In recent weeks, a number of prominent Chinese epidemiologists have cautioned against “quarantine overreach,” pointing out the human toll of a continuing “zero-Covid” policy and reigniting a debate over the best policy for China to combat the pandemic. In a Phoenix TV interview that aired Nov. 8, Dr. Guan Yi, an expert in SARS and other infectious diseases, said that there was zero chance of China’s “zero-Covid” policy succeeding, given the way that the novel coronavirus has mutated. Bloomberg detailed some of Guan Yi’s criticisms of overly rigid controls:
“We don’t stand a chance if we pursue a target of zero Covid,” said Guan, who’s been dubbed the “virus hunter” by the Chinese media for his work on identifying the animal origins of the coronaviruses that caused SARS and MERS. “The virus is here today, just like flu. That’s a fact, whether people like it or not.”
The ability to break away from Covid Zero hinges on the effectiveness of the vaccines and the cost of controlling the virus, Guan said. It’s crucial for China to figure out how much protection its mass vaccination program has afforded the population, he said.
“Let’s not roll out nucleic acid testing for everyone at every turn,” he said. “I think it’s testing antibodies that matters. Everybody should know where their immunity is at.”
Guan’s comments are a rare, high-profile criticism from within the country’s elite of its lingering adherence to Covid Zero, which other adherents like Singapore and Australia have abandoned as the more transmissible delta variant makes it almost impossible to maintain. [Source]
On the same day, three Chengdu-based public health and epidemiology experts issued a letter with “urgent recommendations” toward a more sensible and humane system of outbreak prevention and control measures. The letter was republished by CDT Chinese, and a partial excerpt is translated here:
Urgent proposal regarding assessing the necessity and scientific basis for the “yellow health app code + mandatory nucleic acid testing” approach
In view of the recurring COVID-19 outbreaks in China, the city of Chengdu, Sichuan Province, has implemented prevention and control measures that require a yellow health app code and mandatory nucleic acid testing for all [potentially exposed] individuals within a grid of approximately 504,200 square-meter units (based on the 800m interval between cell towers), in addition to emergency control measures such as the closure and quarantine of communities where infected individuals live. These measures have been in effect for seven days, and we would like to make the following suggestions regarding some existing problems, in the hope of bringing them to the attention of the Sichuan provincial and Chengdu municipal government epidemic prevention and control command centers.
(1) Carry out an assessment of the necessity and scientific basis for the “yellow health app code + mandatory nucleic acid testing” approach
[…] The scope of community screening should remain within certain boundaries, and should focus on areas where infected persons have spent a long period of time. Decisions about whether or not to expand mass screenings to other areas should be based on the following considerations:
- Is the current spread of COVID-19 in Chengdu a localized outbreak, or a widespread epidemic?
[…] 2. With regard to screening population based on cell phone base station location, what is the ideal balance between effectiveness [in preventing disease transmission] and expenditure of medical resources?
The strong transmissibility of the SARS-CoV-2 delta variant necessitates a moderate expansion of community screening, but after the initial round of screening, we should remain mindful of how to classify individuals who have yellow codes [on their health code app], yet have not had close contact, secondary contact or general contact with an infected individual. We should also be mindful of how the expanded use of community screening via “yellow codes” can negatively impact the availability of medical and healthcare resources, fuel public panic and disrupt people’s normal work routines, and we must consider whether such measures are sustainable in the long run for routine management of the coronavirus pandemic.
(2) Do a better job of managing targeted lockdowns of affected communities
Do a better job of informing and explaining to residents the reasons for lockdowns of medium- and high-risk communities. At present, the lockdown measures being undertaken are relatively crude, and a dearth of explanation to residents has caused widespread panic and dissatisfaction. Residents of these communities should be informed gently, and as soon as possible, about the reasoning behind and basis for the impending lockdown, the frequency of nucleic acid testing during the lockdown, and the expected duration of the lockdown.
(3) Take a more rigorous approach to public announcements
[…] Government and health-care personnel should be strictly prohibited from labeling infected individuals with attention-grabbing epithets such as “The Virus King,” and official social media posts and tweets should, as much as possible, avoid using provocative headlines such as “Because of one person, half of Chengdu is riled up.” Reducing the stigma of infection and the fear of having one’s personal information leaked to the public can help encourage potentially infected individuals and high-risk groups to take the initiative and be tested for the virus. [Chinese]
State media has pushed back hard against criticism of China’s “zero-COVID” strategy. Earlier this month, a Xinhua commentary titled “Stop questioning China’s zero-COVID approach” claimed that full elimination is the only alternative to widespread infection:
There is no doubt that, like any other place in the world, strict containment measures do affect people’s lives and local businesses to some extent. However, it’s simply not right to question China’s efforts to eliminate the virus, especially for the United States, a country with the world’s most infections and deaths from COVID-19.
[…] The novel coronavirus is different from any other viruses we’ve seen both in ways of transmission and fatality rate. It’s so devious that there are only two choices for humanity: full elimination or widespread infection.
[…] The virus will not fade away by itself. The best still hope hinges on the full vaccination of most people and highly effective cures, both of which, however, are yet to come. So at present, strict containment measures are still the best way to save lives. China’s efforts in this regard are unquestionable. [Source]
A week before that, Global Times editor-in-chief Hu Xijin wrote an op-ed claiming that a zero-COVID approach has broad public support and should not be abandoned:
First of all, I would like to say that China’s dynamic zero-COVID policy must not be abandoned. Our pandemic prevention approach should not be abandoned halfway. If we change course to the European and US way of “coexistence with the virus,” China will fall victim to the virus within just a few months, with tens of thousands or even hundreds of thousands of cases a day. The daily death toll could mount to hundreds or even thousands of people. I believe that situation is definitely not something most Chinese are willing to bear.
Every time an outbreak occurs, the implementation of zero-COVID policy will mean economic and social costs. But if we don’t adopt this policy, it will lead to a serious spread of the virus, and the cost will only be higher.
[…] Overall, people are cooperating with the dynamic zero-COVID policy. This policy is generally in line with the interests of the Chinese people. The public is not muddleheaded. [Source]
Some Chinese health officials have echoed these talking points. As early as August, Minister of Health Gao Qiang published a strongly-worded op-ed in the People’s Daily in which he branded those advocating for coexistence with COVID-19 as “capitulationists.” One anonymous infectious disease expert in Beijing stated that doctors worried that the imbalanced distribution of medical resources might require a stricter approach, lest more relaxed measures cause cases to rise and overburden the health system in poorer, less-developed rural areas. As Jack Lau from the South China Morning Post reported, Zhong Nanshan, China’s top respiratory disease expert, has stated that the “zero-COVID” strategy is less costly than other alternatives:
The country had no option but to aim for zero infections because the coronavirus was replicating quickly and the global death rate of about 2 per cent was unacceptable, Zhong Nanshan said in an interview with CGTN, China’s state-owned international media arm, published late on Monday.
[…] Zhong said China’s approach was here to stay for a “considerably long time” but the exact duration would depend on how well other countries fared in containing the virus.
“No matter how well China does, once it opens up and has imported cases, transmission will definitely occur in the country,” he said. “Therefore I believe, for now, that the zero-transmission strategy is not too costly, but is in fact a relatively less costly method.” [Source]
"Some scepticism of China’s statistics is reasonable, given that officials in Wuhan…concealed the virus for weeks in late 2019 and early 2020. Yet if large outbreaks were still being concealed today, control systems would start breaking down."@DSORennie https://t.co/Q1JE1YFFad
— Jonathan Cheng (@JChengWSJ) November 15, 2021
The effectiveness of vaccines is a big factor in deciding whether or not to relax COVID restrictions. Reports have shown that Chinese vaccines are generally less effective than Western vaccines, which could explain why Western countries (using mostly Western vaccines) have been able to implement “coexistence” strategies. Stephen McDonell from the BBC described how suboptimal immunity from vaccines naturally requires a “zero-COVID” strategy, and how a policy relapse would challenge the Chinese government’s legitimacy:
Dr Huang Yanzhong, from the New-York based Council on Foreign Relations, says a key problem is that vaccines cannot achieve what the Chinese government would like them to, making Beijing wary.
“They’re not confident about the effectiveness of the vaccines – the ability to prevent infections,” he told the BBC, “because actually even the best vaccines can’t prevent infections – but the zero-tolerance strategy says we can’t accept even one single infection.”
Dr Huang added the Chinese government has found itself in a political and ideological bind when trumpeting its successes to its people.
“The zero-tolerance strategy is also part of the official narrative, to claim the success of the Chinese pandemic response model, the superiority of the Chinese political system. So if you give up that strategy, and then you saw the cases increasing significantly, you know that would lead people to question the model.” [Source]
China's "Zero COVID" philosophy is political not scientific. Part of it could be due to the low efficacy of its domestic made vaccine.
— Charles Mok 莫乃光 (@charlesmok) November 11, 2021
Some experts say there are still some doubts about how effective the Chinese vaccines are against the delta variant. This is also combined with a lack of data shared publicly by Chinese authorities on how effective Chinese vaccines are against other variants.
— William Yang (@WilliamYang120) November 11, 2021
As a result, China’s “zero-COVID” policy will likely persist for some time. The government has already called on families to stockpile daily supplies in anticipation of further lockdowns and travel restrictions during the winter. DW noted that major upcoming events will increase pressure on officials to maintain a strict policy:
Chen [Xi, an associate professor of public health at Yale University,] said the Winter Olympics and the 2022 National Congress of the Chinese Communist Party would factor into Beijing’s decision on maintaining a zero-COVID policy.
“While those events may still seem far away, if there is an outbreak, government officials will be under tremendous pressure as that may send bad signals to the public,” he said.
“Even from the local perspective,” he said, “they will have the strong incentive to overreact rather than underreact.” [Source]
So now that China aims at Covid zero-policy unlike the rest of the world, is she prepared to stay isolated like.. hmmm.. I dunno, forever?
— Sari Arho Havrén (@SariArhoHavren) November 13, 2021
"Zero-Covid" Hong Kong and China looking ever more isolated as countries across Asia begin process of reopening https://t.co/DSZJZXIm7N
— Steve George (@steve0george) November 1, 2021
Australia, Singapore, New Zealand have all given up on eliminating the coronavirus. There's just one country still trying: China.
On why China is the world's last Zero Covid holdout — and how long it can stay that way: https://t.co/qTAbhG3fWm
— Vivian Wang (@vwang3) October 28, 2021
For Chinese citizens facing a third straight year of stringent COVID-pandemic protocols, patience is wearing thin. Referencing a recent policy measure in Chengdu that forced 82,000 potentially exposed people to take nucleic acid tests based on “temporal-spatial overlap” of their cell phone signals, one Weibo user highlighted the inconsistencies of government COVID-prevention policies:
Eat a meal, and the ten people around the same table might get infected. Wait in line without keeping a distance of one meter, and you might get infected. Everyone within a cell phone signal range of 800 meters is considered potentially infected, but you’re not going to get infected standing in line for a nucleic acid test? Is this virus capable of thought? [Chinese]
Over the past year, public challenges to the government’s pandemic response policies have been heavily suppressed and censored. A Weibo post by the esteemed virologist Dr. Zhang Wenhong in late July that suggested a coexistence strategy was met with fierce attacks by state media and former officials, and triggered unfounded accusations of plagiarism regarding Dr. Zhang’s doctoral dissertation. Netizens who pushed back against these state media attacks were censored. A teacher in Jiangxi province was even detained for 15 days for posting an online comment that touched on coexisting with the virus. Given that the Chinese government, health officials and state media will brook no criticism of the inflexible zero-COVID policy, social media posts that mock, criticize or diverge from accepted policy will likely continue to be actively censored.
Translations by Cindy Carter.