rather than having them sneeze on you or emit droplets while talking in proximity to them. 

Studies show that aerosols containing influenza virus are infectious for more than an hour, says

John Volckens,

an environmental health professor at Colorado State University in Fort Collins, Colo., who studies aerosols. 

Some infectious-disease doctors and the U.S. Centers for Disease Control and Prevention say that influenza is spread most often through droplets emitted from sneezing, coughing or talking, which requires closer contact with an infected person, usually within 6 feet. 

“The closer you are, the easier it is to get flu,” says

Peter Chin-Hong,

an infectious-disease specialist at the University of California, San Francisco. 

Some studies suggest that most flu transmission is largely through short ranges, notes Dr. Chin-Hong. But a 2013 study in Nature Communications found that aerosol spread might account for about half of all household influenza transmissions, he said. 

The CDC guidelines say that surface transmission of flu—by touching a contaminated surface such as a doorknob or table—is less common but possible. It is still a good idea to wash hands frequently, doctors say. 

Children 6 months and up and all adults should get their annual flu shot, according to the CDC, with rare exceptions.



Photo:

Mark J. Terrill/AP

How contagious is flu?

Covid-19 is more contagious than influenza, doctors say. One reason is that most people have had flu multiple times and many have gotten multiple flu shots over the years. 

The most common calculation of a virus’s infectiousness is a measure called the R0 (pronounced “R naught”). This metric estimates how many people one contagious person will infect on average. The R0 of influenza is between one and two. R0 data for Covid-19 isn’t definitive, especially as the virus continues to mutate, but studies indicate the number for many Covid strains is higher than for flu. 

When are you contagious with flu?

The CDC and many doctors say you are likely contagious with flu a day before you develop symptoms, which can include a fever, congestion, cough, sore throat, headache, body aches and fatigue. Doctors also say it is possible to be infected with influenza and never develop symptoms, and that asymptomatic people can still transmit the virus to others.

SHARE YOUR THOUGHTS

How are you protecting yourself and your loved ones from the flu this season? Join the conversation below.

Up to half of flu infections may be asymptomatic, says Dr. Chin-Hong, but people with such infections probably transmit less efficiently. A 2021 study in the Lancet Global Health found that asymptomatic individuals transmitted the flu to only about 6% of household contacts.

The incubation period for influenza—the time between when you get exposed to a virus and when you develop symptoms—is about one to two days, says

Seema Lakdawala,

an associate professor in the department of microbiology and immunology at Emory University who studies flu transmission.

Like people with Covid-19, those with influenza start shedding virus before they develop symptoms and can be contagious before they know they are sick, says Dr. Lakdawala. People with influenza are most infectious early on in their illness, in the first two to three days after being infected, she says.

If you’re older, have a chronic disease or are immunocompromised you may shed virus for longer. 

Related Video: 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
Preventing the spread of flu

Covid-19 precautions also work against flu. Pandemic measures largely quashed the flu around the world for two years. Many of us aren’t used to taking those same precautions for flu. Doctors say we should reconsider—but we may not have to be as rigid about it.

Studies show that influenza can spread easily within a household. If someone in your home tests positive for flu, have them isolate as best as possible, recommends

Kristin Englund,

an infectious-disease physician at Cleveland Clinic. Eating separately or having them wear a high-quality mask helps if strict isolation isn’t possible. If they are unable to wear a mask, others in the household should do so to lower risk. And when you’re in the same space, improve ventilation by opening the windows or running a HEPA air purifier.

Dr. Englund says schools and offices should re-evaluate their guidelines for returning after a flu infection. “It’s safest to wear a mask as long as somebody is symptomatic,” she says, as congestion and coughs can linger for days.  

Masking in indoor spaces and avoiding large crowds in poorly ventilated indoor spaces are other smart precautions to take to combat flu during flu season, says Dr. Lakdawala. Most important, stay home if you have symptoms. 

“Be thoughtful,” says Dr. Lakdawala. “We don’t need to take all the precautions that were maybe a little onerous during the Covid-19 pandemic, but we can still take some measures to help reduce risk in our communities.”

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

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World

China’s COVID epicentre shifts to Guangzhou as outbreaks widen

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  • Southern manufacturing hub fighting worst COVID-19 flare-up
  • Cases double in Zhengzhou, production base for Apple supplier
  • Chinese stocks, currency slip over virus fears

BEIJING, Nov 8 (Reuters) – New coronavirus cases surged in Guangzhou and other Chinese cities, official data showed on Tuesday, with the global manufacturing hub becoming China’s latest COVID-19 epicentre and testing the city’s ability to avoid a Shanghai-style lockdown.

Nationwide, new locally transmitted infections climbed to 7,475 on Nov. 7, according to China’s health authority, up from 5,496 the day before and the highest since May 1. Guangzhou accounted for nearly a third of the new infections.

The increase was modest by global standards but significant for China, where outbreaks are to be quickly tackled when they surface under its zero-COVID policy. Economically vital cities, including the capital Beijing, are demanding more PCR tests for residents and locking down neighbourhoods and even districts in some cases.

The sharp rebound will test China’s ability to keep its COVID measures surgical and targeted, and could dampen investors’ hopes that the world’s second-largest economy could ease curbs and restrictions soon.

“We are seeing a game between rising voices for loosening controls and rapid spreading of COVID cases,” said Nie Wen, a Shanghai-based economist at Hwabao Trust.

Considering how the nationwide COVID curbs are crushing domestic consumption, Nie said he had downgraded his fourth-quarter economic growth forecast to around 3.5% from 4%-4.5%. The economy grew 3.9% in July-September.

The rising case load dragged on China’s stock markets on Tuesday, but shares have not yet surrendered last week’s big gains.

Investors see China’s beaten-down markets as an attractive prospect as a global slowdown looms, and have focused on small clues of gradual change – such as more targeted lockdowns and progress on vaccination rates.

“No matter how harsh the letter of the law is…there is a little bit more loosening,” said Damien Boey, chief macro strategist at Australian investment bank Barrenjoey.

NO FULL LOCKDOWN YET

Guangzhou, capital of Guangdong province, reported 2,377 new local cases for Nov. 7, up from 1,971 the previous day. It was a dramatic jump from double-digit increases two weeks ago.

Surging case numbers in the sprawling southern city, dubbed the “factory floor of the world”, means Guangzhou has surpassed the northern Inner Mongolia city of Hohhot to become China’s COVID epicentre, in its most serious outbreak ever.

Many of Guangzhou’s districts, including central Haizhu, have imposed varying levels of curbs and lockdowns. But, so far, the city has not imposed a blanket lockdown like the one in Shanghai earlier this year.

Shanghai, currently not facing a COVID resurgence, went into a lockdown in April and May after reporting several thousand new infections daily in the last week of March.

“We have been working from home for the past couple of days,” said Aaron Xu, who runs a company in Guangzhou.

“Only a few compounds have been locked up so far. Mostly we are seeing disruptions in the form of public transit services being suspended and compound security barring couriers and food delivery. And we have to do PCR tests every day.”

RISING CASES

In Beijing, authorities detected 64 new local infections, a small uptick relative to Guangzhou and Zhengzhou, but enough to spark a new burst of PCR tests for many of its residents and a lockdown of more buildings and neighbourhoods.

“The lockdown situation has continued to deteriorate quickly across the country over the past week, with our in-house China COVID lockdown index rising to 12.2% of China’s total GDP from 9.5% last Monday,” Nomura wrote in a note on Monday.

Zhengzhou, capital of central Henan province and a major production base for Apple (AAPL.O) supplier Foxconn (2317.TW), reported 733 new local cases for Nov. 7, more than doubling from a day earlier.

In the southwest metropolis of Chongqing, the city reported 281 new local cases, also more than doubling from 120 a day earlier.

In the coal-producing region of Inner Mongolia, the city of Hohhot reported 1,760 new local cases for Nov. 7, up from 1,013 a day earlier.

Reporting by Ryan Woo, Bernard Orr, Liz Lee and Jing Wang; Additional reporting by Josh Ye in Hong Kong and Tom Westbrook in Singapore; Editing by Raju Gopalakrishnan, Stephen Coates and Raissa Kasolowsky

Our Standards: The Thomson Reuters Trust Principles.

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Business

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

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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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Business

Inside a Chinese iPhone Plant, Foxconn Grapples With Covid Chaos

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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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Health

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

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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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How are you preparing for cold and flu season? Join the conversation below.

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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Health

Monkeypox Outbreak Leaves Risks, Questions in Its Wake

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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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World

Biden Administration Pares Back Covid Fight as Funding Push Falls Short

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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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Is Congress allocating enough money to fight Covid-19? Why or why not? Join the conversation below.

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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US

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

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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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