In China's capital, mass testing becomes new normal

People wait in line for a swab test at a COVID-19 test site in Beijing, China.

People wait in line for a swab test at a COVID-19 test site in Beijing, China. | Photo Credit: Getty Images

“Have you eaten yet" was famously the traditional greeting favoured in the alleyways of old Beijing. The current flavour as far as greetings go for many residents of China’s capital, is "have you tested yet?"

A regularised mass testing regime, that couples the ruling Communist Party’s sprawling presence at the grassroots with a sweeping high-tech health monitoring system, has emerged as the country’s most key weapon in maintaining its “zero-COVID” status amid recurring outbreaks of more transmissible variants.

The capital has, this past week, reported zero cases on most days, recovering after a gruelling campaign against an Omicron outbreak earlier this year. But that Beijing managed to do so while avoiding the protracted, months-long lockdown in Shanghai that brought China’s financial capital to a screeching halt, has reinforced the leadership’s belief that “zero-COVID” is still an achievable goal, regardless of China being the only country in the planet still pursuing it while most other nations have returned to some normalcy and opened their borders.

President Xi Jinping said as much during a visit to Wuhan, where the COVID-19 pandemic outbreak began in early 2020, on June 29, saying that living with the virus or “herd immunity” would have left China with “unimaginable consequences”. Chinese health experts say opening up would mean mass deaths given the high number of unvaccinated elderly, looking at Hong Kong’s recent wave as a warning sign.

Early lockdowns of neighbourhoods where cases are detected is one key aspect of the strategy. But most important for detection is regularised mass testing of every resident. As Rapid Antigen Tests (RAT) are seen to be both less reliable and harder to monitor, the solution was setting up a sprawling network of polymerase chain reaction (PCR) booths.

In Beijing, the booths have been set up so every resident can find one within a 10-15 minute walk. The tests are free, and the results are uploaded into every resident’s Health Kit. Most establishments require a test result within the past 72 hours for entry. This includes access to even residential compounds. The testing regime thus requires a huge mobilisation of both manpower and technology.

Most residents have, at least so far, taken it in their strides. “As long as the lines are short,” shrugged one office worker in the busy Chaoyangmen neighbourhood near the Foreign Ministry. “And if it keeps us safe.” The tests are mild oral swabs, and not more invasive nasal PCRs that might have triggered a different reaction. Beijingers now share tips about where to get fast tests and the best times of day to beat the queues. “4 pm on weekdays,” advises one post.

The approach is now being followed in most Chinese cities, all of which requires an enormous infrastructure to process millions of daily samples, through pooled sampling. The National Health Commission said in April close to 52 million samples were processed every day. A pooled test would include dozens of samples for early screening.

How long the system continues – which comes with an enormous expense for already cash-strapped local governments – remains unclear. At at least until the Party Congress for later this year, when Mr. Xi will begin a third term, is a wide expectation. Devoting finite resources to mass testing instead of vaccinating the elderly, ironically, only further delays any exit strategy from zero-COVID.

The broader public support for “zero-COVID” is harder to gauge. The leadership’s bet is that keeping the economy ticking and avoiding a wave of cases will make it a less bitter pill to swallow. Ensuring that will mean avoiding a recurrence of Shanghai, and thus keeping in place the mass testing regime. Many Chinese are also unaware of how much normalcy has returned to the rest of the world, as China remains closed off.

Also unclear is how long the tolerance for this now normalised activity will endure. When the Beijing Daily reported last week that the city’s Party Secretary Cai Qi referred to continued pandemic controls for five years, the response on social media was one of exasperation and exhaustion. The authorities quickly clarified that the five year reference was incorrect and added by the newspaper. Mr. Cai, they added, did not offer a time frame.

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Printable version | Jul 19, 2022 1:44:16 am |