Zero COVID in China: what next?

How China was driven into an unsustainable COVID-19 control strategy, and the prospects for change are low. Sean Yuan reports.

More than two years after China’s unprecedented blockade in Wuhan, the Chinese government continues to stick to its Zero-COVID strategy, as the first COVID-19 outbreak paralyzed cities in central China. It raises the serious question of how China will withdraw. This pandemic.

Since March of this year, Shanghai, China’s largest city, has suffered the worst outbreaks, with hundreds of thousands of cases recorded. Subsequent strict blockades of the city caused havoc among the inhabitants, separated families and squeezed food and medical resources.

Initially, only certain districts were blocked and movement between districts was banned, but as the number of cases began to skyrocket, the blockade spread throughout the city. Depending on the risk level, residents were only allowed to leave the house once every few days. Neighbors, and those who test positive, are taken to a quarantine center or hospital, and their neighbors are also banned.

The goal of blocking this round is the same. Adhering to a dynamic zero-corona strategy that is essentially aimed at eradicating outbreaks with extensive testing and blockades to achieve a zero-case called defeating the virus, as set by the government. is.

The Zero Corona Strategy has been a pillar of China’s epidemic response for over two years. Government officials have long touted China’s success in repelling the virus, in contrast to other countries where the virus killed more than 6 million people. According to official statistics, the virus has killed about 5,000 people in mainland China so far, but many question the reliability of that number and attribute it to China’s COVID counting of deaths. I am. President Xi Jinping reiterates that “people’s lives are paramount” to justify border closures and strict domestic control policies. “The Dynamic Zero COVID Strategy has protected most of mainland China from the health and health effects of COVID infections in the community,” said Ben, Head of Epidemiology and Biostatistics at Hong Kong University. Cowling says. However, in the recent blockade round in Shanghai, many people are nationwide because the negative effects of the blockade, such as food supply shortages, economic turmoil and access to medical care, are more noticeable and sometimes more harmful than COVID-19 itself. I seriously doubt how effective the blockade policy is in curbing the spread of the virus.

One Shanghai resident who talked to Lancet Explaining that his father failed to undergo dialysis due to the hospital’s strict policy of not being hospitalized unless the PCR test for COVID-19 was negative, another has reduced the supply of essentials, including food. I complained about that. Many people in Shanghai have written on social media about the collateral damage of confinement rules, including many patients with chronic and non-COVID-19-related illnesses losing access to medical care.

“The government is trying to clear all COVID-19 cases, so they turned all their attention to this virus, but underestimated other illnesses and ignored or ignored deaths other than COVID-19. There is a tendency, “says Xi Chen. , Associate Professor at Yale University School of Public Health with a focus on health policy and economics.

Two officials from China’s state-level health committee Lancet He also expressed doubts about the policy, subject to anonymity. “COVID-19 has become a highly politicized illness in China, and any voice claiming a deviation from the current zero COVID pass will be punished,” one official said. “No one from the top really hears the expert’s opinion anymore, and it honestly humiliates our medical professionals.” Another official expressed similar feelings and policy. Said that the damage caused by the company outweighed the benefits it caused. “This isn’t cost-effective and we all know it,” officials said.

Closely linked to the rigorous implementation of non-pharmaceutical measures to control COVID-19 in China is the vaccination campaign. This seems to be unrelated to the strength of the blockade measures being implemented, according to Yanzhong Huang, a senior researcher on the Council on Foreign Relations. .. After the initially sluggish vaccination campaign, China stepped up vaccination with domestically produced vaccines, especially with Sinopharm and Sinovac, but vulnerable groups were not prioritized. By late February 2021, mainland China’s vaccination coverage had reached only 3.56%, but by August last year it had reached 53% and now 87%. Drawing data from a wave of recent outbreaks in Hong Kong, Hong Kong University experts said that two doses of the Sinovac vaccine were used in non-peer reviews for severe or fatal illness in people over the age of 60. A study investigating infectious diseases from December 31, 2021 to March 8, 2022, which reported that they were effective. With booster immunization, efficacy reaches 98%. However, vaccination rates for the elderly in mainland China remain low. Although more than 87% of the population was vaccinated twice, more than half of people over the age of 80 were vaccinated twice, less than 20%. According to Zeng Yixin, Deputy Minister of the National Health Commission, he is receiving a booster.

This lack of protection in the most vulnerable groups to severe illness makes it difficult for China to change its policies safely. “For most of the last two years, there have been few cases in China, but the elderly who are at highest risk of becoming infected and developing serious viral symptoms could not be fully vaccinated. Is daunting, “says Huang. .. “Experience in Singapore shows that a safe escape from the Zero-COVID policy is possible if the vaccination rate of the elderly can reach very high levels,” says Cowling.

Huang and Chen said vaccine hesitation has been facilitated by the lack of urgency to be vaccinated in China. As China controls COVID-19, citizens have less reason to be vaccinated, especially if false information about the side effects of the vaccine, such as frequent heart attacks and severe allergies, is widespread. The logic is as follows: If you don’t have the virus in the first place, you don’t need to get the vaccine.

The Beijing government continues to work on the Zero Corona strategy. “It is imperative that we keep a clear mind, adhere to the general policy of Dynamic Zero COVID, and fight decisively against all the words and deeds that distort, doubt and deny our anti-epidemic policy.” The president said at the meeting. On May 5, the blockade continued in Shanghai and the number of cases increased in Beijing.

Health experts say some conditions must be met before China considers policy changes, eliminating the possibility of China losing full control of the virus. new zealand.

According to Chen, strengthening vaccinations for the elderly while strengthening the healthcare sector is an absolute “precondition”. It is also necessary to inform the general public about changes in the nature of the infection (decreased severity of the B.1.1.529 (Omicron) mutant and reduced risk after vaccination). One of the frequently used arguments by governments and supporters of the Zero-COVID strategy is that easing policies can quickly overload the health system and increase the number of unmanageable deaths. .. To address this issue, experts have proposed solutions that are in line with international practice. Mr. Chen said the government has aimed to discharge everyone infected with the virus (as previously required) for quarantine at home, and to discharge patients of varying degrees of severity. He said the drafting of treatment regulations or guidelines should begin. Intensive care unit beds for those who need them most. “If we can ban millions of people from leaving the house during the blockade, there is really no benefit to the argument that we can’t ask people with mild symptoms not to go to the hospital,” Fan said. Said.

However, even if the medical guidelines are updated, the political situation in China will still play a vital role. Mr. Huang said the government would maintain the stability that underlies West’s political ambitions as the party convention approaches when President West is ready to secure an unprecedented third term presidential position. He states that he will make an effort.

China’s reopening timeline is unclear at best, as the flu season begins shortly after the party convention. “The earliest possible time for China to withdraw its current measures is early next year, yet there is no guarantee,” Chen said.