China suggests that its zero-Covid policy may be relaxed, but there are more questions than there are answers.

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China Coronavirus Outbreak: Xi Jinping's Covid Zero Is Failing - Bloomberg

China’s senior Covid response official informed health officials on Wednesday that the nation was facing a “new stage and mission” in terms of pandemic control.

According to state media Xinhua, vice premier of China Sun Chunlan stated on Wednesday that “China’s pandemic containment faces (a) new stage and mission with the decreasing toxicity of the Omicron variant, the rising vaccination rate, and the accumulating experience of outbreak control and prevention.”

The comments come in response to a rise in public annoyance at China’s stringent zero-Covid policy and its enormous human cost, which has resulted in unheard-of protests in at least 17 cities since last Friday.

According to Xinhua, Sun, who has represented the Chinese Communist Party’s implementation of the policy, made no mention of “zero-Covid.” Her remarks come a day after a different group of top health officials promised to change certain Covid control strategies and urged local governments should promptly “react to and settle the reasonable requests of the populace.”

The high-level statements, along with minor rule changes and some recent easing of lockdown procedures in significant Chinese cities, imply that China is reexamining its policy, which has grown more disruptive as it struggles to combat highly transmissible coronavirus variants and record case numbers.

However, the change in tone has not been accompanied by a roadmap for getting there or any mention of abandoning the zero-Covid policy, so it is still unclear how it will affect the situation on the ground or calm growing public angst.

Due to their designation as “high risk” as of Thursday, thousands of buildings and residential areas spread over 32 Chinese cities continue to be subject to lockdown restrictions.

Local officials may be hesitant to let cases advance for fear of reprisal because the central government has long taken pride in its zero-Covid policy. Experts claim that the US is still lagging behind in certain crucial areas of preparedness for a significant outbreak.

Priorities

The zero-Covid policy’s expenses have long been defended by Chinese health officials and specialists as being justified by science. They have done this by highlighting deficiencies in medical readiness, such as a low incidence of senior immunization and deficient intensive care infrastructure, particularly in rural regions, as well as unpredictability around the virus’s future evolution and its long-term repercussions.

They have cautioned that these flaws might cause the healthcare system to become overburdened if the virus spreads freely throughout the 1.4 billion-person nation, which could increase the fatalities that are anticipated with an opening up.

Nicholas Thomas, a health security specialist from the City University of Hong Kong, stated that this is still a major problem for the government: “There is still a sizable portion of the populace that is believing in the government’s activities in dealing with the virus. Uncontrolled interaction with the virus might undermine that confidence and put in danger vulnerable groups.

The most recent remarks on the policy, in his opinion, “do not signal that China is prepared to make the transition to living with Covid, but rather a clue that the virus has gone out of control and the government is unable to return to a zero-Covid society.”

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Over 35,000 new cases were reported on Wednesday, continuing a recent trend in which the number of new cases has been at or near record highs. This seriously hinders efforts to lower the number of instances.

Observers claim that China has put the preservation of zero-Covid, which depends on lockdowns, mass testing, and forced quarantines of patients and their immediate family members, before developing strategies for the virus’s wider spread.

According to Alfred Wu, an associate professor at the Lee Kuan Yew School of Public Strategy at the National University of Singapore, one reason for this has been the government’s own narrative about its success and the support of the policy by leader Xi Jinping.

China’s border controls and quick way of identifying and suppressing the virus allowed the country to live relatively virus-free after putting its initial outbreak in Wuhan under control in 2020, while hospitals in most of the rest of the globe were inundated with sick and dead patients. Only 5,233 Covid-19 fatalities have been recorded in China officially since the beginning of 2020, and fewer than 600 were in 2022.

Xi has praised China’s regulations and the noticeably low number of Covid deaths as accomplishments of Chinese leadership. As more individuals became used to the virus due to extensive vaccines and the emergence of the milder but extremely infectious Omicron form, the country continued to use that approach. However, Omicron also exacerbated the disruption and reduced the effectiveness of Chinese restrictions.

According to Wu, maintaining the zero-Covid policy may also be motivated by a desire to strengthen state control over the populace given that Xi has prioritized state security. We also suggested that maintaining the policy may also be due to a desire to claim that China is performing significantly better than the United States.

China “missed so many precious opportunities” to prepare for life with the virus and to prepare the public for a greater number of deaths from Covid-19, he claimed, while pursuing this policy.

Prepared?

One shortcoming that health authorities on Tuesday unveiled a new plan to overcome is the low incidence of booster immunization in the older group most susceptible to Covid-19.

According to official media, on November 11 just 40% of China’s over-80 population had received a booster shot, while about two-thirds had received two doses. This is due to both vaccine reluctance and an initial vaccine roll-out that did not give the elderly priority.

In order to assure adequate protection, a World Health Organization advisory panel suggested last year that older individuals receiving China’s inactivated-virus vaccinations have three doses in their initial course. It is well known that vaccine protection against the Omicron form diminishes with time.

China’s immunity, however, is mostly dependent on vaccination because the virus has only infected a very small number of individuals there. 90% of people have received all recommended vaccinations. Although studies have demonstrated that China’s immunizations can guard against deadly diseases, they provide less antibody protection than the commonly used mRNA vaccines in other parts of the globe. Any mRNA vaccination has not yet received Beijing’s approval.

In Hong Kong, where poor vaccination rates among the most at-risk demographic contributed to the Chinese territory’s Covid-19 mortality rates becoming among the highest in the world last spring, a clear warning of the hazards for the mainland was witnessed.

According to infectious disease specialist Peter Collignon of the Australian National University Medical School, vaccinations and booster shots are essential for nations transitioning away from policies aimed at “zero-Covid,” even though they won’t completely prevent an increase in deaths when restrictions loosen.

“The preparedness is not only vaccinations; it’s surge capacity; it’s making sure you have enough hospital personnel; it’s making sure you have enough beds; and particularly it’s making sure the elderly (are protected),” he added.

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Next, what?

China has hinted that it would put more effort into fortifying its anti-virus defenses. An action plan to increase senior immunization rates was announced by officials on Tuesday. This was in line with a goal outlined in a 20-point plan to improve zero-Covid measures that was unveiled last month and which also urged hospitals to stockpile anti-viral medications and medical supplies.

The same notification also loosened certain restrictions on testing and quarantine and issued a warning against excessive local policy enforcement — all statements that have since been reaffirmed by senior health authorities.

State media has emphasized a number of localities that have made minimal modifications to their policy in response to that advice and in the aftermath of the recent demonstrations, most notably regarding testing and quarantine regulations.

On Wednesday, authorities in the southern city of Guangzhou loosened quarantine rules and lifted lockdowns in four areas. Local authorities in Urumqi, Xinjiang, said on Saturday that they would progressively relax lockdown restrictions in areas deemed to be of “low danger,” and they proceeded to restore crucial enterprises and public transportation the following day.

At least 10 people perished in a horrific fire on November 24 in Urumqi, which spurred demonstrations across the country. Videos of the tragedy appeared to show that lockdown precautions prevented firemen from reaching the victims. They were included to a list of fatalities that have been often connected in popular discourse to Covid-19 restrictions.

On China’s strictly controlled social media, a discussion on Omicron’s relative “decreased pathogenicity” was trending on Thursday. This might be an indication that the government is trying to change the public’s image of the virus after years of emphasizing its dangers.

However, several social media users remained dubious, claiming that the modifications to the testing specifications were too little to lessen the effect of zero-Covid on daily living.

And at least one city, Jinzhou in northeast China, resisted the changes made by other cities by announcing on Thursday that it would not ease up on its precautions in advance and abandon its efforts to control an ongoing outbreak, arguing that “not having (the virus) is still better than having it” regardless of how virulent the coronavirus was.

Experts predict that the nation’s true test will be released in the following months.

Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations in New York, said that if the vaccination campaign and other proposed measures boosting medical readiness were “completely implemented,” China would have “a route forward for future openness.” “However, they have not yet received a greater priority in the implementation process.”

Another issue is the discrepancy between Beijing’s rules and how they are carried out by local governments, who are under pressure to reduce the number of cases since doing so might result in their dismissal, a common penalty for officials who have allowed epidemics to expand in the past.

There will be problems if you open up and make a mistake, Huang said. Before any significant improvements can be made, “you have to modify the incentive structure of the local governments,” he continued.

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