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14 September 2022

Millions of people under lockdown for 1,100 cases. When will China’s zero-covid policy end?

Lili Pike

Locked down and locked in. That’s how people felt when a 6.8 magnitude earthquake hit China’s southwestern Sichuan province last Monday. In Chengdu, China, the provincial capital, the government had ordered residents to stay home in the face of a growing covid outbreak, and some buildings were literally closed off to stop the spread. Even as the earth shook, the rules were the rules. One video posted on Chinese social media showed people begging pandemic workers to open the locked gate to their apartment building.

It was just the latest example of the extremes that officials and healthcare workers have gone to under China’s zero-covid policy, which aims to eradicate all infections through mass testing and lockdowns. Even in the face of the highly contagious omicron variants, China has stuck steadfastly to its approach while other countries have abandoned the idea of shutting down cities to stop transmission.

Chengdu, a city of 21 million people, was locked down after only 156 cases were reported. As of last week, officials extended the lockdown as cases rose further, and 48 other Chinese cities, home to some 292 million people, were under full or partial lockdown, according to the investment bank Nomura. Shenzhen, the country’s huge technology hub, was among them — all public transit was shut down for several days, for a city of 18 million people.

This is all in response to an average daily case load of less than 3,000 nationwide. During the same period, the daily caseload in the U.S. has ranged from 65,000 to 90,000.

By some metrics, the zero-covid lockdown strategy has been successful. Overall, China has been able to keep cases and deaths low compared with many countries, including the U.S., and the Chinese government has made that a point of pride. But defining success by these statistics alone obscures the broader — and increasingly profound — costs of China’s zero-covid push. The lockdowns are propelling the economy into a crisis — driving up unemployment, slowing down manufacturing and contributing to the housing market’s slide. The social toll is rising too: Local government failures to provide enough food and access to medical care have led to public outcry over the past six months.

Meanwhile, omicron continues to challenge the feasibility of the strategy; even though the nationwide case count is low by U.S. standards, the outbreak is China’s most widespread in two years.

Some experts have predicted that the policy will be relaxed after the Communist Party congress in October, a crucial meeting for Chinese President Xi Jinping, at which he is expected to secure a third term. But the party has yet to signal a shift.

“It is puzzling why the economic factors haven’t weighed more,” Oxford University public policy professor Thomas Hale, who has been tracking government responses to covid, told Grid. The twin traumas of the pandemic and the economic woes have left Xi with a conundrum: On the one hand, after single-mindedly championing the zero-covid policy for two years as a sign of China’s superior approach, it will be hard to explain a shift to a new strategy. On the other hand, the policy threatens to further damage China’s already-faltering economy.

“I don’t think the policy is long-term sustainable,” Hale told Grid. “I think it’s a question of when it will change, not if it will change.”

Where public opinion stands on zero-covid

In the ideal version of China’s zero-covid policy, routine testing identifies cases before they spread too quickly, and lockdowns are imposed only briefly — with only minimal disruption to a city and its population.

In some cases, cities have been able to pull this off. In Shenzhen, many residents were allowed to return to their daily lives after the recent three-day lockdown brought infections under control.

In Chengdu, Mr. Li, a retired civil engineer who has been spending the summer with his in-laws, said that his lockdown experience had been mostly smooth so far. (Li spoke on the condition of partial anonymity due to the sensitivity of the topic). People were given half a day off work to prepare for the lockdown and buy groceries. “Chengdu people have a good sense of humor and jokingly called it the ‘Official Shopping Festival,’” Li said, “because everyone rushed to the stores to grab vegetables and meat, and it was as lively as a holiday — as lively as New Year’s.” Despite the crowds, Li said he was able to buy enough food for his family and has been able to receive deliveries of additional goods.

But in other cases, the battle against omicron has been far messier. The experience of people locked in during the earthquake was one example. Shanghai is another. There, an initial small-scale lockdown was extended overnight, as cases climbed in late March. The lockdown, initially planned for four days, lasted two months and the delivery system buckled under the pressure. Many people faced food shortages because they couldn’t receive deliveries while trapped at home — an unfathomable situation for such a cosmopolitan city. “Voices of April,” a video containing first-person audio clips describing the pain of the lockdown, went viral on social media. The accounts were heard across the country before China’s censors removed them.

In the latest wave of outbreaks, people in the southern city of Guiyang, have experienced echoes of Shanghai’s troubles. Posts on the Chinese social media site Weibo showed residents struggling to find basic supplies; one elderly person reportedly didn’t have food for three days. City officials apologized for delivery breakdowns and said they would address the problem. Similarly, people in Yining, a relatively small city in Xinjiang, have reported issues accessing food and medical care as their monthlong lockdown continues.

“The high socioeconomic costs associated with draconian ‘fangkong’ [covid prevention and control] measures have begun to weaken the social foundation for the policy,” wrote Dali Yang, a University of Chicago political scientist, in a recent paper. “National pride over the successful containment of the pandemic is giving way to uncertainty and anxiety.”

Even for Li, who had few complaints about Chengdu’s handling of the situation, the policy is growing tiresome. “I share the general consensus, which is a feeling that it’s not really necessary,” he said, citing the milder symptoms of recent variants. “Everyone thinks the situation is kind of laughable, but everyone knows why it’s like this: It’s a political necessity.”
The economic burden grows

With its far-reaching censorship regime, the Chinese government has been able to tamp down criticism of the policy. But the economic toll has become impossible to hide.

Each lockdown upends supply chains, businesses and factories. That’s especially true when China’s huge metropolises are shut down. In Chengdu, some factories have asked employees to live at work to keep business going, and in some cases workers have complied. But other plants, including a Volvo-owned factory, have paused operations, according to the Wall Street Journal.

The cumulative damage is clear in China’s recent economic statistics. In the first half of the year, China’s gross domestic product grew by only 0.4 percent, an anemic figure for China. It’s also far below the government’s 5.5 percent target for the year. One-fifth of young people in cities were unemployed as of July. And amid the joblessness and general economic turbulence, consumer spending has fallen. Summer vacations — or the lack thereof — are one indicator: Summer train travel was at its lowest level since 2013. Uncertainty about the future has also driven housing sales down — adding pressure to China’s growing real estate crisis.

The policy has also been weighing heavily on local government finances. Not only must local officials implement the lockdowns and provide supplies for those who cannot leave their homes; they also have to conduct millions of covid tests multiple times a week during an outbreak.

Houze Song, a senior fellow at the Paulson Institute, told Grid that the policy needs to change for China’s economy to bounce back. “The No. 1 challenge is really zero-covid,” he said. “My opinion is that as long as the zero-covid [policy] is in place, no other policy matters, regardless of how well it is designed or implemented. They will not be able to offset the impact of zero-covid.”

Chinese leaders aren’t blind to these issues. “I think the central government is aware of the risk of sacrificing too much economic output,” Hao Zha, a researcher at the University of Oxford Blavatnik School of Government, who leads its tracking of the Chinese government response to covid. He pointed to new orders released by China’s National Health Commission in June that urged local officials to avoid overreacting to outbreaks.

But for local government officials, it is very difficult to strike the right balance between pandemic control and economic growth as long as zero-covid remains the overarching goal. More than 4,000 officials have been punished for covid management issues, according to Bloomberg.

Does zero-covid have an expiration date?

Assuming Xi and the government have the political will to change course, there will then be public health ramifications to consider. In late April, Liang Wannian, the head of a National Health Commission panel on covid, laid out some of the foundational steps: boosting the vaccination rate among the vulnerable and ensuring sufficient medical capacity to handle a surge.

One of the biggest problems with making the shift is that China’s lockdowns have left the majority of the population with no natural immunity, meaning the virus could tear quickly through the population. A May study from scientists at Fudan University projected that China could see 1.6 million cases if the zero-covid policy was dropped.

China has increased vaccinations in the months since, but a sizable population remains under-vaccinated. Among China’s 60-and-over population, 86 percent have received two doses of vaccine, but only two-thirds have received three doses, according to data from China’s National Health Commission. In Hong Kong’s outbreak this spring, 96 percent of deaths were among the elderly, who were more likely to be under-vaccinated — a stark warning sign for China.

The fact that China hasn’t made a stronger vaccination push has surprised many public health experts. “They have very good execution power in China, but still the vaccination rate in the elderly remained very low for so long, which is actually quite puzzling,” Jin Dong-yan, a virus expert at the University of Hong Kong Medical School, told Grid. China has also rejected foreign-made mRNA vaccines in favor of its domestically produced shots, which have shown solid protection with three doses but are less protective than the Pfizer and Moderna vaccines. “If they do care about the efficacy and effectiveness of the vaccines, they should quickly approve the Pfizer or the Moderna,” Jin added.

Why hasn’t China fully embraced the tools and measures needed to abandon the costly zero-covid policy? Again, the answer seems to be largely about politics.

The policy has been held up as an example of China’s superiority. In a September 2020 speech, Xi said China’s recovery from the initial outbreaks “fully demonstrates the remarkable advantages of China’s Communist Party leadership and our socialist system.” In a June 2022 visit to Wuhan, Xi insisted that the lockdowns and other measures had to continue. “Even if there are some temporary impacts on the economy,” he said, “we will not put people’s lives and health in harm’s way.”

For people who oppose the party, there is a hefty price to pay. The few Chinese scientists who have suggested a different path forward have felt the wrath of both the public and government officials. Zhang Wenhong, a Shanghai doctor with millions of followers, was widely castigated after suggesting China should shift to living with covid last year.

“In the United States, Dr. Anthony Fauci […] I mean at least his voice has been heard by the leadership and by the general public,” Jin said. “But in China, there’s no voice from the experts.”

Ultimately, foreign public health and China experts say the policy will have to change due to the economic costs, but for now the question is when and how Xi will lay out a post zero-covid vision for China. “The main thing is preparing a political narrative that can help move the country and society, which is now quite attached to this narrative, to a new way of doing it,” said Hale. “That’s a challenge for any government, and it will be a really big barrier holding back the transition.”

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