Epidemics test China’s efforts to limit the cost of ‘zero Covid’

Barely a week after no longer requiring residents to present a negative Covid test to use public transport, authorities in northern China’s Shijiazhuang city have locked down much of the city for five days as infections increase.

In Shanghai, many neighborhoods resumed requiring frequent Covid testing just days after residents were told testing was rarely needed.

And in much of Beijing, authorities ordered schools and many businesses closed as daily cases rose over the past week to more than 1,400 and the country acknowledged its first related deaths. to the coronavirus for months.

China said earlier this month that it refine Covid restrictions to limit the disruption caused by lockdowns, quarantines and daily mass testing. Beijing’s leaders were looking for ways to adjust the strict measures that have isolated the country from much of the world, dragged its economy down and changed the lives of millions of citizens.

But in cities across the country, the rapid spread of Covid outbreaks is testing the government’s resolve to deliver on its commitment and raising questions about when – if at all – the world’s second-largest economy will reopen.

“It’s maybe 10 steps forward and nine steps back,” said Chen Long, a political analyst at Plenum, a Beijing consultancy.

The number of new infections in China has increased almost every day since late October, with more than 25,000 cases a day now scattered across all provinces in the country. The number of cases announced on Tuesday, 27,307, edged closer to China’s single-day record of 28,973, set on April 14 at the start of Shanghai’s lockdown.

According to Nomura, a Japanese brokerage firm, 49 cities representing a third of China’s population and two-fifths of its economic output are now under partial or full lockdown, a sharp increase from the previous week.

China is the only major country in the world still trying to eradicate Covid infections three years into the pandemic, with the ruling Communist Party saying it is the only way to protect Chinese lives. But even as Beijing pledges to maintain a zero-tolerance approach, officials have begun to recognize the strain it places on resources.

When Chinese officials announced on November 11 that they were working to make the containment strategy more precise, they cited a shortage of beds and quarantine facilities, as well as a shortage of people for contact tracing work. . They introduced changes to the rules, including stopping the quarantine of personal contacts of contacts of people infected with the virus, and discouraged mass testing.

The changes brought relief to citizens like Yin Wenbo, a 41-year-old kindergarten teacher in Shijiazhuang, who immediately stopped requiring a negative PCR test to ride public transport or enter many buildings. “We all have to work, and sooner or later we have to deal with it – in addition to Covid there are many other infectious diseases, so you will never go out?” she says.

Other residents were less optimistic. Fears of the infection spreading rapidly have prompted families to strip shelves of herbal cold and flu remedies and ask the city to protect them from Covid. As cases have indeed started to climb, Shijiazhuang announced on Sunday that it would take five days of mass testing across the city and told most residents to stay at home.

As new lockdowns and recurring rounds of testing show, officials at the provincial and municipal level are likely to err on the side of caution, given the risk of being fired for outbreaks, as has been the case since the start of the pandemic.

There are longer-term challenges to any effort to change the “zero Covid” strategy. Most Chinese have never been exposed to the virus. Vaccination efforts faltered over the summer and fall. This has left a population with low immunity, warn public health experts. No significant easing of Covid restrictions is likely unless the country steps up its national vaccination programme.

“It’s really important, it’s the most important thing to do in China,” said Jin Dongyan, a virologist from Hong Kong.

Hospitals are only now beginning to expand intensive care units for a surge of serious infections. Little effort has been made to set up triage centers that could, in the event of a large wave of infections, send only the most seriously ill to hospitals and send everyone else home to recover.

“Early in the spring, they were talking about hospitals not being needed to treat minor cases, but that hasn’t been the case,” as even asymptomatic cases continue to be hospitalized, Yanzhong Huang said, public health specialist at the Council on Foreign Reports.

Many in China are terrified of any infection because the country’s vast propaganda apparatus has spent the entire pandemic terrorizing the virus with grim reports of mass deaths and numerous “long Covid” cases in other countries.

In southern China, rapid antigen tests for Covid are in short supply as local governments run out of money for the free curbside PCR tests they have offered so far.

Joanna Yeung, a 25-year-old resident of Guangzhou, is considering whether to buy an oximeter for her parents. “It can be difficult to see a doctor when the number of cases increases,” she said.

Citizens will only be reassured, said Beijing commentator and newsletter editor Wang Xiangwei, when trusted health experts appear on TV to discuss the lack of gravity of the Omicron variant for those who have been vaccinated, especially young people who also have strong immune systems. A possible candidate, he said, was Zhong Nanshan, who helped uncover the SARS outbreak in 2003 and played a key role in bringing national attention to the initial Covid outbreak in Wuhan there. almost three years old.

There is also a question of resources. China has not made it clear who will pay for medical care if a surge of cases finally occurs, raising fears among many citizens of financial hardship. The country’s public health insurance system offers only limited coverage.

This is the concern of Ken Feng, a 50-year-old worker in Shenzhen, who fears that his parents will be among the first to succumb.

“If one person is infected, it can cause more infections and put a huge strain on the finances of the whole family,” he said.

The biggest worry among public health experts is that China’s vaccination effort has shrunk to almost nothing.

When China began large-scale vaccination in late 2021, it reserved rare doses for working-age adults. Health officials have warned older people against vaccination, warning there could be side effects – advice that has been hard to reverse and has contributed to continued vaccine hesitancy. A third of the country’s citizens aged 60 or over have never received a booster.

In the spring and summer of last year, China was vaccinating around 25 million people a day as it rolled out its own vaccines. Last week it was 120,000 to 220,000 a day.

The urgency to scale up vaccinations grows every day as more Covid infections slip through China’s ‘zero Covid’ net, making the economic toll increasingly difficult to mitigate. Many restaurants and other small businesses have closed permanently as families and migrant workers stay home to avoid being caught in quarantines or shutdowns. Retail sales fell last month from October last year, the government revealed last week.

“To continue this for the next few years no longer makes sense, given the socioeconomic costs,” said Richard Reithinger, global health expert at the Research Triangle Institute in North Carolina.

But China does not want to endure a wave of cases that would inevitably be triggered by any easing of measures, said Andy Chen, senior analyst at the Shanghai office of Trivium China, a policy consultancy.

“They will definitely lock down again if the cases get out of hand,” he said, adding, “It’s really hard to see how they’re doing.”

Li you, Olivia Wang, Amy Chang Chien and John Liu contributed to the research.