Caught in a zero-COVID trap | Extreme measures, state power, and the lives of ordinary Chinese citizens

China’s strategy of lockdown and mass testing that made sense in a world without vaccines is now past its sell-by date. Ananth Krishnan reports on what the extreme measures and the expansion of state power have meant for the daily lives of residents

Updated - September 17, 2022 06:44 pm IST

Published - September 17, 2022 03:41 am IST

The police work with railway authorities to check nucleic acid test reports and travel codes of passengers in Shenyang, Liaoning Province, China.

The police work with railway authorities to check nucleic acid test reports and travel codes of passengers in Shenyang, Liaoning Province, China. | Photo Credit: Getty Images

In pre-pandemic times, visitors to Shenzhen would often feel as if they were travelling in time to the future. China’s technology hub is famed for being at the forefront of adopting new technologies that still remain on blueprints in the rest of the world, from futuristic buildings with sprawling indoor gardens that appear right out of a sci-fi movie, to the ubiquitous use of facial recognition technology for everything from riding subways to entering supermarkets.

Today, arriving in Shenzhen still feels like time travel — except now it is to the past. More precisely, it is to two years ago at the height of the pandemic, when lockdowns were part of the daily vocabulary globally and COVID-19 was seen as a deadly and life-threatening disease in a world without vaccines.

On an afternoon this June, a group of travellers arrived in Shenzhen in the Chinese mainland from Hong Kong. The journey, once a smooth, 20-minute train ride, now involves a gruelling 12-hour exercise at the border control point. This includes two deeply invasive nasal swabs that, for some travellers, even drew blood. The group was greeted by an army of Shenzhen health personnel dressed in full-white PPEs.

The ‘Big Whites’ or ‘Da Bai’, as the PPE-clad healthcare enforcers are known in China, have in the past two years become the faces of the country’s stringent COVID-19 regulations. China is the only country that still follows a heavy-handed ‘dynamic zero-COVID’ policy, which calls for mass testing, lockdowns and quarantining of close contacts to eliminate outbreaks in the shortest possible time.

“Keep on your masks!” a Big White yelled at one arrival whose mask had slipped slightly below her nose. The group cleared immigration after downloading and scanning numerous Chinese ‘health code’ apps that are an indispensable internal travel passport in the country today. They were then sprayed with disinfectant, along with their luggage, before being whisked away on buses, with full police escort, to be confined in a room for a mandatory 22-day quarantine. And these were all vaccinated travellers who had also been tested no less than twice in just a few hours.

While the rest of the world has sought to move on to some form of post-pandemic normalcy, China remains firmly in the grip of a harsh zero-COVID policy. China is where the pandemic began, and it appears increasingly likely that this is where the last chapter of the pandemic will end.

Endless lockdowns

On September 14, World Health Organization (WHO) director-general Tedros Adhanom Ghebreyesus noted that the number of weekly reported deaths from COVID-19 in the second week of September was the lowest since March 2020. “We have never been in a better position to end the pandemic,” he said. “We’re not there yet, but the end is in sight.”

In China, however, there appears to be no end in sight to measures that were first imposed in Wuhan — at a time when the idea of a lockdown was still unheard of in the rest of the world — and remain a part of life for a third straight year.

Within China, through 2020 and 2021, the zero-COVID strategy was by most accounts widely popular as it ensured a degree of normal life while the rest of the world was dealing with waves of deaths and lockdowns. By the summer of 2020, China had in fact largely emerged from the pandemic’s first wave quicker than most nations, with its stringent lockdowns and bans on international travel paying dividends. Outside of Wuhan and Hubei province, no cities faced mass deaths. Across China, schools remained open, and with the world closed off, domestic tourism boomed. So did manufacturing, with China’s exports reaching a record high during those two years while factories in much of the world were hit by COVID-19 restrictions. Zero-COVID certainly saved hundreds of thousands of lives in 2020 and 2021, a point that the government uses to justify continuing the approach.

Yet, that has become an argument increasingly difficult to make. Confronted with more transmissible variants, the ‘test and trace’ bedrock of zero-COVID has struggled. The number of cities in China under lockdown now is the highest since the early days of the pandemic. Moreover, a strategy that made sense in a world without vaccines looks increasingly past its sell-by date as the rest of the world opens. If zero-COVID gave China an advantage in the first year of the pandemic, it has now left China struggling.

Harsher measures, mounting costs

As of early September, the Chinese magazine Caixin reported, 33 cities and an estimated 65 million people in China were under lockdown (‘static management’ is the term preferred by the Chinese authorities). As vast swathes of China confronted more transmissible sub-variants of Omicron, Caixin noted, governments again “turned to the usual toolkit of mass testing and lockdowns…. despite the rising economic costs and public frustration over disruptions to daily life.”

Passengers at the Hankou railway station in Wuhan.

Passengers at the Hankou railway station in Wuhan. | Photo Credit: Getty Images

As variants began to spread more easily, the measures to tackle them became harsher. Shanghai was placed under a brutal lockdown of two months, with most residents not allowed to step out of their homes and many complaining of food shortages.

When an earthquake in early September struck Sichuan province, which was dealing with an outbreak, residents rushed to leave their apartment blocks to find Big Whites barring their exits.

When parts of Beijing came under lockdown in May, cancer hospitals stopped taking patients for treatment. “As long as it’s not COVID that you die from, it seemed they did not care,” the daughter of one of the patients told The Hindu.

Editorial | Disease and the cure: On China’s zero COVID strategy

In Yining in western Xinjiang, which has been under a harsh lockdown since early August, thousands of residents took to social media to complain of acute food and medicine shortages. Most of the posts were deleted, while state media responded with a campaign to show an efficiently managed city. One Yining resident posted that his young child had died in lockdown without access to medical treatment.

Meanwhile, economic costs are mounting. Currently, planning internal travel within China is a fraught exercise, as each city has its own health code app and internal quarantine rules. The health code app determines every aspect of life. In Beijing, residents have to take a PCR test every 72 hours to preserve a green code, without which they cannot access schools, hospitals, offices or public transport. Uncertainty of lockdowns has dampened business sentiment amid already brewing troubles in the property market, a lynchpin of growth. In the second quarter of the year, China’s economy grew by 0.4%.

Most people in China have been largely accepting of the measures — they do not, of course, have a choice in the matter — seeing it as a price to be paid for normalcy and to avoid the high death toll seen in the West (a fact highlighted ad nauseam by state media). Yet, three years into the pandemic, there are signs of public acceptance waning as more cities come under restrictions. Generally supportive attitudes to zero-COVID change overnight when one’s own town is in lockdown. As Shanghai’s residents faced two months of lockdown, thousands took to social media to ask what the point of the measures was when few severe cases had been reported officially.

No exit strategy

If China were to open tomorrow, its healthcare system would certainly be overrun and likely face a near-collapse (as India’s did during the second wave). This is the argument from Chinese officials in justifying the current approach.

It is also the argument used right at the top. As more questions began to be raised about China’s approach in sticking to zero-COVID, President Xi Jinping, during a symbolic visit to Wuhan in end June, mounted a robust defence of the measures, saying they “must be upheld unwaveringly”.

“If China had adopted the ‘herd immunity’ policy or a hands-off approach, given its large population, the country would have faced unimaginable consequences,” he said. “Even if there are some temporary impacts on the economy, we will not put people’s lives and health in harm’s way, and we must protect the elderly and the children in particular. If we make an overall evaluation, our COVID-19 response measures are the most economical and effective.”

Indeed, as Chinese officials underline, there is no denying that China would face a wave of cases and deaths if it opened up tomorrow. Yet, the quiet criticism from some Chinese health experts is that there hasn’t even been any consideration of or planning towards an eventual exit strategy, leaving China locked in what most agree is an unsustainable and cost-heavy approach.

The most puzzling element of the current approach is the low priority accorded to vaccination. While more than 90% of the population have received two doses, the booster campaign, particularly among the elderly, has flagged. Data from Hong Kong show that three doses of Chinese vaccines are effective in preventing serious hospitalisation and death. The efficacy falls significantly when only two doses are administered.

Local government officials say their health resources are being entirely spent on regular testing and lockdowns to ensure zero-COVID. The same health workers who could have been sent door-to-door to vaccinate the elderly are instead occupied with administering lockdowns and PCR tests.

China also briefly considered and then abandoned vaccine mandates. In July, Beijing rolled out the country’s first vaccine mandate, but abandoned it within 24 hours without explanation, amid suggestions that authorities were alarmed by the number of the elderly who had not completed their full doses.

While the unvaccinated elderly remain a significant concern, also complicating any easing of zero-COVID is continued official messaging that portrays COVID-19 as a life-threatening disease. As one Beijing doctor puts it, “Even one asymptomatic case now means an entire neighbourhood will be locked down. How do you then communicate with people that at some stage we have to live with the virus?”

The politics of zero-COVID

That the doctor requested anonymity reveals how politicised this public health issue has become. There is no debate in China on the viability of the current measures, which are seen to have the personal endorsement of President Xi.

When Shanghai faced a surge in Omicron cases in February, the local health authorities, who had generally adopted a more open approach than elsewhere in the country, briefly suggested the city avoid a lockdown and adopt an approach that would mark a shift in China’s COVID-19 strategy by only focusing on severe and elderly cases.

Passengers wait at the departure area of Hankou railway station in Wuhan.

Passengers wait at the departure area of Hankou railway station in Wuhan. | Photo Credit: Getty Images

According to a recent account from the former Central Party School professor, in Foreign Affairs magazine, Cai Xia, who was removed in 2012 after criticising Xi’s policies and is now living in the U.S., an online gathering of 60 experts decided that life in the city could go on despite the cases. “But when Xi heard about it,” Cai wrote, “he became furious. Refusing to listen to the experts, he insisted on enforcing his zero COVID policy... Just like that, a modern, prosperous city was turned into the site of a humanitarian disaster, with people starving and babies separated from their parents.” Cai was referring to Shanghai authorities taking away COVID-19 positive children from their homes without their parents.

Asked why China hasn’t considered planning an exit strategy, with 90% of its population receiving two doses and two-thirds receiving a booster dose — a number that would have been far higher with a sustained campaign — Chang Jile, who is the Vice Administrator of the National Disease Control and Prevention Administration, said the view is that the time isn’t right. “Globally, the current pandemic is still at its height and the virus is still mutating,” he said, reflecting a sharp divergence in Beijing’s view and that of the WHO. “With the dynamic zero-COVID policy, we can bring infections under control in the shortest time and at the lowest social cost.”

He also made it clear that this was the directive from the top. “President Xi has stressed the importance of targeted prevention, to get maximum results at the lowest cost, and to minimise the impact of the pandemic on social development. This requirement from central authorities is unchanged,” he said. “Our philosophy on prevention and measures is about putting people and lives first... These measures may cause some inconvenience to normal functions and life, but we should bear in mind the overall interests of the country.”

Leaving aside the fact that most residents who have suffered lockdowns would question his characterisation of “some inconvenience”, the reality is zero-COVID has become intensely political in China, seen as one of Xi’s legacies ahead of the start of his third term.

Some health experts privately hope that after the Communist Party’s twice-a-decade conclave, on October 16, when Xi is expected to secure his third term, the country will begin to consider an exit. But there are few signs of a shift in approach in public messaging about COVID-19 to back those expectations.

What may prompt a change is the economic situation in China. Local governments, already dealing with a slowing economy, are running out of money to fund the continued testing and lockdown regime. From January 2020 until April 2022, according to Caixin, China had carried out 11.5 billion PCR tests, costing $45 billion.

A cautionary tale on state power

Within China, zero-COVID has been framed as evidence of the superiority of the Chinese political system. Yet, if it was hoped that China’s extraordinary pandemic record in 2020 and 2021, after the missteps in Wuhan, would present to the world a model to be emulated, zero-COVID has instead increasingly become a cautionary tale on state power. The model has given the state extraordinary control over people’s lives in China.

The potential for abuse has already come to light. When people converged in Zhengzhou in June, in the central Henan province, to protest a financial fraud that had cost them their savings, many arrived at the city’s train station to find their health codes had turned red, meaning they would be immediately quarantined. The provincial authorities had tampered with their apps to prevent them from gathering. After the case caused an outcry, officials were later punished.

The other side of the lockdown model is the extraordinary power it has given local-level officials and neighbourhood committees, who haven’t wielded this much influence on the lives of residents since the days of Mao Zedong. Officials now have the power to indefinitely confine residents to their homes or to close businesses by citing the pandemic. A new pandemic-centred bureaucracy now controls local-level governance in China. Signs are that it has been established for the long haul. All this has also marked a significant retreat in China’s efforts to build a system of ‘rule by law’ as a constraint on official power. On the contrary, official power is arguably at its highest in decades.

Chinese social media is full of stories of local pandemic enforcers running amok, from confining residents to buildings during an earthquake to welding doors shut to prevent people from leaving. The system encourages the extremism, as a local outbreak, for Party officials, would likely be career-ending, taking precedence over every other aspect of governance, including driving economic growth. For the first time since the Mao era, the Chinese people need government permission to renew passports and leave the country.

On one recent afternoon in Beijing, Big Whites from a local neighbourhood committee descended on a small business in a Beijing complex and ordered it shut down, confiscating its property. Vague “pandemic violations” were cited for the move. When the employees protested that they had their rights under Chinese laws, the local officials said, “We can do whatever we want.”

Rather than a model to be emulated, the zero-COVID machinery in China has emerged as a warning tale. When states accumulate extraordinary power, they are unlikely to easily relinquish it.

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