COVID-19 has now entered its third consecutive year. Over 5.5 million people have died worldwide. Many hospitals in countries around the world, including those in the United States, have reached crisis levels again. The global economic woes of coronavirus continue to plague the globe. And then there’s China. As one of the last countries to follow a zero-COVID policy, the world’s most populous nation has lost less than 6,000 of its 1.4 billion people to COVID-19, while expanding its economy by 8.1% in 2021 and registering a record trade surplus.
China’s critics are numerous. Many decry China’s weeks-long, city-wide lockdowns and call them sensational instances of authoritarian excess. The zero-COVID approach is dismissed by these people as a failing, poor science, or an attempt to shore up their political control. But without whole-of-society support for the zero-COVID approach, it would be virtually impossible to make 20 million people stay at home over a handful of cases—as China has done in the run up to the Lunar New Year, mostly in the western city of Xi’an and in the northwestern province of Henan.
“Few countries have the ability like China in terms of effectively mobilizing the resources and capacities for pandemic control,” says Dr. Huang Yanzhong, a senior health policy expert from the Council of Foreign Relations (CFR)—not only in terms of “the clear commitment from the top leaders” but also “the overwhelming support from the public.”
The comparative fragility of China’s hospital system makes one important reason plain. According to OECD researchers in 2018, the U.S. had 26 ICU beds for every 100,000 inhabitants. According to data from 2017, Germany has almost 34 ICU beds per 100,000. China, however, had 4 more ICU beds than Germany for the exact same population in 2017. Following a Malthusian strategy of “letting COVID rip” through the country would lead to enormous loss of life.
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The 2022 Beijing Winter Olympics in February, and the emergence of the highly contagious Omicron variant, will see China’s strategy put to a fresh test. The Chinese capital has reported its first local Omicron transmission, but is hoping to protect the Games with a “closed-loop bubble”—a system by which everybody participating in the Olympics will be physically isolated from the general population. If no major outbreak occurs, it will strengthen Beijing’s argument that its zero-COVID policy was the right approach all along. The strategy does not come cheap—according to the latest available figures, China spent nearly $63 billion in the first eleven months of 2020 to combat COVID-19—but the country appears willing to pay.
China’s zero-COVID approach saves lives
The term “zero-COVID” is a misnomer. “Currently, we are not capable of ensuring there will be no more new domestically transmitted infections,” the head of the National Health Commission’s COVID-19 task force, Liang Wannian, told the state-owned China Daily Have you seen this earlier in the month?. “But we are capable and confident of stamping out local infection clusters as quickly as possible.”
This approach is based on tracking, testing and inoculation. According to Reuters, China has administered 2.93 billion does—enough to cover the entire population—and continues to administer more than 6 million does a day. It is remarkable to note that China has maintained its zero-COVID strategy, despite its high vaccination rate. This includes making allowances for Chinese-made immunizations which many consider to have lower effectiveness. It may be an indication that vaccines can reduce the risk of serious illness, but not the spread of coronavirus..
Community mitigation is emphasized instead. Each citizen of China, as well as foreign residents, is given a unique colored code upon completing a survey using a smartphone app. A separate app for Olympic Games attendees is required. Green status allows you to travel, use public transportation and enter public buildings. Red status refers to COVID-19-related illness or probable COVID-19. Yellow status, which means the holder has been in close contact with someone suffering from COVID-19), requires that they be placed in isolation for recovery.
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It is intense. The following figures are from the South China Morning PostMore than 8430 hospitals in the nation can perform nucleic acids tests, which allow them to test 12.55 millions samples per day. Residents are restricted from leaving their homes for groceries or other necessities if a crime is committed.
It is extreme. But what does abandoning zero-COVID look like? According to the Chinese Center for Disease Control and Prevention, the country can have up to 600,000. cases per day if they follow the laissez-faire model of the U.S. and U.K. China reports between 155-230 new cases every day since the beginning of the year. The center’s chief epidemiologist Wu Zunyou, estimates that China’s management of COVID-19 has to date prevented 200 million infections and 3 million deaths.
John Hopkins University statistics show that COVID-19 has claimed the lives of approximately 2,500 Americans per million and 2,200 in the United Kingdom per million. However, only three people die per million from the disease in China. Dr. Huang of the CFR says China has created a “safe haven” from COVID, where people feel much safer: “China did a far better job keeping the disease under control than any other country.”
Politics of Zero-COVID
The system is not without its critics. Chinese novelist Fang Fang was booted out of the Chinese Writers Association, and ostracized by the country’s publishing community, when her candid diary of life in the 2020 Wuhan lockdown was published in the West. Zhang Zhan (a blogger) was jailed for 4 years after she angered authorities through live streams from Wuhan and posted numerous posts. According to BBC, her health is declining rapidly due to intermittent hunger strikes.
When prominent Shanghai virologist Zhang Wenhong, popularly known as “China’s Anthony Fauci,” took to social media last July to suggest that China had to “return to normal life, while at the same time protecting its citizens from fear of the virus,” he was met with a huge backlash. A few weeks later, however, the virus was finally eradicated. GuardianReports said that he was now willing to back down. “The COVID-19 strategy our country has adopted is one that suits us the best at present,” he said.
More recently, public anger was generated during the lockdown in Xi’an, where restrictions came into force on Dec. 22 and have only just started easing. According to reports, two women miscarried and one man suffered a heart attack after being denied entry by hospital officials without having received COVID-19 results. Social media was also rife with claims of food shortages, with users on China’s Twitter-like platform, Weibo, claiming that some residents had resorted to barter in order to feed themselves.
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These incidents attracted international attention. However, the official response was quick. The authorities stepped up efforts to provide food for households. Xi’an’s data chief was suspended after contact-tracing apps crashed. Hospital officials were either suspended or fired, with Sun Chunlan, a member of China’s powerful politburo and a vice premier, saying she was “ashamed” over the hospital incidents—adding that medical institutions should not be turning away patients for any reason.
Internationally, the response to China’s zero-COVID strategy has gone from initially cautious praise and admiration to suggestions that Beijing should at least partially relent. Dr. Ooi Eng Eong, an infectious disease expert from the Duke-National University of Singapore Medical School, tells TIME that COVID-19 will never go away in the foreseeable future, so at some point governments should take steps to bring back a semblance of normalcy in people’s lives.
“Life isn’t just about whether there’s COVID or not,” Ooi says. “There’s a lot more to what makes our life enriched… so we need to begin to move towards that direction. There is never a perfect moment. It’s just that there will always be [a] trade-off.”
There is also a growing chorus of impatience at the ongoing impact of China’s strategy on global supply chains, with predictions of significant economic consequences. Katrina Ell, senior economist at Moody’s Analytics, told CNBC that “given China’s zero-COVID policy and how they tend to shut down important ports and factories—that really increases disruption.” She added that the strategy “will have important ramifications for inflation and also central bank policy-making in the next couple of months.”
It is also hard to disagree with Chen Long’s logic, founder of Chinese research company Plenum. Fortune: “If they didn’t do preliminary lockdowns, then you’d have millions of cases in China, and then you’d have a worse supply-chain crisis.”
Radhika Dasai from Geopolitical Economy Research Group in Canada says that COVID-19 has become an ongoing tug-of war between saving people’s lives and keeping them profitable. “If you look underneath the surface rhetoric and the gestures of our governments,” she says, “the most important priority for them has been to save capital assets.”
Desai cautions against relying too heavily on vaccines to stop the pandemic. This is due to the inevitable mutating variants, and the huge vaccine inequity among poor and rich countries. She says that the question of when China will end its zero-COVID policy is out of reach for anyone. Instead: “I think we should ask when will we learn from China.”