Restaurants and cinemas shut, residential areas closed off, people waiting in line for Covid tests… After a year, over 30 Chinese cities are once again on high alert, reflecting the authorities’ resolve to get the latest round of infections to zero.
However, as coronavirus variants get increasingly contagious, the cost of eliminating it is also growing. And while other countries are gradually loosening controls and learning to live with the virus, Chinese society is also re-examining the question of whether aiming for zero infections is a feasible long-term plan.
The latest wave of infections sparked by the Delta variant has spread to about 20 provinces, cities, and areas, with cases topping 500. On 5 August, the authorities announced a new round of measures, including deploying 20 working groups to monitor checks at major coastal cities, cancelling travel groups to medium- and high-risk areas, and getting medium- and high-risk areas to postpone reopening schools.
The coronavirus is endemic and people need to learn to live with it
At the same time, more and more experts are calling for people to learn to live with the virus. After the outbreak in Nanjing, Zhang Wenhong, director of Huashan Hospital’s department of infectious disease, wrote an article saying that most virologists now agree that the coronavirus is endemic, and the world needs to learn to live with it. The latest outbreak in Nanjing has led to pressure on China to carry out testing, and has also provided more food for thought on future coronavirus control.
It has the will as well as the way. I hope that China could do what other countries could not. - Singapore’s infectious diseases specialist Leong Hoe Nam
Dr Zhang said: “The future choice that China makes will ensure that it builds a community with a shared future for mankind and connects with the world. It will work towards a return to normal life while ensuring that people do not need to fear the virus. China will have the wisdom to achieve this.”
On 4 August, the head of Hong Kong University’s Centre for Infection Ho Pak-leung said on a radio programme that Macau’s situation is unstable, which shows that aiming for zero cases is not a feasible long-term policy, but short-term and transitory, and the most important thing is to get everybody vaccinated as soon as possible.
Singapore’s infectious diseases specialist Leong Hoe Nam told Zaobao that from a virology perspective, aiming for zero is the best way to control a virus. As long as the virus continues to spread, there is a possibility of new variants. And this seemingly impossible goal of “aiming for zero” in Western countries has a chance to be realised in China.
Dr Leong is optimistic that China can win out against the Delta variant, because it “has the will as well as the way”. He hoped that China “could do what other countries could not”.
China’s large capacity and ample resources made it the best positioned country in the world to aim for zero, and to buy time to increase vaccinations and hit herd immunity. - Singapore’s public health specialist Wong Chiang Yin
China well-placed to go for zero, but it will come at a cost
Singapore’s public health specialist Wong Chiang Yin also felt that China’s large capacity and ample resources made it the best positioned country in the world to aim for zero, and to buy time to increase vaccinations and hit herd immunity.
Currently, China has administered a total of 1.72 billion vaccine doses, for an inoculation rate of over 60%, according to Reuters. Vice-Minister of the National Health Commission Zeng Yixin forecast that the target of 70% vaccination rates will be met by the end of the year. However, the Infectious Diseases Society of America recently noted that given that the Delta variant is more contagious, at least 80% vaccination rates will be needed for herd immunity.
Dr Wong said China can administer an average of 180 to 200 million vaccine doses a day, and its testing capabilities are among the top in the world, with experience in enforcing lockdowns. “All factors considered, currently the policy of aiming for zero cases is a healthy one. China can gradually shift to opening up when vaccination rates hit 80% or more.”
In the UK, where 72% of the population have received both doses, lockdown was lifted three weeks ago, while in the US — where vaccination rates have stagnated at around 50% — many states are moving towards lifting lockdown restrictions as well. A report last month by the Economist Intelligence Unit was of the view that as Europe and the US gradually lift restrictions and open up, a lot of suppressed demand will be released.
As a result, Asia-Pacific countries that are still aiming for zero cases might see slower economic recovery, such as not being able to benefit as international travel resumes, while company investments and talent flow would also be affected.
The report also noted that China’s self-sufficiency based on its large economy means that it is under the least pressure in aiming for zero cases, while possibly holding the policy for the longest time, with restrictions lifted as late as after the end of the Chinese Communist Party’s 20th National Congress in autumn of next year.
The biggest impact of the zero-Covid policy has been on the Chinese service industry, which was just beginning to recover. According to Tommy Xie, head of Greater China Research at OCBC Bank, this summer outbreak led to the closure of many tourist venues, while travel across provinces was also halted. The Purchasing Managers' Index (PMI) for August for the service industry is expected to fall.
China’s internal circulation model can support its zero-Covid policy for at least a year, until after the Beijing Winter Olympics and the 20th National Congress. - Tommy Xie, head of Greater China Research, OCBC Bank
Xie optimistically estimates that if the Chinese government can quash this outbreak within a month as it did in Guangdong back in May, the economic cost of aiming for zero cases will be relatively smaller. He said, “China’s internal circulation model can support its zero-Covid policy for at least a year, until after the Beijing Winter Olympics and the 20th National Congress.”
Compared to economic cost, Xie feels that the social costs and impact on international relations of a zero-Covid policy should be of greater interest. For instance, on-and-off lockdowns and testing would lead to fatigue among the people and social instability, while long-term limiting of interaction with foreigners would also affect international exchange and cooperation, exacerbating already tough relations with the US and Europe. “What China needs is not just international exchange on a diplomatic level, but even more so on the level of ordinary people.”
To die of illness, or of poverty and hunger? This philosophical question needs to be answered by those who are wiser than doctors. - Singapore’s infectious diseases specialist Leong Hoe Nam
Dr Leong feels that balancing the inconvenience of zero-Covid and the risks of living with the virus is fundamentally a balance in the value of life. “To die of illness, or of poverty and hunger? This philosophical question needs to be answered by those who are wiser than doctors.”
Related: Annihilation or protracted war — which is our best bet against Covid-19? | China's top infectious diseases expert Zhang Wenhong: Division stands in the way of defeating the pandemic | Can a messed up world fight the pandemic together? | Stop squabbling over ideology and fight the virus
