Health authorities and clinicians across China are warning of a significant surge in COVID‑19 infections this July, driven by the NB.1.8.1 variant—a descendant of the JN.1 lineage that now dominates the country’s caseload. Public health officials in Hong Kong and Taiwan have already responded to rising case numbers with renewed masking guidance and hospital preparations.
In May, the Chinese Centre for Disease Control and Prevention identified NB.1.8.1 as the principal agent behind the sharp rise in cases nationwide, mirroring similar trends across Asian neighbours. Evidence from CDC screening in the United States detected NB.1.8.1 infections among travellers from Asia between late April and mid‑May, reinforcing concerns over its transmissibility. Preliminary Chinese research indicates the variant may bind more effectively to human cells than predecessors, potentially accelerating its spread.
Hospital insiders in China refer to an uptick in “white lung” patterns—dense opacifications on chest scans—and sudden deaths among previously healthy middle‑aged adults, although experts emphasise the term remains colloquial and lacks precise medical definition. At the same time, nothing yet suggests the emergence of a new pathogen. Health agencies, including the WHO, note the wave aligns with rising circulation of known respiratory agents—COVID‑19, influenza, RSV and mycoplasma—without evidence of an unusual strain.
Hospitals in Beijing and Liaoning report increased admission volumes, with clinics in cities like Dalian and Chongqing grappling with larger-than-normal respiratory caseloads. Despite this, national health statements have stressed that surveillance shows no new pathogens, attributing the climb to seasonal factors and immunological gaps following post‑lockdown easing.
Regional governments have reinstated basic safeguards—including mask recommendations on mass transit and in healthcare settings—in response to the epidemiological models forecasting July peaks. Authorities in Taiwan have also begun stockpiling vaccines and antivirals in anticipation of increased demand.
Global health bodies are closely monitoring: CDC representatives in the U.S. maintain active communication with counterparts in China, Hong Kong and Taiwan regarding variant spread. Several cases of NB.1.8.1 have been recorded at U.S. ports of entry, though limited sequencing has so far prevented it from showing up prominently in national variant dashboards.
In vaccine policy circles, U.S. regulators are debating updates for the autumn season, with mRNA manufacturers presenting candidate boosters targeting JN.1 lineages—such as LP.8.1—that could also offer immunity against NB.1.8.1.
Metapneumovirus, an endemic respiratory pathogen, was also notably active during winter 2024–2025 in China, accounting for over 6 per cent of positive respiratory illness tests and hospitalisations. Health officials affirmed this activity was consistent with typical seasonal patterns.
Medical experts stress that while chest imaging showing “white-out” lung appearance can be alarming, it is not indicative of a novel syndrome; it occurs with severe pneumonia from various known agents. Treatment protocols remain standard, including antibiotics for bacterial pneumonia and antivirals when appropriate.
