From reading scientific papers about the occurrence of complications in people who've had Covid twice, it looks like the virus inflicts long-lasting damage to the body, even if it isn't readily apparent.

People how have Covid twice have a higher rate of complication the second time around (including post-Covid syndrome a.k.a. long covid). There are no reasons to think that people in places where "living with Covid" is a thing really are rotting with it. Vaccines do little to protect against this.

In Europe, the cumulative incidence of confirmed infections is nearing 50% of the population (and ~30% in the US). In China, that number is less than 1%.

Major caveat regarding the reasoning above, the studies were carried before omicron emerged. These variants have fewer complications, not sure how this will compound.

It is possible that the drop in productivity in the US that's been reported this week (https://news.ycombinator.com/item?id=33405389) is in part driven by lower mental acuity or immune system performance. The decline may not be large enough to be noticeable on a day to day basis, yet show up in aggregate measurements.

Xi may be playing the long game here. If the above holds, even if Covid ends up endemic in China after a while, its workers would have an edge on the rest of the world.

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https://www.researchsquare.com/article/rs-1749502/v1 (it's only a preprint, but third party experts vouch for it: https://edition.cnn.com/2022/07/05/health/covid-reinfection-...)

I've read an earlier paper on the topic, but I can't find it right now.