Shanghai residents are finally out on the streets,
celebrating the end of a strict two-month lockdown.
But it might not be the last time they have to go through this.
As China clings to what it calls a “dynamic zero-COVID strategy,”
people can face stringent lockdowns any time there’s a rise in cases where they live.
In Shanghai, residents were basically locked up at home for weeks.
Shops, schools and offices were closed. The lives of 25 million people were put on hold.
The social and economic consequences of these tough restrictions have been painful.
And the suffering might seem very unnecessary,
especially when the rest of the world has basically returned to normal.
So why is China sticking to its zero-COVID policy?
The answer is that it has little choice. China's failure to capitalize on its early
pandemic success and adapt to different circumstances today means it's now stuck.
To understand why, we need to go back to the very beginning of the pandemic.
Remember Wuhan, the city where the coronavirus was first found? It was also the first city
in the world to enter a COVID lockdown. And by December 2020, while most countries were still
battling devastating outbreaks, life for the city’s 11 million people was back to normal.
That’s thanks to a strict lockdown that was imposed right after the COVID outbreak.
In China, their first objective is to keep the virus out of the community as much as possible
with travel restrictions. And then if the virus does get in, which we know
will happen sooner or later when there's an outbreak in a particular community, [it] does
very stringent control measures: case finding, isolation of cases,
contact tracing and quarantine. And that's facilitated as well typically by lockdowns.
Professor Cowling is an epidemiologist based in Hong Kong – where pandemic measures have
been mostly in line with mainland China. The city has been pretty much COVID-free until recently.
It's a very efficient strategy compared to other strategies, because as long as most of the time
can be spent at zero daily cases, actually life can be pretty normal inside cities in China.
In fact, China’s initial approach was so effective that
it was regarded internationally as a successful example to learn from.
Professor Jane Duckett spent 18 months with her team,
funded by the UK government, looking into China’s pandemic strategy back in 2020.
I think it was successful in the beginning, obviously, in the sense that they
got infections and deaths, death rates back down to zero from around late March 2020.
But what was effective then is now less so.
With the arrival of the more transmissible Omicron variant, it has become much more
difficult to stop the spread of the virus – even with measures like lockdowns.
Countries like Singapore and New Zealand, which initially adopted their own zero-COVID policies,
have changed tack and are now trying to ‘live with’ the virus.
But China has not. Its success story back in 2020
has arguably become the biggest hurdle in the way of a more flexible approach today, in 2022.
A major reason for China’s hesitation to open up
is that the vaccination rate among its elderly population
is exceptionally low – and that’s largely due to the consistently low number of infections.
I think in a sense the successful containment
made the vaccination, especially of older people, seem less
necessary. Right? If you don't have it spreading through society, you don't seem to need vaccines.
Only 19.7% percent of people above the age of 80 in China have received a vaccination booster,
while just over 50% of them have completed their primary vaccinations.
I suppose you could say they trusted the government to protect them…As long
as the zero-COVID strategy continues, then the public health measures are limiting infections.
And so vaccines would be like a backup plan, but maybe not an urgent priority for older adults.
A recent study published by Shanghai’s Fudan University claims that,
with the currently low vaccination rate among elderly people,
the lifting of the zero-COVID policy could lead to over 1.5 million deaths.
China could have pushed for a more aggressive vaccination campaign before the Omicron
variant appeared. Missing that window has resulted in the struggle it’s facing today.
That wasn't really planning for the future and wasn't really
planning for the contingency of a more transmissible variant as we've seen.
On top of that, there’s the question of vaccine efficacy. Research has shown that
the Chinese-made, inactivated-virus vaccines are less effective against infections with Omicron
than mRNA vaccines, like, for example, the Pfizer-BioNTech vaccine.
But China still hasn’t approved the use of foreign-made vaccines for its population.
Instead, it is betting on home-grown mRNA vaccines,
which are still undergoing clinical trials.
And that seems to be driven purely by political decisions, you know,
political motives to not want to be seen, to be reliant on international support,
international science and technology, but to be able to develop their own vaccines and use them.
This possibility of high death rates and infections
if China drops its zero-COVID approach is just too risky for the ruling Communist Party.
A lot of how people see COVID, in 2020, 2021, is in comparison with the West. So in countries
like the United States and Western European countries, COVID rates were very high, death
rates were very high, people had waves of lockdown and a lot of political disturbances. And it's just
felt like chaos in the West, whereas China was relatively peaceful and had very low death rates.
Professor Nancy Qian is currently based in the US.
She has been observing and writing about China’s COVID strategy.
And I think that's what the politicians want to avoid and they just don't know how.
They can’t avoid it completely. They're trying to find the path of minimal political cost.
And the political cost of abandoning the ‘zero-COVID’ strategy currently
seems to be too high. It has become President Xi’s signature policy.
He is expected to announce his intention for a landmark third term at China’s 20th Party Congress
coming up in September – So it’s bad timing for a gamble on a new way to handle the pandemic.
They think that they have demonstrated the superiority of the system in containing the virus.
And therefore, they would like to continue with that. And they think they can continue with that.
But the costs of continuing with the policy are growing.
The stringent COVID strategy is taking its toll – not only on people’s daily lives,
but also on China’s economy. And that too will tarnish the ruling Party’s popularity.
Is there a way, then, for China to both transition out of its
zero-COVID strategy and save the Party’s image?
I believe that it should be possible for them to find a face-saving way to message this.
It's all about the messaging, to say: Look, there is going to be some risks,
but if we don't open up, there are other types of risks and other costs that we have to pay.
The difficulty is that the longer they go on as they are now,
the harder it will be for them to do that messaging effectively. Because the longer they
go on like they do now, the more unhappy people are and the less people trust the government.
And this all leaves Xi Jinping and the Communist party in a particularly tricky situation.
They do just seem to think that they can keep testing and containing their way out of this.
However long term, It doesn't look very sustainable.
There is going to be a political hit no matter what. They can’t escape it.