China is facing an increasingly precarious situation as new COVID cases soar and the population seems to be hitting a breaking point with the government's stringent zero-tolerance policies.

Why it matters: The world's most populous nation has massive vulnerabilities heading into this winter, starting with the fact the vast majority of its population has yet to be exposed to the virus and has little 'natural immunity.'

• China's vaccines didn't work well compared to those distributed in the West, and the government refused to approve foreign vaccines and doesn’t have a version to combat Omicron.
• Vaccine uptake was particularly low among the elderly.
• And now, public outrage over new COVID lockdown restrictions has fueled rare protests, Axios' Herb Scribner writes, with residents demanding the government lift restrictions quickly and some calling for President Xi Jinping's resignation.

State of play: Overall, China's number of reported COVID cases and COVID deaths are far lower than other nations, but there have been recent reported spikes in the number of infections and some new deaths.

• It came after the Chinese government announced some easing of its zero-COVID policy, such as reducing mass testing and quarantine requirements, earlier this month.

Reality check: China’s doctors have warned that the health care system isn't prepared for the huge outbreak likely to follow any easing of public health measures, Axios' Bethany Allen-Ebrahimian writes.

• That includes worries the nation doesn't have enough ICU bed capacity to handle such circumstances, according to the Financial Times.

The bottom line: China's zero-COVID policy has kept disease spread relatively low compared to the rest of the world.

• But even as the societal and economic consequences of shutdowns become apparent, it faces a very difficult path ahead in unwinding strict public health policies.

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Driven in large part by the growth of Medicare Advantage, a number of startups are vying to create the next value-based care model for senior care in patients' homes, Axios' Sarah Pringle reports.

Why it matters: As we recently reported in our Elder Care Crisis Deep Dive, there is a shortfall of enough cash and caregivers to handle the massive amount of aging baby boomers reaching their senior years.

State of play: Senior care-related startups commanding fresh rounds of investor funding this year include Upward Health, Biofourmis, ConcertoCare, and Vytalize Health.

• "The cool thing about value-based care?" General Atlantic managing director Robb Vorhoff said. "There’s hundreds of business models."

Reality check: Scaling remains a challenge for new models looking to shake up the senior care market.

• "There are a lot of options out there that you don’t know about," Town Hall Venture’s Andy Slavitt says. "Some are the best-kept secrets; some are not worth knowing about."

Be smart: While most elderly adults would prefer to age in place, there is still a need for institutional care settings like nursing homes, which presents its own major challenges, Sarah writes.

Related: As Gen X and Boomers age, they confront living alone (New York Times)

Biosimilars for AbbVie's Humira — one of the world's most-used drugs — are coming to the U.S. market in 2023, and that could mean big bucks for the nation's largest drug middlemen, the Wall Street Journal reports.

Driving the news: Biosimilars drive down the costs of drugs for consumers, similar to how generics might, by offering near-identical versions of biologics.

• Pharmacy benefit managers, or PBMs, are also likely to greatly benefit from Humira's biosimilars because of how they are distributed through specialty pharmacies, per the WSJ.

Between the lines: More than 70% of total branded sales going off patent through 2025 will be covered by pharmacy-benefit managers and dispensed directly by their specialty pharmacies to patients, the WSJ wrote, citing an analysis by Morgan Stanley.

• That will give PBMs "greater influence on how demand is shaped," per Morgan Stanley, and thus help them demand greater rebates from drug makers, WSJ writes.

Yes, but: Even with a number of companies waiting in the wings to offer Humira biosimilars, many PBMs may be slow put Humira into more expensive tiers or booting the biologic off their formularies due to consumer demand, Axios' Bob Herman reported in February.

"The paradox of the pandemic is that while vaccines against COVID-19 were developed in record time and deployed in the largest vaccination campaign in history, routine immunization programs were badly disrupted, and millions of kids missed out on life-saving vaccinations against deadly diseases like measles."

👉 Former Surgeon General Jerome Adams said he struggled to find a job — and raise awareness around his wife's cancer — after serving under former President Donald Trump. (Washington Post)

👀 Outgoing NIAID Director Anthony Fauci said over the weekend he "has a completely open mind" when it comes to considering the COVID lab leak theory. (Politico)

🎂 Happy Birthday to Omicron, the variant that keeps surprising virologists. (New York Times)

🐓 The avian flu outbreak in the U.S. is the worst on record with over 50 million birds dead. (Axios)