China's National Health Commission announced on December 7 that it was easing Covid restrictions. The decision of PRC authorities was motivated by nationwide anti-Covid and anti-government protests and their coverage in global media. Chinese residents can now move freely around the country and visit most establishments without a test. But experts warn that the unplanned abandonment of the Zero-COVID policy, combined with low vaccination rates in China, could lead to a dramatic increase in Covid mortality, which would trigger another crisis.
Growing dissatisfaction with the Zero-COVID policy
The pitfalls of lifting Covid restrictions
Growing dissatisfaction with the Zero-COVID policy
China's coronavirus policy has been in the spotlight since the beginning of the pandemic. Dubbed “Zero-COVID”, the policy aimed to reduce the number of new infections to zero. It's also referred to as “dynamic clearance” because of the rigorous set of anti-Covid measures: Find, Test, Track, Isolate, and Support (FTTIS). Other states, such as South Korea, Taiwan, and New Zealand, have adopted similar policies. However, China is at the forefront of everyone's mind when it comes to Zero-COVID, primarily because of its extreme rigor and particular emphasis on isolation.
The Chinese take on Zero-COVID included strict and prolonged lockdowns and tight control of the borders between regions. Thus, Chinese citizens were banned from entering and leaving cities and regions affected by the pandemic. Lockdowns were followed-up with mass public testing and contact tracing. At first, the strategy appeared relatively effective in suppressing the spread of infection and preventing excess mortality. The initial success convinced the main “architect” and proponent of the strategy, Chinese leader Xi Jinping, that he had chosen the right course and had to stick to it, making the Zero-COVID principle the backbone of China's sanitary policy.
Zero-COVID has become the backbone of China’s sanitary policy
Despite other countries reviewing their approaches to Covid control and the evolution of the virus itself, China has retained the principal elements of the Zero-COVID strategy to date. These measures were designed as an alternative to the vaccination campaign, which China had failed – to some extent, due to Xi's reluctance to rely on Western vaccines.
Xi's course has not been questioned or criticized within the party and the government; therefore the protests against the Covid restrictions also received a political component directed against the CCP and Xi specifically. During his rule, and especially in his second term, Xi rapidly expanded his personal authority and increasingly curtailed the remaining freedoms. But even China's population, which has not been prone to active protest in the past decade, is subject to political anxiety associated with the rise of authoritarianism and the erosion of civil liberties. Finally, the accumulated concerns, combined with the Covid crisis, eventuated in mass protests.
The first protests took place on November 15 in Guangzhou. Amid a spiking infection rate (unprecedented since April), the PRC government began discussing a return to a strict lockdown. Tired of the restrictions, Guangzhou residents responded with large-scale marches. Protesters tore down sanitary and police barriers and clashed with workers in biohazard suits. However, the international press did not give much coverage to these protests, and social media posts were promptly cleaned up by Chinese censors. Protest posts, hashtags, and search results on major platforms like China's Weibo were also instantly deleted. Online censorship in China has proven to be very effective in major protests as well.
On the night of November 25, protests engulfed the city of Urumqi in the Xinjiang Uygur Autonomous Region. They were triggered by a fire in a quarantined residential building, which had taken a long time to put out the fire, while the occupants could not get out of the building because of the sanitary barriers and blockades. The resulting death toll stood at ten people. Residents blamed the government and the lingering Covid restrictions for this. The tragedy in Urumqi was immediately followed by widespread unrest. Despite the frosty night, crowds of protesters gathered in the city's central square as they chanted “end lockdown” and repeated a passage from the Chinese national anthem: “Stand up! Those who refuse to be slaves!” It was also then that the protest borrowed a symbol from the 2020 Hong Kong demonstrations: the ban on protest symbols pushed protesters back to using blank sheets of paper as signs. The wave of protests became known as the “white sheet revolution”.
fire has been many Chinese people's worst fear since the spring of 2020, that is, since many people's homes are forced into periodic quarantine with metal bars and barriers— Chenchen Zhang 🤦🏻♀️ (@chenchenzh) November 25, 2022
from the bus in Guizhou to the fire in Urumqi
the worst thing you can imagine happened and will happen pic.twitter.com/p1s9EmFutm
Despite censors’ efforts, the horrifying news about the fire and the mass nature of the unrest spread like wildfire. As early as on November 27, rallies were held in other regions. In Shanghai and Beijing, protesters formed long lines. Protests erupted at several universities in Beijing and spread to educational establishments in Chengdu, Guangzhou, and Wuhan. Nanjing University came to be one of the major protest hubs.
A public protest in Beijing
twitter / @whyyoutouzele
In Shanghai, protesters first gathered in mourning processions. However, city residents soon moved on from silence to political demands and calls for reforms. It was there that the protests proved the most radical. According to social media reports, mass marches in Shanghai featured slogans rare in modern China, such as «Communist Party out, Xi out!”.
Soon mass detentions, arrests, and even beatings of protesters began. According to eyewitness accounts, police approach to the protesters changed from day to day: the longer the marches went on, the more harshly, faster, and more aggressively the police responded. Among the police brutality victims was the BBC reporter Edward Lawrence. His violent detention was caught on camera: several police officers aggressively handcuffed the journalist, ignoring the protesters' demands to release him. The Chinese Foreign Ministry acknowledged the detention but stated that Lawrence had failed to identify himself as a press worker and had thus misled the police officers. The Foreign Ministry later clarified that the police had acted in Lawrence’s interests, looking to “protect him from contracting Covid in the crowd of protesters”.
In an attempt to curb the protest, some municipal and provincial authorities have acceded to protesters' demands and eased sanitary restrictions, for example, by allowing the use of public transport without a negative test for Covid. Guangzhou and Hong Kong reopened their markets and lifted almost all movement restrictions within the city.
Meanwhile, the Chinese Center for Disease Control and Prevention announced a new mass vaccination plan, with a focus on older generations. Thus, the government aims to have vaccinated 90% of residents over the age of 80 with at least one dose by January 2023, with 77% of this age group vaccinated at the moment. Officials have also announced goals to provide boosters to 90% of the entire population: an ambitious plan with the current outreach of a modest 58%. These low rates are due in part to the fact that the government prioritized Zero-COVD restrictions over the vaccination campaign.
The Chinese government immediately started talking about ending or significantly easing the Zero-COVID policy. Due to dissatisfaction with the inadequate response of the authorities, detentions, and the accumulated inertia of political demands, the protests could not be completely extinguished and continued to flare up in different regions. Students remained the most active: On December 4, students at Wuhan University walked out in protest; on December 6, students at Nanjing University picked up the torch, while students at Anhui Medical University continued their protest as well.
The pitfalls of lifting Covid restrictions
On December 7, a new nationwide easing of the Zero-COVID policy was announced. Citizens with a mild or asymptomatic course of Covid could now self-isolate at home instead of in special quarantine centers. Chinese residents no longer have to present a negative test result to travel between provinces. Also, those shopping for cold medicine no longer have to give their name and registration address, which were used to track potential cases of infection. Lockdowns will be limited to five consecutive days, which is a significant reduction from the 100-day quarantine in Urumqi, for one, and should be more specialized. On December 13, Chinese authorities stopped using the long-distance passenger tracking app, which was introduced in 2020.
Meanwhile, the Chinese government has repeatedly stressed the danger of new virus variants and their high level of contagiousness. Despite all the relaxations, the authorities are still not ready to completely abandon the Zero-COVID policy, and the restrictions may still be reintroduced.
The response of the general public and experts to their cancellation has been varying. On the one hand, the Chinese are happy about the success of the protests and the easing of the Covid restriction; on the other hand, they call on the authorities to take responsibility for those who suffered and died because of them:
“This is a definite victory for the protesters. But we still don't know the names of the 27 who died in the bus accident, or the 10 who died in the Urumqi fire, or all the many who died because they couldn't get treatment or committed suicide (because of the lockdown).”
The Chinese bureaucracy does not have time to adjust to sudden changes in anti-coronavirus measures. Thus, according to a Beijing resident, there are huge lines for Covid shots:
“Since we no longer have to present tests in many establishments, the number of testing sites has plummeted. However, you still need a 48-hour test to go to the supermarket. As a result, we now have to stand in even longer lines. I stood in the cold for more than two hours but never got the result, so I still haven't done my grocery shopping.”
Experts fear that an unplanned departure from the Zero-COVID policy, combined with low vaccination rates, will lead to a spike in infections because the Chinese healthcare system is not prepared for this turn. This makes a dramatic increase in Covid mortality almost inevitable. Yale University public health expert Xi Chen warns:
“Reopening too soon will crowd out resources, crush the medical system, and cause more deaths.”
Xi Chen's opinion is shared by some of his colleagues. For example, Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations in New York, believes that China is not ready for a complete repeal of the measures:
“(Is China prepared?) If you look at surge capacity three years on and the stockpiling of effective antivirals – no. If you talk about the triage procedures – they are not strictly enforced – and if you talk about the vaccination rate for the elderly, especially those aged 80 and older, it is also overall no.”
According to a model developed by a group of scientists from Shanghai and published in Nature last May, China's abrupt departure from the Zero-COVID policy without additional measures will cause the epidemic of Omicron and other Covid variants to overwhelm the PRC's medical system, with the shortage of ventilators once again presenting a challenge. The study suggests that the demand for ventilators would exceed the available stock fifteen-fold:
«Should an Omicron variant epidemic be allowed to spread uncontrolled in mainland China, we project 1.10 deaths per 1,000 inhabitants over a six-month period. By comparison, 187,372 deaths have been reported in the United States38 (that is, 0.57 deaths per 1,000 inhabitants) over the period from 15 December 2021 to 15 April 2022, roughly corresponding to the Omicron wave.”
The rise of a new infections wave may already have begun, considering that Covid clinics in major Chinese cities have been getting sixteen times the usual number of visitors in the last week. The rigid Zero-COVID policy has created many risks for the population: social, economic, and directly related to public health. The overemphasis on compliance with these measures has resulted in a dependency on them and vaccination deficiency. Therefore, abolishing restrictions will almost inevitably trigger yet another crisis.