Testing times

Shanghai looked like a ghost town during the lockdown

This week Shanghai finally re-opened after a two-month lockdown.

But residents quickly discovered a new addition to their streets: 9,000 permanent testing booths.

The idea, say the authorities, is to “normalise” regular Covid testing so that individual cases can be caught early and another full-scale lockdown can be avoided.

Similar networks are being established in other major cities such as Beijing with each municipality also setting rules that require residents to get tested every three days in order to use public transport or enter public spaces.

This massive investment – the booths, the staff, and the tests – is a sign that China is still deeply committed to the idea of ‘zero-Covid’.  Salaries of up to Rmb10,000 a month are being offered to people to man the booths.

In April the head epidemiologist of the national Covid response team, Liang Wannian, warned that the country’s medical system would be overwhelmed if China relaxed restrictions because vaccination rates amongst children and the elderly were not high enough.

Vaccination is not mandatory in the country and many elderly people have shunned the jab.

This means China’s population – which also has lower resistance levels having avoided earlier waves of infection – is highly vulnerable to existing strains and possible future variants.

Yet testing is a huge inconvenience: lines at booths across Shanghai after the first day of opening up were an hour long. For now the tests are free but analysts at Japanese bank Nomura have calculated it would cost Rmb900 billion ($135 billion) to test 50% of China’s population every two days for a year.

That’s a huge burden for local governments especially those in smaller cities; as of now Beijing says it’s a cost it won’t cover.

The county-level city of Langzhong in Sichuan province tried to make up this shortfall by asking residents to pay Rmb3.5 for their mandatory nucleic acid tests.  But public anger at being forced to pay for compulsory thrice weekly tests forced the authorities to rethink. The new rules now make the test optional – though if anyone is using a health app to access public services they’ll still need to have regular tests to make sure their health pass stays green.

In places like Beijing the necessity of having a ‘green code’ from a health app has caused people to treat it like a precious item that must be protected. So unpredictable is the system that underpins it that people find themselves not taking ‘risks’ (for example, going for a walk) in case they encounter someone or something that triggers the dreaded pop-up window notifying the user that their green code needs to be recertified.

“I live in fear of the pop-up,” says one woman who said she now avoids all trips that aren’t strictly essential.

“I don’t love the idea of vaccination but it’s better than constantly standing in line for tests,” said another.

China began its booster vaccination roll-out last October but as of March this year just over 50% of the population had received one.

Particularly reluctant are the elderly who fear the vaccines might not be safe for their age group – this stems from that fact that early ones hadn’t been tested on older age groups. They also find it hard to differentiate between news on domestic vaccines and foreign ones.   

Furthermore, the elderly aren’t working at companies that might encourage vaccination, nor do they want to travel as the young might. 

And until the recent Omicron outbreaks, China felt safe from infection.

Of course, the obvious and perhap more cost-effective approach would be for the government to pare back its massive testing programme and make vaccinations mandatory. After the economic and social fallout of the Shanghai lockdown, many are puzzled why this course has not already been adopted – given that in the tradition of policymaking it would seem to achieve the greatest good for the greatest number…

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