The Stakes of China’s Covid Policy

Between early April and June 1, life in Shanghai – China’s financial hub and a city home to 25 million people – came to a halt. Streets emptied from their usual constant bustle, shops and restaurants shut their doors, and living compounds were bolted in with physical barriers. The worst episodes of the lockdown included residents deprived of fresh groceries, officials barging into homes to spray antiseptics that destroyed furniture, and children who tested positive being separated from parents. Over 200 people are thought to have died, not due to Covid, but from restricted access to hospitals. At one point, pets of owners who tested positive were reportedly killed off for fear of Covid transmission.

The Shanghai lockdown – China’s largest Covid response since the first lockdown in Wuhan – was crippling for its residents, national sentiment, and China’s broader prospects. From February 26 to June 15, Shanghai logged 58,098 positive cases and 588 Covid-related deaths, peaking at over 26,000 cases per day in April, according to the city’s Health Commission. Although the lockdown was officially lifted on June 1, its blistering legacy of scars – economic, social, and political – is yet to heal.

At the core of the Shanghai lockdown is China’s “Zero Covid Policy,” the government’s Covid prevention strategy with the unambiguous goal of complete Covid eradication within Chinese borders. In practice, Zero Covid Policy involves mass testing schemes along with tracking and tracing apparatus, mass quarantine, and lockdowns when necessary. Before the worst outbreak began in March, authorities and the Chinese public at large basked with pride in Zero Covid success, as the strategy appeared highly effective against the Delta variant. China’s reported case numbers and mortality rate were far lower than the rest of the world, while its economic growth rate had been one of the highest among the world’s major economies for the past two years. From when the virus was first in late 2019 until March this year, Shanghai recorded only 392 local cases and seven deaths.

But the highly transmissible Omicron variant, emerging in late 2021, brought trouble for the exacting strategy. With patriotism amidst international seclusion and President Xi’s personal reputation tightly bound to the success of Zero Covid Policy, China buckled down with force on Shanghai.

The lockdown drained the patience of many Chinese people and gashed new grievances for the most affected individuals. Distress, dread, and disillusionment surged from the enclosed city, unleashed to the rest of the country over the internet. Despite online censorship, people around China accessed snapshots of life in Shanghai under lockdown – and were grieved, frightened, and angry with what they saw.

In early 2020, China instituted Zero Covid in the first outbreak against the novel virus in Wuhan. The 85-day lockdown with mass testing, intense surveillance, isolation, quarantines, and border closures was credited with fending off Covid throughout 2020 and 2021 in China, keeping Covid deaths to remarkably low levels, and restoring China’s economic growth following an almost 7% drop in GDP. A dramatic demonstration of China’s administrative resolve, might, and efficiency, Zero Covid Policy was gloriously juxtaposed against Western countries’ delays, incompetence, and internal division. By May 2022, one million people had died from Covid in the US, while China reported a mere 5,200 fatalities.

Two years after Wuhan, however, the Omicron variant shifted the playing field for Covid control. Beyond the over half-million cases in Shanghai between March and late May, outbreaks spread across much of China’s urban landscape. In March, an estimated 345 million people across 46 cities were in full or partial lockdowns, a population accounting for 40 percent of national GDP.

Since June 1, Shanghai has remained in strained defense against the virus: massive quarantine hospitals have not been shuttered, and restaurants only opened for indoor dining in late June. Even as Shanghai reopened, an estimated 133 million people in 16 cities remained under some form of lockdown, and outbreaks persist. There is widespread fear that as long as China’s Zero Covid Policy remains in place, outbreaks will continue to trigger sudden lockdowns and other severe restrictions disrupting normal life. From there a massive testing machinery has evolved that can test half a billion people every 48 hours. In major cities around China, Covid PCR testing every two to three days is becoming the norm to gain access to offices, schools, groceries, and public services.

Since the advent of Omicron, China’s Zero Covid battle has exacted high social, economic, and political costs in a short period – both domestically and abroad. New doubt has been cast on Zero Covid Policy’s efficacy at actually protecting public health, with social interaction and mental health clearly compromised. The strategy has disrupted production and consumption whilst ramping up mammoth costs. Meanwhile, widespread resentment over unrelenting regulations has worked its way into social media outbursts threatening popular trust in the government.

Certain commentators have proposed a particularly lethal view on Zero Covid Policy: that it fails to actually protect against the Covid health threat, thus nullifying the trade-off between public health and the economy that is in pursuit. This argument emphasizes both the lower protection of Chinese vaccines and lower vaccine rates as leaving China dangerously vulnerable to infection, especially among the elderly. An estimated 100 million Chinese above 60 have not received more than one dose as vaccine hesitancy remains high. While nearly 90 percent of China’s population has had two doses, booster rates remain stubbornly low. The Chinese inactivated vaccines offer significantly lower protection compared to mRNA vaccines, and immunity wanes more rapidly. Zero Covid, in the absence of sufficient, effective vaccination, may create more risk for vulnerable populations, as health resources and workers pivot to testing and quarantine, leaving little available to accelerate vaccinations.

With stringent quarantines as those imposed city-wide in Shanghai and sporadically across China, the pressures of prolonged isolation are taking a toll on public mental health. During the Shanghai lockdown, a survey of residents found that more than 40% were at risk of depression. Searches in Shanghai for counseling on the search engine Baidu rose by 253% in April.

Economic costs of enforcing Zero Covid Policy are further mounting to terrific heights: Chinese economists estimate that mass testing could cost China 1.7 trillion yuan ($354 billion) per year. Zero Covid Policy disrupted manufacturing, supply chains, and consumer spending, and economic growth has plateaued with the looming risk of recession. On May 25, Premier Li Keqiang sounded alarm over China’s economy at a meeting with 100,000 officials, acknowledging the gravity and prevalence of recent economic setbacks, surpassing what was experienced in 2020.

Popular outcry, most visibly in Shanghai, has spilled onto social media in rare nationwide protest, over the simultaneously dogged and arbitrary nature of Zero Covid controls. Vehement expressions against inhumane scenes of basic necessity crises and personal rights violations, leaked from inside lockdowns and across Covid-stricken communities, engage in a constant game of cat and mouse with online censors deleting material and suppressing dissent. The Chinese elite – of urbanites, students, business leaders, scientists, health experts, economists, and political figures – increasingly unite in opposition to Zero Covid Policy. They are frustrated by disruption to their personal lives, work, and travel, alarmed by disproportionate regulatory spasms as with Shanghai, and concerned over the grueling, seemingly infinite haul of Zero Covid the government has conscripted into.

China’s economic dislocations from Zero Covid Policy are spilling into the rest of the world – fuelling inflation, disrupting supply chains, heightening the risk of a global recession, impeding foreign businesses in China, and exacerbating China’s international isolation. 

Foreign confidence and business sentiment in China is plummeting, as multinationals reassess China’s economic and political prospect and their futures in it. Many businesses have held off new investment in China, others have begun to shift production elsewhere – a trend to last until the end of Zero Covid is in sight.

 The World Health Organization has repeatedly described Zero Covid Policy as “unsustainable… considering the behavior of the virus now and what we anticipate in the future”. But when Shanghai trimmed down to 29 cases on May 31t before lifting the lockdown the next day, this was proof for the Chinese leadership that Zero Covid had again succeeded.

In contrast to countries that have secured mass immunity through infection and vaccinations such that life can return to some level of pre-pandemic normality, China’s population is by far immunologically naïve. The Chinese leadership’s defense of the Zero Covid Policy holds that ending this policy of impermeability would cause mass illness and deaths to overwhelm the health system, citing Hong Kong’s high death rate in the spring as proof. China is then stuck to shuttle down the Zero Covid track and rack up huge costs along the way: if Beijing abandoned the policy without revamping vaccination, the consequences would be disastrous. However, critics argue that such worst-case scenarios fail to take into account the new reality under the milder (despite more transmissible) Omicron variant, noting that Shanghai’s Covid death rate was only 0.1% during the lockdown.

Another boost for Zero Covid Policy comes from President Xi Jinping himself. Xi’s objective is to ensure a smooth pathway to the 20th Party Congress at the end of 2022, for re-election in his third five-year term. Having pegged his own authority and legitimacy of leadership to the success of Zero Covid Policy, Xi cannot afford to give up the policy – which equates to admittance of failure to transpire an unacceptable reputational risk. In this new phase of the pandemic, Omicron’s flux and buoyancy tease at the bulky weight of Chinese Covid policy. It is possible that change will follow the 20th Party Congress or later in 2023. Meanwhile, the stakes of Zero Covid Policy rise toward a great test for the country – if, in this evolving moment, China can overcome political baggage and economic and innovative paralysis, to humbly reassess and boldly push ahead.