No end in sight?

“How could some of China’s remarkable achievements be made to look less credible by the Western media?” That was the question from China’s foreign ministry spokesman Zhao Lijian on Twitter this month. “Easy. Just add ‘at what cost’ to the headline,” Zhao answered himself, providing screenshots of a series of English-language media reports about China. All the headlines ended with the phrase “at what cost”, he noted, no matter whether the discussion was about economic growth, the development of the local tech sector, or fighting pollution.

Zhao’s complaint underlines a clash of perspectives. Beijing takes enormous pride in the economic achievements of recent decades, especially in lifting 800 million people out of poverty and building the world’s second largest economy from the socio-economic chaos that marred much of the 1960s and 1970s under Mao Zedong.

Commentators from outside China often argue that this collective accomplishment came at the price of environmental disaster, rampant corruption and surging disparities in economic opportunity.

Since the beginning of the year, the same ‘at what cost’ qualification has been repeatedly raised again. This time the question is being asked about Beijing’s response to the pandemic. As the Omicron variant pushes the numbers of newly confirmed cases to new highs around the world, observers are asking if China’s so-called ‘zero Covid’ policy is sustainable given the costs and disruptions that accompany it and what might be the exit plan…

How does China’s zero-Covid policy work?

The government has explained that the strategy doesn’t actually imply “zero infection”, which isn’t a practical goal. Instead, the country’s prevention and control campaign is “dynamic” in nature, the National Health Commission (NHC) insists, with measures that try to wipe out new outbreaks as quickly as possible.

According to Ma Xiaowei, director of the NHC, this approach is crucial to cutting off transmission of the coronavirus within the “golden first 24 hours” after new infections have been detected. Central to the strategy is a widespread push into mass testing, the introduction of strict lockdowns and a rapid response to data from contact-tracing apps. Cities with more than five million people are now required to complete a round of testing within three days whenever untraceable cases are flagged, for instance.

Take Xi’an. The city of 13 million people in northwest China logged nearly 200 infections at one point last month. Since then it has conducted at least seven rounds of mass testing. The city went into lockdown on December 23 and it was announced that strict quarantine measures would only be lifted if no new cases were reported for 14 consecutive days.

Unlike in many other countries, a lockdown in China means just that. People are not allowed to leave their homes or hotel rooms. The country’s political setup means there is less resistance to efforts to mobilise the public to achieve a collective objective. A mandatory track-and-trace app also provides essential information for mapping new outbreaks, although such ‘health codes’, as the Chinese government terms them, have often been less applicable elsewhere (even in Hong Kong) on privacy concerns.

Is the strategy effective?

China has adhered to the zero-Covid stance since the coronavirus was first identified in Wuhan in late 2019. It has managed to contain more than 40 clusters of Covid resurgence since last April when Wuhan’s lockdown was first lifted, the state broadcaster CCTV claims.

The reported toll from Covid-19 on a national basis has also been incredibly low so far, with 104,189 confirmed cases as of Tuesday (mostly reported in Wuhan and Hubei two years ago at the outset of the pandemic). The death toll has stayed unchanged at 4,636 for months: i.e. not a single Covid-related fatality has been reported for nearly a year.

The spread of the hyper-contagious Omicron variant has seen China’s pandemic policy come under new strain, however. Elsewhere in the world, the data on infection rates has spiked spectacularly, with huge surges of newly confirmed cases. The World Health Organisation tallied up a record 9.5 million cases of Covid-19 globally over the last week. The US reported a staggering 1.48 million new cases (and 1,904 new deaths) on Monday alone, an unwanted record for the pandemic. Data from Johns Hopkins University suggested that the total number of Covid-19 cases in the United States topped 60 million as of January 9, or roughly a fifth of the population. The official death toll now exceeds 843,000 too.

Figures like these were seized upon by Chinese state broadcaster CCTV in highlighting how China would have faced massive levels of infection and death if it had followed a similar policy to the Americans. Without the ‘zero-Covid’ policy, the pandemic could have resulted in nearly 265 million local cases and more than 3.6 million fatalities, state media said, if China had experienced similar infection and fatality rates.

But at what cost?

Of course, the zero-Covid approach is weighing heavily on people’s daily lives. The upcoming Spring Festival is an important time for family reunions, for instance, but for many the Chinese New Year (which begins on February 1) will be the third festival in succession in which migrant workers and students won’t travel back to their hometowns due to quarantine rules in many cities.

The sudden restrictions in Covid-affected cities have also been a major cause of concern for the public, highlighted by an incident in Xi’an when a heavily pregnant woman was refused admission to a local hospital because her Covid test results had expired. Reportedly the woman was made to wait at the hospital entrance for hours and eventually lost her baby to a miscarriage.

This extreme interpretation of ‘zero tolerance’ prevention measures stoked public fury and the local government in Xi’an quickly sacked a number of hospital staff and announced Thursday it would shut for three months to undergo a “rectification process”.

This is not the first incident of its kind in China and heavy-handed enforcement like this periodically sparks outrage. For instance, there was consternation last year when a video went viral showing health workers beating a dog to death after its owner was sent into quarantine (see WiC564).

According to Nikkei Asia there were demonstrations against the ‘zero-Covid’ policy last month, when a small crowd of about 200 staged a protest in Ruili, a town on the border with Myanmar, where trade has been stymied by measures to control cross-border contact.

But while it seems okay for the public to vent their frustration towards mishandling of quarantine measures by the local authorities (such as the aforementioned Xi’an hospital), questioning of the central government’s fundamental approach is unheard of (or censored, perhaps). On the contrary, the state media insists that, despite their frustrations, the vast majority of the Chinese people have complied with the containment effort for the sake of the collective good and minimise Covid deaths.

How about impact on the economy?

Eurasia Group, a US-based consultancy, put China’s virus prevention effort at the top of its risk assessment for 2022, suggesting that the policy will further weigh down on the global economy.

“China is in the most difficult situation because of a zero-Covid policy that looked incredibly successful in 2020, but now has become a fight against a much more transmissible variant with broader lockdowns and vaccines with limited effectiveness,” its analysts warned in a report this week.

The consultancy isn’t alone in its pessimistic forecasts for the Chinese economy this year, especially if the spread of Omicron results in more lockdowns and travel restrictions. “We are monitoring very carefully what’s happening over there because Omicron has the potential to significantly change the picture in China compared to 2020 and 2021,” Guillaume Faury, the chief executive of Airbus, said during a conference call on Monday, adding that the aircraft manufacturer hasn’t had much disruption in Tianjin, where it runs an assembly line.

There were media reports, however, on Thursday that Toyota and Volkswagen had suspended production at their own Tianjin factories as the situation worsened.

Of course, businesses that rely on flows of people are even more affected, because of the tight border controls in place. Travellers to China still need to go through three weeks of quarantine and while the country’s internal Covid policies may hold down infection levels, economists are warning that China’s relative isolation from the rest of the world comes with growing costs, especially as other countries start to treat the virus as endemic and move towards a strategy of ‘living with it’ in a bid to get their economies firing again.

Why is ‘living with the virus’ not an option for China?

The question of whether Beijing could change tack on its zero-Covid policy was debated briefly when the Delta variant first started to spread. Zhang Wenhong, an infectious diseases expert with a large social media following (see WiC495), was one of the more outspoken on the issue, calling for “the wisdom to co-exist with the virus long term”.

Zhang’s remarks were soon met with a strong rebuttal from other Chinese medical officials, including former health minster Gao Qiang, who urged the government to stick to existing policy and chastised other countries for easing their own restrictions too soon.

Chinese policymakers argue that their own Covid approach is a “people-centric” one, despite its emphasis on the collective good over individual liberty. “Foreign economists who argue that China’s approach is inefficient and just too costly have overlooked one simple but inconvenient fact – for policymakers, people’s lives are non-negotiable. They don’t come with a price tag,” Xinhua rebuked in a commentary piece on Wednesday. Shifting to “coexistence with the virus” while less than half of the world’s population is vaccinated is making a “de-facto choice of letting innocent lives perish,” it further warned.

When will China reopen?

Medical experts insist that the country’s ‘dynamic’ Covid policy means it can always be adjusted at a suitable time. As Zhang Wenhong had tried to explain, Covid-19 is unlikely to disappear completely, so humankind must learn to coexist with it. But a number of conditions will have to be met before China lowers its guard. These include higher vaccination rates to help achieve herd immunity against the virus, say local media. Other commentators cite breakthroughs in vaccination efficacy or mutations of the virus into something less transmissible as catalysts for a change of direction on Covid-19, perhaps in starting to see it more as a common disease like seasonal flu.

Next month China will also host the Winter Olympics in its capital city and on ski slopes nearby. Although the Games has been dogged by diplomatic boycotts from political figures in other countries, China still sees the event as a means to showcase its achievements, which include the containment of the spread of Covid-19.

(Film director Zhang Yimou will orchestrate the opening ceremony for the Games again – just as he did for Beijing 2008 – with a show featuring 3,000 performers. The South China Morning Post reports it will highlight three major themes: world peace, the Olympic motto and ‘together for a shared future’.)

All of this will be happening at a time when other cities may have to order their own residents not to leave their homes, however. Case in point: public health teams were testing 14 million people in Tianjin this week after another Omicron outbreak there. Tianjin is only about an hour’s travel time from Beijing, which is probably why authorities yesterday suspended train, bus and taxi services to other cities from there.

Even more important in scheduling terms is the Communist Party’s 20th Party Congress in the autumn, when it is widely expected Xi Jinping will have his tenure in the top job extended beyond 10 years. With an inevitable focus on the achievements of his initial terms in office, he won’t want the lead-up to the Congress to be marked by hundreds of millions of new infections or economic instability.

Another milestone before that is the 25th anniversary of Hong Kong’s return to Chinese rule on July 1, with it even rumoured Xi will visit the city to mark the handover. There is also speculation that the anniversary might see a loosening of tight border restrictions with the former British colony, flagging further changes in how the containment strategy will be managed.

But until that happens the government is likely to persist with its “dynamic clearing” instead, which puts the onus on local governments to stamp out outbreaks before they spread.

“We do not yet have the ability to prevent local cases from appearing, but we have the ability and confidence to quickly put an end to an epidemic when a local case is found, so this is what we want to emphasise on. It is not the pursuit of ‘zero infection’, but the pursuit of eliminating the epidemic as soon as possible,” Liang Wannian, another senior official at the NHC, insisted last month.

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