Two years ago, China was being lauded by the World Health Organization for its success in beating the coronavirus. But its insistence on adhering to a so-called Covid Zero policy is leaving it increasingly isolated as other countries that suffered far-worse outbreaks return to a semblance of pre-pandemic life. Their populations have built up a large degree of protection through waves of infections and more-effective vaccines. Chinese officials have said shots alone can’t prevent infections and stringent curbs aimed at wiping out the virus are needed to avoid a health care calamity. President Xi Jinping has pledged to try to reduce the economic and social impact resulting from enforcing the strategy, which Hong Kong also follows. But he has vowed to stick with it despite continued flareups -- including one that locked down the financial capital Shanghai for two months this year.
1. Does Covid Zero mean zero cases?
Ideally, but it’s not that simple. Beijing’s perception of Covid hasn’t changed much since the virus first emerged in late 2019 in the central Chinese city of Wuhan: It’s a public health threat that must be eliminated at all costs. That’s why China still requires strict quarantine for anyone arriving from abroad -- though the duration was cut by half to seven days in late June as the omicron variant appears to have a shorter incubation period. Any outbreak domestically is met with a barrage of targeted testing, contact tracing and quarantines to try to nip it in the bud, with citywide lockdowns as a last resort. That approach, which has become known as “dynamic clearing,” acknowledges that infections occur but aims to stop onward transmission. More infectious variants have made it more difficult for China. In early April the daily case count topped 20,000 -- surpassing the opening days of the pandemic in China, when testing wasn’t readily available -- before falling back.
2. Why is China sticking to it?
In its calculus, the benefits outweigh the costs. The government estimates the strategy has avoided 1 million deaths and 50 million illnesses. It’s reported fewer than 6,000 deaths from Covid on the mainland, mostly early in the pandemic. That compares to about 1 million in the U.S., which has a population less than a quarter the size. China has used those figures to portray its system of governance as superior. Along with saving lives, Covid Zero also allowed the Chinese economy, the world’s second biggest, to grow while other major economies contracted in 2020. In late June, Xi declared Covid Zero the most “economic and effective” policy for China. A modeling study by researchers at Shanghai’s Fudan University, published in May in Nature Medicine, offered a glimpse of what could happen if omicron were allowed to spread unchecked: a “tsunami” of infections resulting in 1.6 million deaths.
3. What’s the domestic impact been?
As the virus has become more contagious, it’s led to more frequent outbreaks, some of which have resulted in hardcore lockdowns, where most people are required to stay home. A handful have dragged on for more than a month, such as in Shanghai and the northeastern industrial province of Jilin, leading to economic and social hardship and distress for people with chronic medical conditions. When the western city of Xi’an was locked down, one woman suffered a miscarriage and a heart attack victim died after difficulty accessing emergency care. On the other hand, the giant tech hub Shenzhen emerged from just a week of lockdown relatively unscathed, with some factories continuing to operate under a new closed-loop system throughout. Workers are effectively put in a bubble, ferried between their company-run dormitories and the plant -- or sleeping on the floor at work -- with regular testing and temperature checks. Authorities in Beijing and other cities including Hangzhou, home to tech giant Alibaba Group Holding Ltd., have avoided full lockdowns by initiating testing blitzes and other restrictions immediately after the first cases turn up.
4. And on the economy?
While this year got off to a stronger-than-expected start, the outlook has been clouded not only by Covid but trouble in the domestic property market and the global repercussions from Russia’s invasion of Ukraine. All the disruption and fear of infection have weighed further on the economy. People have avoided travel, shopping and dining out. Even partial lockdowns have snarled industrial supply chains. Economists have been steadily downgrading their growth forecasts to well below the government’s target of around 5.5% -- which was already well below last year’s final rate of 8.1%. Xi has said China would strive to minimize the economic and social impact while still achieving “maximum prevention and control.”
5. What are the hurdles to getting back to normal?
Here are some:
• While nearly 90% of the population has been vaccinated and a growing number received boosters, the rates are lower for the elderly: 82% for those between 70 and 79 and about 51% for those over 80, health officials said in mid-March. (In Hong Kong, which had similar problems vaccinating the elderly, people 65 and older accounted for more than 90% of the more than 9,000 Covid-related deaths in the city this year through April.)
• Many analysts point to the lower efficacy of vaccines developed in China. The most widely used are inactivated shots, which offered less protection against infection caused by the original strain of the virus in clinical trials than the mRNA vaccines developed by Pfizer Inc., BioNTech SE and Moderna Inc. The mRNA shots are the backbone of immunization in much of the world but are unavailable in mainland China.
• Chinese health officials have made it clear that vaccination alone isn’t enough, since breakthrough infections are common even with Western vaccines.
• The run on hospitals across the world, both in under-resourced places like India and in the developed world, is a constant reminder about how China’s patchy hospital network could easily crash under a sudden spike in infections.
• Switching tactics to let the virus infect a large swath of the population could create bad optics ahead of the national congress of the ruling Communist Party slated for later this year, where Xi is expected to try to extend his power.
6. What’s the cost to the rest of the world?
Covid Zero has sent ripples through the global supply chain. Tesla Inc.’s Shanghai plant was shut down for three weeks before the company started a closed-loop system. Outbreaks have led to temporary production halts at the factories of other foreign carmakers in cities including Tianjin and Jilin and disruption for chipmakers in Xi’an. But abandoning the policy could cause far greater disruptions, at least temporarily, if workers were too sick to show up at work, given how much the world relies on China for everything from raw materials to finished consumer and industrial products. In the worst-case scenario of the virus spreading out of control and China imposing a national lockdown, Bloomberg Economics and Bloomberg Intelligence estimated that could slow China’s economic growth to 1.6% this year -- the lowest in more than four decades -- and send shock waves through the world economy. Among the likely results: lower commodity prices, and a more gradual pace of Federal Reserve interest-rate hikes. WHO Director-General Tedros Adhanom Ghebreyesus called on China to “shift” its strategy, saying the approach no longer makes sense as the omicron variant spreads and the country’s economy suffers.
7. What’s the endgame for China?
Government officials haven’t explicitly said how they expect the pandemic to end. Meanwhile, there are mounting signs the country expects to stick with Covid Zero for the foreseeable future. Visiting Wuhan this year, Xi said the country is willing to endure temporary blows to the economy rather than put lives at risk. Across China’s biggest cities, testing booths began sprouting up everywhere this year as new rules require hundreds of millions of urbanites to get tested as frequently as daily. Authorities also updated their Covid Zero playbook in June by standardizing policies for mass testing, targeted lockdowns and contact tracing that had varied widely. Such moves, along with the shorter quarantine, are meant to make the strategy less disruptive and more tolerable for the public, rather than a move toward eventually living with the virus -- an idea Xi has scoffed at. Some experts think the strategy will eventually crumble as the virus becomes too transmissible to control. Another possibility is a new variant may emerge that’s mild enough for the government to relent without harming the population. Without any meaningful pivot, life in China in the coming years could be drastically different from the rest of the world.
8. What’s the outlook for Hong Kong?
The financial hub and gateway to China has prioritized aligning its policy with the mainland in an effort to reopen the border. Successive outbreaks on both sides have kept that from happening. As omicron swept through Hong Kong early this year, public hospitals became overcrowded and the government’s priorities shifted to vaccinating the elderly and reducing fatalities. In March, after acknowledging that public tolerance was fading, city leaders dropped a plan for mandatory citywide testing and instead sent kits to all residents and asked them to test themselves. As case numbers fell, the city eased social-distancing restrictions in stages and shortened the mandatory hotel quarantine for most incoming travelers to seven days. But officials said efforts to reopen borders still face challenges.
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