HONG KONG -- Just 10 days after Shanghai lifted its harsh two-month lockdown and less than a week after Beijing declared its outbreak under control, China’s two largest cities found themselves walking back on loosening up restrictions.
Beijing delayed reopening schools on Monday as a new outbreak centered around a popular bar district pushed cases to a three-week high and Shanghai, once again, suspended dine-in services at restaurants.
Both cities were back to conducting mass testing over the weekend as outbreaks of the Omicron variant stubbornly persist despite the country’s no tolerance zero-COVID measures. Shanghai even briefly placed most of the city back in lockdown Saturday morning to conduct its mass test, which only turned up 66 cases through the weekend.
As much of the world has shifted definitively to living with the virus, China, by all measures, is digging in and even expanding their method of mass testing and suppression authorities call “Dynamic Zero-COVID” where all positive cases, no matter how mild, needed to be isolated and quarantined.
Before Omicron, China’s zero-COVID measures had allowed Chinese citizens to go about their lives as normal for nearly two years as COVID-19 ravaged the rest of the world. China still has one of the lowest official COVID-19 death rates in the world.
The chaotic implementation of the Shanghai lockdown, however, came to show the economic and social toll of the country’s stringent measures with Bloomberg Economics predicting that China’s will grow slower than the U.S. economy for the first time since 1976.
Council on Foreign Relations Senior Fellow for Global Health Yanzhong Huang believes that, despite this, Chinese authorities are drawing a very different lesson from the omicron outbreak and lockdown in Shanghai than when previous zero-COVID stalwarts like New Zealand opened up after omicron broke down their defenses.
“[The Chinese health authorities] believe they didn't respond speedily enough,” Huang told ABC News. “[They believe] if they took action in the very beginning of the outbreak they would have been able to cut the transmission and bring the situation under control right away.”
In other words, it wasn’t the zero-COVID policy that didn’t work, it was poor implementation that landed Shanghai in lockdown.
So instead of realizing zero-COVID methods were increasingly ineffective against highly transmissible variants like omicron, Huang says authorities came to opposite conclusion: they needed to double down and that zero-COVID is the only way to go.
Since May, China has rolled out a stringent new PCR testing regime in most major cities across the country -- including those where no cases have been detected -- and are requiring people to test negative for COVID-19 every 48 to 72 hours in order to work, shop or use public transport.
This has resulted in hundreds of thousands of new semi-permanent testing facilities being set up across the country with the aim of having a testing booth within a 15-minute walk of every resident in all provincial capitals and cities with more than 10 million residents.
Officials argue that constant screening will allow them to catch cases early before they spread exponentially so they would not have to resort to a prolonged lockdown like Shanghai’s.
Shanghai alone has set up 15,000 testing sites in the city but even then social media is teaming with daily clips of long lines of residents waiting to be tested. These booths are usually manned by one or two technicians sealed in an air-conditioned metal and glass cabin with two rubber gloves or openings to take a patient’s sample.
The English-language Chinese outlet Sixth Tone calculated it would cost an estimated $12.55 billion a year to maintain just this testing regime which would have be paid for by the local governments.
Meanwhile according to Japanese investment bank Nomura there are still eight cities across China and an estimated 74 million people currently under full or partial lockdown measures, down from an estimated 355 million people in April.
Last month, the Director-General of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus commented that he did not believe zero-COVID is “sustainable, considering the behavior of the virus now and what we anticipate in the future.”
Prompting the Chinese Ministry spokesperson Zhao Lijian to immediately retort, “we hope that relevant people can view China’s policy of epidemic prevention and control objectively and rationally, get more knowledge about the facts and refrain from making irresponsible remarks.”
“The Chinese government’s policy of epidemic prevention and control can stand the test of history, and our prevention and control measures are scientific and effective,” Zhao said. “China is one of the most successful countries in epidemic prevention and control in the world, which is obvious to all of the international community.”
With the focus on testing and isolation, the conversation around vaccinations has been comparatively muted. Though China was one of the first countries to roll out a vaccination program, an estimated 100 million Chinese citizens remained unvaccinated or under-vaccinated, the majority of which are vulnerable seniors.
China has relied primarily on their own domestic traditional technology vaccines that -- although proven to be less effective against infection than the mRNA vaccines now used in much of the world -- still protected people from hospitalization and death.
CFR’s Huang believes that even if vaccinations rates improved or an effective domestically-made mRNA vaccine is rolled out, it was unlikely to change the government’s attitude towards zero-COVID.
“This is the problem,” Huang said, “if your intention is zero-COVID and cannot tolerate any infections no matter how mild they are, even if they do achieve a 100% vaccination rate, even if you have the best of vaccines in the world, you cannot prevent infections.”
Huang believes the longer China maintains this policy, the larger the immunity gap grows between China and the rest of world.
“You are basically prolonging the inevitable,” says Huang. “You have to face the reality that with such a large population not exposed to the virus and that has relatively low immunity level to virus, no matter how draconian the measures you undertake, you cannot prevent the virus from infiltrating the borders and affecting the Chinese people.”
China’s borders have remained effectively sealed off since March 2020 and in early May this year the National Immigration Administration announced on Weibo that it would "strictly restrict non-essential departures of Chinese citizens” and ban the approval of new passports.
While many had hoped that China would begin easing restrictions after the Beijing 2022 Winter Olympics in February, the outbreaks that emerged soon afterwards dampened that outlook. An important Communist Party meeting coming up in the fall where Chinese President Xi Jinping is expected to gain an unprecedented third term was seen as the next milestone but that looks increasingly unlikely as well.
In a sign on how long China’s strict measures may last, look no further than next year’s Asia Football Confederation’s Asian Cup soccer tournament set to begin in mid-June 2023. China had won the bid to host and even purposely built or renovated stadiums in 10 cities but last month completely relinquished its hosting rights “due exceptional circumstances caused by the COVID-19 pandemic.”
“The zero-COVID policy is the biggest impediment to right now to China’s economic recovery,” said Huang. "But if they choose to pivot away from zero-COVID it will be difficult because that issue is being politicized. Pivoting away means you have to admit to the failure of zero-COVID in which the top leader himself has invested so much.”
On a visit to the western province of Sichuan Friday, Xi made his position clear.
“Persistence is victory,” Xi said. “We must unswervingly adhere to the general policy of ‘dynamic zero-COVID’, strengthen confidence, eliminate interference, overcome paralyzing thoughts, pay close attention to the key tasks of epidemic prevention and control, and resolutely consolidate the hard-won results of epidemic prevention and control.”