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Italy has become the first country in Europe to make it obligatory for people arriving from China to be tested for Covid-19 following Beijing moving to reopen its borders after lifting some of its toughest anti-Covid restrictions.
The move, which sees Italy join a number of countries closer to China in changing its travel policy, comes amid concerns over the potential for new variants to emerge during fresh outbreaks of the virus in China and quickly spread overseas. Japan, Malaysia, South Korea and India are among the Asian states that have introduced measures to prevent an influx of cases, including mandatory PCR tests and genetic sequencing of positive cases.
Italy’s decision to impose testing for all China arrivals comes almost three years after it became the first western country to be hit by the pandemic, which to date has claimed more than 180,000 lives in the country.
“The measure is essential to guarantee the surveillance and identification of any variants of the virus in order to protect the Italian population,” said Orazio Schillaci, the Italian health minister.
Italy has already been monitoring swab tests at Rome’s Fiumicino airport and Milan’s Malpensa airport, where on Monday one in two passengers arriving on flights from China who undertook non-mandatory tests were found to be positive for coronavirus.
Virologists are watching nervously how China’s decision to drop quarantine for overseas visitors from 8 January and from the same date resume issuing visas to foreigners and passports to its own people may affect the global spread of the disease.
A Downing Street spokesperson said the UK was not looking at travel restrictions on visitors from China.
The end of China’s zero-Covid approach comes amid surging case numbers, with low vaccination rates especially among elderly people. Ascertaining the spread and severity of Covid is more difficult than ever as Beijing has stopped publishing daily case numbers and ended mass testing.
“They’ve changed very quickly from a zero Covid approach to completely relaxing things, so maybe that’s happened too quickly to keep up,” said Australian infectious diseases expert Prof Dominic Dwyer, one of the team tasked with travelling to Wuhan early in 2021 to investigate the origins of the pandemic in a report for the World Health Organization (WHO).
“We don’t know what variants are circulating in China at the moment … [and] whether those variants are different in terms of their response to vaccination.”
While official statistics from China report just three new Covid deaths for Tuesday after Beijing changed the way it recorded Covid-19 deaths to include only those who die from respiratory failure or pneumonia, the British health data modelling firm Airfinity estimates there are now more than 1m cases and more than 5,000 new infections each day.
Experts say the lack of data is likely to be masking the number and severity of cases, and physicians in China are reporting a massive infection and death surge. Howard Bernstein, a Beijing-based doctor, told Reuters that patients are arriving sicker and in greater numbers, and that the ICU ward where he works at the Beijing United Family hospital was full.
Nearby countries are taking their own measures to prevent a surge of infections. Japan’s prime minister, Fumio Kishida, on Tuesday announced that from 30 December, arrivals who have been in mainland China at any time in the seven days prior will need to provide a negative Covid test on arrival or quarantine for seven days.
Having eased its own border restrictions in October, Japan is also capping the number of arrivals from China. “Concern has been growing in Japan as it is difficult to grasp the detailed situation,” Kishida said as he announced the measures.
Taiwan’s government said on Wednesday that it would test arrivals from China from 1 January and that it will conduct virus sequencing for those who test positive to track new variants. In Malaysia, the ministry of health is preparing for a feared Covid surge by pushing for people to get booster doses and promoting antiviral drugs.
US officials are also considering whether additional measures are needed to monitor returned travellers. “There are mounting concerns in the international community on the ongoing Covid-19 surges in China and the lack of transparent data, including viral genomic sequence data,” officials said.
An Australian government spokesperson told the Guardian that while the department of health “continues to monitor the global situation, travel arrangements for Australians and visitors to the country remain unchanged”.
China’s decision to resume issuing passports for the first time in almost three years could allow large numbers of Chinese tourists to travel abroad for next month’s lunar new year holiday. Travel services companies Trip.com and Qunar said international ticket bookings and searches for visa information on their websites rose five to eight times after Tuesday’s announcement, with top destinations including Japan, Thailand, South Korea, the United States, Britain and Australia.
The WHO director general, Dr Tedros Adhanom Ghebreyesus, has called on China to share data and conduct relevant studies to help the world understand which Covid variants are circulating. Dwyer said data was crucial because in countries where Covid-19 is out of control, the sheer number of people infected makes it more likely that there will be a rare event that leads to changes in the virus, potentially creating a new variant of concern.
Prolonged lockdowns in China also mean a significant proportion of the population have not been infected with newer variants, and the Sinovac and Sinopharm vaccines China has relied on appear less effective than mRNA vaccines used elsewhere.
“That is the environment where you’d expect new variants to appear,” Dwyer said. “So therefore monitoring people returning from China who are sick is going to be important. We don’t know … whether those variants [in China] are any different to what we’ve seen elsewhere.”
China has rejected western reporting of the surge in Covid cases since it dramatically relaxed restrictions. “Currently the development of China’s epidemic situation is overall predictable and under control,” the Chinese foreign ministry spokesperson, Wang Wenbin, said on Wednesday.
“Hyping, smearing and political manipulation with ulterior motives can’t stand the test of facts,” he added.
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