Why China can’t just end its zero-COVID policy

Protesters in China demanded an end to the country’s draconian zero COVID policy, a pandemic prevention strategy that President Xi Jinping the claims have kept her people safer than the less stringent measures taken by other nations, as the suffering she has caused becomes increasingly unbearable.

Experts said it was unlikely the government will permanently end zero-COVID any time soon, although it may continue to change the policy. But even if Xi wanted to abandon the strategy entirely, as some localities would start to do, it could lead to even more misery.

Zero-COVID – defined by city-wide lockdowns, mass testing and enforced quarantines – was once a paragon of the coronavirus pandemic containment approach. Nowadays, Data from Johns Hopkins University shows that China has the lowest number of COVID-19 related deaths per capita in the world. The number of deaths in the country, according to the World Health Organizationis only 30,205, compared to the more than one million deaths in the United States, although questions were asked on the accuracy of China’s official data reports.

However, for nearly three years, the same measures intended to protect China and its people have also taken their toll. The inhabitants of certain regions found themselves scramble for food and vital resourcesand others have blamed zero-COVID for deadly delays in emergency responses. Mental Health in the country has plummeted, while the economic fallout, domestically and worldwidecontinue to grow.

Read more: The rising costs of China’s zero COVID policy

No wonder some Chinese have expressed frustration with zero-COVID. But experts suggest ending the strategy now would invite a public health crisis. Focusing on containment for so long has distracted the country from increasing vaccination rates – especially among its vulnerable elderly – and investing in needed health infrastructure. The prolonged isolation has also delayed the herd immunity of the population.

And even if zero-COVID suddenly ended, analysts say the economy would not rebound immediately, possibly taking months or even years to recover amid the turmoil of an expected spike in infections.

Donald Low, professor of public policy at the Hong Kong University of Science and Technology, describes this to TIME as one of the “great tragedies” of zero-COVID: “It has led to a serious misallocation of resources and preparing for the things they needed to do when they finally decided to transition.

Maintaining zero COVID, however, not only threatens to further harm the lives and livelihoods of China’s 1.4 billion people, it also risks undermining Xi’s legacy as public discontent escalates. Observers believe any choices Beijing makes to handle COVID-19 in the future could be heading for disaster. Low says, “They created this trap for themselves.”

How China is ill-prepared for a reopening

Should we lift zero-COVID, rather than living with the virus, millions could die from it. This is because, although about 90% of the country has been vaccinated, China has relied on less effective vaccines to prevent serious illnesses, and it lacks adequate health care infrastructure to cope with a surge in hospitalizations.

Most residents in China are vaccinated with one of two local COVID-19 vaccines using an inactivated form of the virus, one developed by Chinese biopharmaceutical company Sinovac Biotech and the other by state-owned Sinopharm. .

But these traditional-type vaccines have proven to provide less protection against infection compared to mRNA-based vaccines from foreign companies. A 2021 peer-reviewed study in Brazil of people aged 70 and over found that Sinovac’s vaccine was only 56% effective in preventing hospitalization and 61% effective in preventing death from COVID-19. By comparison, the Pfizer-BioNTech and Moderna vaccine offering more than 90% protection against the hospitalization of the elderly. The United States Centers for Disease Control and Prevention has also found that getting at least two doses of mRNA vaccines is linked to a 90% risk reduction deaths related to COVID-19.

Read more: mRNA technology gave us the first COVID-19 vaccines. It could also upset the pharmaceutical industry

China, however, has refused to import foreign-made vaccines as local companies pushed to develop their own mRNA-based COVID-19 vaccine. In September, Walvax Biotechnology’s vaccine, which was approved for large-scale clinical trials in 2021, became the first Chinese mRNA vaccine to be approved for emergency use—in indonesia. Earlier this month, state media reported the Walvax jab is ready for public use, but China has not yet approved it.

According to FinancialTimesChina’s cash-strapped and understaffed hospitals could be overwhelmed by an influx of under-vaccinated patients if the country were to experience an ‘exit wave’ – the inevitable spike in infections after restrictions are eased zero-COVID.

A study 2020 found that China had only 3.6 intensive care beds per 100,000 people (compared to, for example, 11.4 per 100,000 in Singapore), and improvements in the health sector since then have taken off. delay. Reuters reported in July that dozens of private hospitals had filed for bankruptcy over the past two years. Meanwhile, public hospitals, which account for 85% of the country’s patient demand, have seen a significant number of medical staff have quit their jobs due to low income since the start of the pandemic.

Why China can’t hide from the virus forever

What happened in Hong Kong earlier this year may provide a chilling glimpse of what could happen on the mainland if the virus overtakes China’s COVID-19 controls. Hong Kong has largely kept the virus at bay through social distancing measures, border controls and mass testing for most of the pandemic. But the overuse of such measures has led to complacency. In January, only about 25% Hong Kong residents aged 80 and over had been vaccinated.

In early 2022, more contagious variants shattered the city’s defenses. For much of February to April, Hong Kong went from being a pandemic success story to having the highest COVID-19 death rate in the world. Out of a population of 7.5 million, some 9,000 lives were lost in a 10 week period as Hong Kong appeared to be caught off guard, despite widely available vaccines and two years to prepare for the possibility of a massive outbreak.

Read more: How Hong Kong Became China’s Biggest COVID-19 Problem

Chinese authorities say they have learned from Hong Kong’s mistakes. “The outbreak in Hong Kong has taught us a particularly profound lesson, as well as an example: severe cases and deaths will be high if vaccination rates are low,” said Wang Hesheng, vice minister of the National Commission. Health, to reporters in Beijing in March, according to the South China Morning Post.

But just over 65% of people aged 80 and over have been fully vaccinated and only 40% have received a booster shot, according to state media. Although authorities on Tuesday announced a campaign to increase vaccination rates among older people, especially octogenarians, it may be too late. Even with zero-COVID still in place on Wednesday, some places, like the capital Beijing, record number of reported cases that the country knows a wave of infections.

The way forward from zero-COVID

Under Xi, China’s ruling party has never communicated an endgame for zero-COVID. The country’s leader has repeatedly declared a “war” on the virus without hinting at any possibility of ever coexisting with it.

“Once zero-COVID was ideologized, there was no way for local governments to deviate from it,” Low says, adding that it created a false sense of assurance among the Chinese public that the virus would eventually disappear.

But while zero-COVID has kept infections low for a long time, the strict measures have also made people more susceptible to the virus, especially as new variants emerge, due to higher levels of natural immunity. low, says Catherine Bennett, an epidemiologist at Deakin University in Australia. .

The dilemma Xi now faces is whether to double down on lockdowns – which are proving ineffective in preventing the current rise in cases and fomenting unrest – or lifting the restrictive measures to appease protesters, and possibly welcome a even greater increase in cases by doing so.

Either way, as infections continue to rise, Bennett tells TIME, the government needs to focus on protection; in other words, increasing vaccination rates among vulnerable populations – and with effective vaccines.

It would force Xi to admit that the virus cannot simply be contained, which he might be reluctant to do as he has staked his credibility on zero-COVID. However, such a confession, Bennett suggests, may actually bolster government authority and influence. Recent protests signal that compliance with pandemic rules is already on the decline, but if Xi links vaccination with openness, she says, “people who relied on the government to keep them safe could now be more likely to get vaccinated.” updated or get vaccinated.

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Write to Amy Gunia at [email protected].

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