The recent surge of respiratory illnesses in China is probably due to the reemergence of common seasonal sicknesses that were previously controlled by extended Covid lockdowns, rather than a new pandemic.

Infectious disease experts informed POLITICO that children are currently filling hospitals in a similar manner as they did in the United States one year ago.

As the virus season approaches, China is currently experiencing a rise in cases due to its extended implementation of Covid lockdown measures. These measures were only lifted in January after a public uprising. The lockdowns not only protected against Covid, but also against other contagious respiratory illnesses that pose a greater risk to children, such as the flu and RSV.

Some children may not have come into contact with certain viruses or bacteria before, making them more vulnerable to getting sick.

However, the recent request from the World Health Organization for details from China regarding “documented cases of pneumonia in children in Northern China” served as a reminder of the beginning of the pandemic nearly four years ago. This also sparked concerns that a new pathogen could potentially lead to another widespread outbreak.

The increase in cases has been attributed to common viruses and bacteria, rather than a new virus, according to China’s health ministry on Sunday.

Health care experts were consulted by POLITICO for their analysis.

Could this be a novel virus or a result of weakened immunity?

Last year, the United States experienced a comparable widespread of illnesses after lifting official pandemic measures: Influenza, Covid-19, and RSV all reached their highest levels concurrently, leading to what was known as the “tripledemic.”

The concept of “immunity debt” has become popular to explain this phenomenon, and it appears that China may be catching up on its debt later than expected, due to their longer implementation of Covid lockdown measures compared to other nations.

The CDC agrees that prolonged avoidance of infectious diseases can make a population more vulnerable once measures like lockdowns, mask wearing, social distancing, and other precautions are lifted.

According to Andrew Pekosz, a professor of immunology at Johns Hopkins Bloomberg School of Public Health, a significant portion of the population may not have immunity and has not been exposed to various pathogens. As a result, there is now a surge of infections among these individuals in a single year.

Experts stated that the current testing does not indicate the presence of a new virus, so the outbreak in China should not be a concern for health officials in the United States.

Last year, Amesh Adalja, a senior scholar and adjunct assistant professor at Johns Hopkins, stated that this has already occurred in the United States. He explained that when respiratory pathogens are given a chance to spread, the number of people who are vulnerable to infection increases, leading to larger outbreaks.

What is the level of risk for global spread?

According to experts, since there is currently no new disease-causing agent, the likelihood of the outbreak spreading to individuals residing outside of China is minimal. The main consequence of this situation is expected to be an increase in strain on China’s healthcare facilities.

Adalja stated that the impact of this situation is limited to individuals who are currently in China.

In China, the spread of respiratory infections may start to increase due to the fact that children are often responsible for passing on diseases to their families, according to Pekosz.

According to him, the increase in infections can be overwhelming for the healthcare system. Therefore, it is crucial to monitor if this spreads to older age groups and how many new cases are reported each week.

According to Adalja, the chances of the outbreak reaching the United States this year are slim due to the country already dealing with illnesses such as RSV in the past year.

Infants born during the pandemic were not as exposed to RSV due to safety measures, but once these precautions were lifted and social gatherings resumed, there was a significant increase in RSV cases in the United States last year.

According to Adalja, we are currently in the RSV season, but unlike last year, the situation is more typical because all the affected children have recovered. This means that we are now experiencing the usual fluctuations of respiratory viruses, with the addition of Covid.

How can the United States prepare itself?

Experts recommended increasing the surge capacity of hospitals, particularly for children.

According to Dr. Peter Hotez, co-director of the Texas Children’s Hospital Center for Vaccine Development, many pediatric hospitals in the United States operate at full capacity even during prosperous periods in order to remain financially stable.

Dr. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said he’s seen cuts in health care capacity overall, and even harsher downsizing of pediatric units.

The speaker stated that in Minnesota, there has been a significant reduction in size and closure of many pediatric units in non-specialized hospitals, with minimal expansion in children’s hospitals.

This causes him to question the true amount of ill children in China in relation to the country’s healthcare system’s capabilities.

He mentioned that no one is providing specific information about disease rates. Instead, they simply state that clinics are overwhelmed. But what exactly does that imply? Is it 3% or 10% of the population infected?

Is it possible to rely on the information coming from China?

“I believe the crucial factor is, as President Reagan famously said, ‘trust but verify’,” stated Dr. Ashish Jha, the former coordinator of the White House’s Covid-19 response.

In addition to evaluating the information released by China, the United States also has its own methods of confirmation, including traveler data, in order to ensure there are no discrepancies, according to Jha, who currently serves as the dean of Brown University’s School of Public Health.

However, even though China has not been transparent about Covid, public health experts are not noticing any concerning signs this time.

According to Osterholm, the current state in China is in line with our predictions.

The speaker stated that the current situation is not caused by a novel infection, but rather by the resurgence of previous ones such as influenza, mycoplasma, adenovirus, and Covid.

What’s mycoplasma?

Although viruses are primarily responsible for the outbreak in China, there is also a bacteria called mycoplasma that is spreading.

Unfortunately, that is unfortunate timing with the rapid spread of the virus.

According to Hotez, outbreaks of disease can still occur despite consistent exposure to pathogens. He stated, “Mycoplasma epidemics happen every few years.”

Mycoplasma commonly results in mild respiratory infections, but can be more severe in certain cases, particularly in young children, and may require hospital treatment. It may also trigger asthma attacks, cause inflammation in the brain, or impair kidney function, although it is uncommon for it to be fatal.