My thanks to commentor YY_Sima Qian, who has done so much to keep us all updated on the situation in China since I first started my Covid / Coronavirus Update post:
In last Friday’s Covid post comments, there were some questions of why is China persisting w/ the “Dynamic Zero COVID” strategy, and the costs being incurred. I thought I will share my perspective here, as someone who has lived through the entire pandemic to date within China, in Wuhan, but having family, friends & colleagues throughout Mainland China, as well as Taiwan & the US.
I am also fairly confident that I have followed the course of the outbreaks & their suppression & elimination in China more closely than just about any journalist or commentators in open source anywhere.
First, let’s get the political motivations out of the way. A number have been suggested, all have at least an element of truth, most a considerable amount:
1) The CCP regime in general, & Xi Jinping specifically, need the “Dynamic COVID Zero” strategy to be seen as effective leading up to the 20th Party Congress (scheduled to start on 10/16), where Xi is expected to obtain his 3rd term; the regime has staked its legitimacy as China’s ruling government, Xi has staked his personal credibility as China’s unquestioned leader, & the regime has staked its claim to a “superior” governing model relative to the West, on containing the spread of COVID-19 w/in China’s borders.
2) The CCP regime & Xi cannot afford to have the immensely negative impact of an exit wave from ending of “Dynamic COVID Zero” – overwhelmed hospitals, large number of deaths of the vulnerable elders, massive worker absenteeism from uncontrolled spread – leading up to the 20th Party Congress.
3) To ensure 1) & 2), any dissent, or anything that could be construed as questioning the “Dynamic Zero COVID” (even if unintended) are immediately stifled; these could be (& indeed especially) public comments from high level officials, technocrats in the health care bureaucracy (such as the Chinese national CDC), & respected health experts in academia.
Where foreign (even domestic) commentators tend to go awry is when they extrapolate to conclusions that evidence do not necessarily support:
1) Comparing the CCP regime’s singled minded focus on pursuing “Dynamic Zero COVID” to Mao’s anti-scientific campaigns against sparrows/snakes/weasels, which in the end led to heightened infestations of rodents & locusts.
2) Suggesting that the CCP regime aims to gradually close off China to the world & return to the autarky of the Mao decades, using “Dynamic Zero COVID” as the excuse.
3) Suggesting that Xi & the CCP regime are blind to the economic costs of “Dynamic Zero COVID”.
Based on my close following of COVID developments in China since the beginning, my assessment is that the regime’s actions are still rational within its perceived reality, albeit having certain self-imposed limitations. Most importantly, I believe the regime’s perceived reality is still not too far off from the actual reality (unlike, say, in the case of V. Putin).
1) Even in the face of Omicron BA.5 variants, the tools employed in the execution of the “Dynamic Zero COVID” strategy are still effective in containing, suppressing & eliminating outbreaks; even as massive an outbreak as the one in Shanghai from April-May 2022 was successfully eliminated, though at enormous economic & social cost due to the terrible execution of the lock down there.
2) Even in 2022, for every city (or more likely, townships/sub-districts or counties/districts w/in a city) that goes into a lock down & reach international news, there are a dozen much smaller outbreaks that have been quickly eliminated without significant disruption to most of the city. These do not make international headlines; even now, the vast majority of Chinese population is not under any movement control. Case in point is the most recent outbreak (BA.2.76 variant introduced from Tibet) in Wuhan that emerged two weeks ago, which saw >150 positive cases in ~1.5 weeks, concentrated in Huangpi District, but with a smattering of cases spread across the city, a sub-district in Huangpi was locked down, as well as a few compounds & office towers in the rest of the city. Frequency of community screening was increased to daily; there have not been any new positive cases in the past 3 days. In the meantime the rest of the city carried on as usual; the first week of Fall Semester has been online, but schools are expected to return to in person instruction next week after the Mid-Autumn Festival long weekend, & there is no fear that the students will be exposed to COVID. Without “Dynamic Zero COVID”, Wuhan would have been inundated w/ cases in a matter of weeks, in every part of the city.
3) The tools employed to execute the “Dynamic Zero COVID” strategy have been evolving in response to the changing transmission dynamics of the evolving SARS-CoV-2. Since mid-2020 China has been locking down communities/villages, sub-districts/townships, districts/counties, & entire cities/prefectures when there have been outbreaks. Since late 2020 repeated mass screening campaigns have been adopted. Rapid contact tracing, quarantine of close contacts, & isolation of positive cases have been standard from the start. Now, in the face of the much more transmissive Omicron variants with a higher percentage of asymptomatic/very mild cases, the bedrock of the strategy is no longer lock downs, but regular mass screenings for surveillance purposes & even more rapid & precise contact tracing. The lock downs (as defined by the extent of Medium/High Risk areas) are now more targeted & narrower in scope. Wide area lockdowns & cordon sanitaires are the backstop measures to prevent an outbreak from getting out of hand (which can happen very quickly with Omicron variants) & represent failures of the primary tools. They are now also less frequently imposed, and lengths of quarantines & the duration of elevated risks have been shortened to reflect the shorter incubation periods of Omicron variants. In summary, Chinese response has evolved from lock own at the first instance until elimination, to lockdown then mass test, to regular mass testing to avoid lockdowns as much as possible.
4) While Xi personally & the CCP regime’s propaganda apparatus continue to extol “Dynamic Zero COVID”, the actions & the tools currently employed suggest to me that literal “Zero” is no longer the goal at national or even provincial levels, because they are clearly unobtainable. Each local outbreak will still be contained/suppressed/eliminated, because the epidemiological curve will rebound very quickly with the Omicron variants if they are not snuffed out, but current pandemic response policies suggests that the Chinese government has accepted that the border defenses are porous against Omicron. The cordon sanitaires are leaky, and there is higher probability of a small rebound when restrictions start to be loosened. So why the continued rhetorical drumbeat for “Dynamic Zero COVID”? My take is that it is messaging to the administrative Party-State & the population, in the CCP regime’s fragmented authoritarian system. If the bureaucracy & the population get any whiff of wavering from Beijing, they will take matters into their own hands & loosen up or “lie down” far more than Beijing actually intend; in a way this is how the agricultural privatization movement started at the local level during the 1st years of Reform & Opening in the late 70s.
5) While the virus has greatly increased transmissivity, the tools being employed against it in China are becoming more precisely targeted: if getting to “Zero” ASAP was still the overriding objective, China would be going in the other direction. That China has not done so is not because the CCP regime is incapable of widely implementing such draconian policies, but that such policies will be economically & socially debilitating, given the much increased frequency of Omicron outbreaks. Case in point is Chengdu in Sichuan, which made international headlines when it went into hard lockdown last week as daily incidence reached triple digits; a week later daily incidents have dropped to mid double digits, almost all of them from persons under quarantine or residents in elevated risk areas. Now in 16 districts one member of each household can leave the compound every other day to purchase daily necessities (except those in elevated risk areas, which by definition remain under hard lockdown); in 2020 – 2021, the authorities would wait until 14 days of 0 cases outside of quarantine before starting to loosen restrictions.
6) Different jurisdictions in China are experimenting with a mix of tools to see which ones strike the best (or the least worse) balance between effectively containing/suppressing/eliminating outbreaks & minimizing economic/social impact. Shanghai in March-April 2022 was an example of a glaring failure of such an experiment, where the municipal authorities were so arrogant that they never considered or prepared for the possibility that their experiment would fail & they would need to implement a lockdown as back stop. Shenzhen is the often cited counterpoint: the city went into a one-week snap lockdown to snuff out an Omicron BA.2 outbreak in March as daily incidence reached high double digits; however, in the current BF.14 (an evolutionary descendent of BA.5.2 w/ even greater transmissivity) outbreak the city has eschewed citywide lockdowns even as daily incidences closed on 100, instead, hundreds of sites have been designated as Medium/High Risk & placed under lockdown (a number of my colleagues there have been caught in such compounds. As daily incidents have dropped to low double digits (& very few from the community), most of my colleagues under lockdown are having restrictions lifted & schools in most parts of the city are expected to resume in-person instruction from next week.
7) The currently strategy allows China to concentrate its medical resources to areas with outbreaks, a standard practice for large outbreaks since Wuhan in Spring 2020. Case in point, medical teams from across the country converged on Shanghai, Hainan, Xinjiang, & Tibet in their outbreaks. Another case in point, the 4 cases found at Enshi Prefecture in Hubei Province on 9/7 were transferred to the main infectious disease hospital in the provincial capital of Wuhan as soon as they tested positive, which is 9 hrs away by expressway & 5 hrs away by high speed rail, to benefit from the better facilities & the more skilled/experienced staff. These actions would not be possible if there were outbreaks in every jurisdiction & every hospital was full.
8) China is clearly trying to avoid, or at least postpone, the massive exit wave. Using western mRNA vaccines would reduce the sizes of waves of hospitalizations & deaths somewhat compared to Chinese domestic inactivated whole virion vaccines (data out of Hong Kong suggests the effectiveness of the Sinovac against deaths among the >80 y.o. is equivalent to the BioNTech after boosting), but there will still be a massive wave of hospitalizations & deaths compared to the “Dynamic Zero COVID” baseline. The current vaccines do little against infection; Taiwan suffered ~10K deaths since the start of the Omicron wave in May in a population of 24million, South Korea suffered ~24K deaths since the start of Omicron in late 2021 in a population of 51million. Extrapolated to China’s 1.4billion that would mean more than 600K deaths in a matter of months, not to mention the overwhelmed hospitals for months on end & Long COVID.
9) Foreign commentaries on China’s “Dynamic Zero COVID” have focused on the costs of the strategy, without considering or modeling what would happen if China exits the current strategy. The alternatives facing China is not “Dynamic Zero COVID” with significant economic/social disruption, versus far fewer restrictions resulting in “just a little more spread” with less economic/social impact. The likely result of significantly reducing restrictions is a COVID-19 tsunami that collapses health care systems & rampant worker absenteeism from falling sick, with still significant (possibly higher) economic/social damage. Much has been made about the threat of snap lockdowns in Chinese cities to the global supply chain. In fact companies & authorities in China have become practiced at keeping manufacturing operations going in face of outbreaks & movement restrictions; on the other hand, if high worker absenteeism due to massive infections cannot be mitigated, then we would see the effects to global supply chains (we have already seen a version of this when Delta swept across SE Asia in Fall 2021). The majority of my colleagues in Taiwan have contracted COVID-19 at some point in the past few months. The effect on work efficiency is noticeable due to the number of people out of office/labs at any given time — what used to take 1 week to turn around now often takes 2-3 weeks. Taiwan just posted the slowest economic growth in Q2 2022 since the beginning of the pandemic (actually saw a seasonably adjusted Q-to-Q decline) as it exited “Zero COVID”. In contrast, China has continued to expand its share of global exports throughout the pandemic, including in 2022 to date, certainly not a sign of Chinese policies hurting the manufacturing juggernaut in the aggregate.
10) The hospital is the primary point of health care for the vast majority of Chinese, many of whom visit even for minor ailments such as the common cold. As a massive exit wave results in a surge of infections, hospitals will be overwhelmed & will squeeze out people seeking care for other illnesses. China has considerably lower health care resources per capita than Taiwan or South Korea; the situation needs years or decades to address, not weeks or months.
11) China has been slowly loosening entry requirements for foreigners in recent months, even setting up charter flights to finally bring the foreign students hitherto attending Chinese universities remotely into China; people going overseas for study or business (just not for leisure) are still issued passports, hardly signs of a regime looking to close itself off to the world.
Now on to the costs.
1) No question, disruptions from “Dynamic Zero COVID” have had significant economic/social impact, especially when there is a snap lockdown implemented that lasts weeks. The hardest hit sectors are in service industries — as I said, factories are generally kept running (or can resume operations quickly) through the lockdowns, but shops/eateries/malls are all closed for the duration. For the most of the pandemic, domestic travel industry has benefited from the loss of international travel, but recent Omicron outbreaks across the country have heightened the risk of getting caught in movement restrictions & quarantines, & have depressed domestic travel (& associated hospitality industries).
2) Outbreaks in China in the age of Omicron are far more frequent & less predictable, despite regular mass screening in most parts of the country, meaning onset of restrictions in response to outbreaks are also far more frequent & less predictable. Many outbreaks & clusters do not have their sources identified; this has increased uncertainty for businesses & helped to depress investment, & increased psychological pressure on everyone.
3) The cost of regular mass screenings indeed weighs on local government finances, & local finances across the country are under severe pressure.
4) Chinese trade surplus has been ballooning for the past year, partly due to increasing strength of the export machine, but also because of lackluster domestic demand suppressing imports.
5) The overriding focus (at least rhetorical) on maintaining “Dynamic Zero COVID” inevitably leads to overzealous implementation at local or grassroots levels, such as hospitals refusing to admit persons w/ medical emergencies if they do not have negative RT-PCR results w/in 24 or 48 hrs., or pandemic response workers refusing to open the door to allow residents of a tower under lockdown to evacuate during an earthquake. However, most of them are isolated incidents, quickly corrected after inciting popular outrage.
6) International travel restrictions have led to a collapse of Track 1 (governmental), Track 1.5 & Track 2 (non-governmental) exchanges w/ the rest of the world, especially the developed West, which has contributed (at least marginally) to the deteriorating relations w/ the developed West in general & the US in particular.
While the Chinese economy is indeed facing severe challenges, IMHO the foreign (& domestic) commentators who cite “Dynamic Zero COVID” as the primary driver are misleading their audiences, either deliberately or out of ignorance, presented without any attempt at serious analysis.
1) China is not the only economy facing significant challenges. Those who have let COVID-19 repeatedly rip through their populations, as well as those exited “Zero COVID” after reaching vaccination targets, are all under duress; there are both cyclical & structural dangers to the global economy as a whole.
2) The main headwinds to the Chinese economy are the deflating real estate bubble (~25% of the economy, & in parts of the country the bubble has burst) & the regulatory campaign against private sector monopolies & oligopolies. Both are direct result of government actions initiated by Xi in the 2nd half of 2021 when China’s economy was strong, taken to address long standing & widely recognized structural imbalances. Unfortunately, the timing proved quite poor (the Omicron tsunami, the Russian invasion of Ukraine, & inflation have all heightened global uncertainty), & too much stress was placed on the economy simultaneously in a deteriorating environment. The ever intensifying technology war between China & the US (almost entirely driven by US sanctions & export restrictions against Chinese entities) have also introduced great uncertainty into global supply chains, & will have a further inflationary effect everywhere.
3) The cost of regular mass screenings is a burden the local governments do not welcome (though done to reduce the risk of greater costs of lockdowns or rampant spread). But the far greater factor stressing local government finances is the deflation of the real estate bubble; for decades, sale of land usage rights to developers has been a critical part of local government revenue stream, & that stream is drying up for the time being. Sentiments among buyers & developers of real estate are quite depressed, although the current low is probably not the new market equilibrium. While there is a huge stock of housing built & building, and there is significantly oversupply in parts of the country, overall there is also a substantial quantity of housing stock built in the 50s – 80s of low quality that will need to be replaced. There are still 600million people currently living in rural areas, a majority of whom will eventually move to urban areas, & people who bought small 2nd/3rd hand apartments as their first homes will eventually look to upgrade to newer & larger dwellings. Nevertheless, the golden age when housing prices largely moved one way at a fast pace, & an ever more bountiful revenue stream to local governments, is truly over.
4) Consumer sentiments in China is in the doldrums: stresses in local government finances have seen many public servants’ salaries/bonuses cut. There has been a negative wealth effect from the deflating real estate prices. There have also been substantial layoffs in the targeted private sectors (real estate, internet platforms, after-school education, etc.). As I said, restrictions associated w/ “Dynamic Zero COVID” do negatively affect consumption of services when they are in effect, but I think it is very hard to argue they are more significant than the other factors.
5) Investor sentiments are also depressed in many sectors, due to uncertain economic outlook & regulatory uncertainty, the latter primarily due to the perception (& partial reality) that the regulatory assault on select sectors have been sudden & arbitrary (even though Xi had telegraphed his intentions months in advance).
6) The Chinese government is capable of giving the faltering economy an immediate sugar high by removing regulatory pressure on targeted sectors, turning the spigot fully open again for infrastructure spending, & taking on more debt, at the cost of exacerbating the structural imbalances & ballooning debt in the medium to long term. However, so far the government has only carried out targeted modulations of policy to provide a bottom, and refrained from the types of massive stimulus seen in the past. It appears the Chinese leadership is willing to accept an extended period of slower growth to see through the correction of structural imbalances. One of the greatest structural correction required is increasing domestic consumption, which will necessitate massive wealth transfer (from the state to the population & from one segment of population to another), which is a politically fraught subject in every polity regardless of form of government. The other is the structural imbalance between central & local government finances, where almost all of the tax revenue go to the central government but not enough is returned to local governments to cover the liabilities & responsibilities that the central government has designated to local authorities. (This is partly the reason local governments came to rely upon sale of land usage rights, a model borrowed from Hong Kong). If & how the CCP regime navigates these structural corrections (more likely by muddling through) remain to be seen, but it seems to be trying to confront these challenges head-on.
Having said all of that, there are clear signs that the “Dynamic Zero” is unlikely to be sustainable in China even in the medium term.
1) Fatigue & weariness in the population is increasingly evident: the risk of being caught in lockdowns & quarantine is now higher in the age of Omicron compared to 2020 – 2021, even if the risk is not high in the absolute sense & durations now tend to be shorter. The incompetently managed outbreak in Shanghai dealt a body blow to trust & confidence in the competence of the authorities, because the city locked down a day after publicly declaring it would not do so, & declared a 3 day lockdown that ended up being 2 months long. (I told my colleagues there to prepare for >6 weeks, based on the epidemiological curve & the geographical spread). Many residents were poorly supplied in the initial weeks; now, whenever a local authority declares a 3-day “quiet period” to conduct mass screenings after finding evidence of community transmission, everyone thinks they will be locked down for weeks (when epidemiological data might indicate that the risk of extended lockdown to be very low).
2) Many people see that the rest of the world has “returned to normal”, they see the very high percentage of asymptomatic/very mild cases & very few reported deaths, & they do not understand the need to continue “Dynamic Zero COVID”. What they do not see is that the “normalcy” in the rest of the world is really a bad situation normalized. (If a flu bug came around in 2019 that resulted in the current level of COVID-19 hospitalizations & deaths, in the “off season”, public health emergencies would have been declared in every country). They have not come to grip with experiencing the inevitable massive exit wave from ending “Dynamic COVID Zero”. They have also failed to consider that the current level population immunity in the rest of the world has been achieved over a mountain of dead bodies, many more disabled from Long COVID, & 2+ years of economic roller coaster. This is the same challenge the world has faced since the beginning — the risk to the individual (except the most vulnerable) has always been low, but the aggregate effect to society has always been severe.
3) The level of response the Chinese government is currently willing to use is just about enough to contain Omicron BA.2.76, BA.5 & BF.14 outbreaks in summer; if an even more transmissive variant arrives (making it more transmissive than measles?), or with the onset of winter, the virus might render China’s strategy ineffective & inoperable.
4) It has been reasonably speculated that China is waiting/hoping for better vaccines that are actually effective in stopping transmission (which is none of the current or coming ones) and/or a less virulent variant to emerge. At this point they appear to be forlorn hopes. If the new bivalent vaccines targeting Omicron variants are effective against transmission, we should have heard by now, & the Omicron variant is as dangerous to immunologically naive populations as the earlier variants (except Delta).
There have been several notable failures or oversights in the CCP’s policies so far.
1) Although China has achieve very high vaccination & relatively high boosting rates for its population, uptake is perversely the lowest among the oldest & most vulnerable population: vaccination has slowed to a trickle in the last month, 10% of the >60 y.o. cohort still have not taken a single shot, likely concentrated in the >80 y.o.
2) Like everyone else, I am somewhat mystified by China’s failure to mandate vaccination for the elders & other vulnerable populations. The government has put pressure on civil servants, public sector employees, & Party members in general to get their elderly relatives & acquaintances vaccinated, cash/material incentives were rolled out, everything but a hard mandate. My only guess is that a few thousand deaths of elders from post-vaccination complications (or so perceived) under a mandate is more damaging to the regime than a few hundred thousand deaths from COVID-19 run rampant — the latter can be argued as damage from a force of nature, & the former can be construed as direct result of policy. Furthermore, many/most of those still not vaccinated were probably advised against taking the shots due to underlying conditions, often the same underlying conditions that make them the most vulnerable in the 1st place (the same issue had plagued uptake among elders in Hong Kong & Taiwan); to increase uptake among the most vulnerable, the medical guidance has to change.
3) Like everyone else, I too am deeply disappointed that China has not approved foreign mRNA vaccines, especially the BioNTech one where a Chinese private company (Fosun Pharma) invested before Pfizer. The motivation has to be political; no word on the availability of the domestic Abogen-Walvax mRNA vaccine, whose Stage III trial should have ended at the beginning of 2022. Even widespread usage of mRNA vaccines would not prevent China’s hospitals from being overwhelmed in an exit wave. The performance of Chinese vaccines after boosting is pretty close, but fewer hospitalizations & deaths is fewer hospitalizations & deaths.
4) The current vaccination strategy in China is befuddling: > 90% of the population is fully vaccinated & nearly 60% boosted, but most of them the last shot came in late 2021. There is no plan announced for additional boosters heading into winter. Chinese pharmaceutical companies have been working on Omicron specific vaccines for nearly a year, but no word on the timing for their availability. The approval of the CanSino inhalable vaccine is certainly welcome, but that one still targets the original variant, & China needs more than that to boost its population.
5) The CCP regime has not explained to the population why “Dynamic Zero COVID” is still being maintained, & the real dangers & costs of exiting the strategy given experiences in the rest of the world. Nor has it started to prepare the population for the inevitable exit wave when “Dynamic Zero COVID” does end, either as a policy choice or forced by the evolving virus. Long COVID is not often discussed in China, either, most of my relatives, friends & colleagues are not even aware of the issue, probably because so few in China have caught COVID-19 to begin with, even in Wuhan. Being über-paternalistically authoritarian, the regime generally does not deign to explain itself to anyone, foreign or domestic.
So, where do I see things go from here? Hard to predict. I didn’t think China’s “Dynamic Zero COVID” would still be viable in face of Omicron BA.1/2, let alone BA.5, but it has held on, enough time to get my daughter vaccinated. However, whether the strategy is still tenable w/ BA.5/BA.2.76/BF.14 going into winter is unknown.
Xi is going to Uzbekistan next week for the Shanghai Cooperation Organization summit, where he is to meet Putin & Modi. He will also head to Indonesia in November for the G20 summit, where a meeting w/ Biden (& presumably other leaders) is planned. So China is slowly emerging from its shell.
Chinese population will inevitably adjust to the exit wave when it comes, just as people in Taiwan & New Zealand adjusted. In 2020 – 2021, a few positive cases in a city would empty the public spaces. Now, a dozen cases a day in one district, & life carries on as normal in the other parts of the city, restaurants are still full (if the waiting lines may be shorter), & rush hour traffic is still rush hour traffic. People will adjust to the new “normal”.
Nevertheless, I do not subscribed to the notion prevalent in the rest of the world that “it will probably fail at some point anyway, so let’s give up now”. I do not relish the prospect of Long COVID from repeated infections. I still hope a vaccine that is effective in stopping transmission can be developed somewhere, though I am not that hopeful.
My apologies for the wall of text, but I feel discussions concerning China tend to lack any nuance.
raven
yo
YY_Sima Qian
Thanks for front paging this, A.L.!
phdesmond
Thanks for posting it.
twbrandt (formerly tom)
thanks for all this, YY_Sima Qian. This is much more detail and nuance than we normally see.
Citizen Alan
Just signed up for booster number 3 on Monday morning. Do you think it might be a problem if I’m still hung over from the ole miss game?
MazeDancer
Fascinating report. Thank you for it.
Dagaetch
A much appreciated report, thank you!
Princess
This is both clear and comprehensive. Thank you.
Sparkedcat
Thank-you for this well written post.
Lyrebird
@YY_Sima Qian: Thank you so much for sharing your insights!
Barbara
Wow. Thanks for taking the time to do this. Very illuminating!
BruceFromOhio
This represents 2.8 billion people, and three countries that have have nuclear weapons.
I wonder what they will discuss.
Indeed. Thank you so very much for writing this, I appreciate your detail and … nuance.
AJ of the Mustard Search and Rescue team
Thank you for all the time and thought you put into writing this up. I appreciate the scope and thoroughness and feel much better informed having read it.
YY_Sima Qian
Thank you all for your kind words! Glad to know that I bring value to the community.
ColoradoGuy
Thank you so much for the even-handed and thoroughly researched post on China’s Dynamic Zero Covid policy. The coverage in the American press has been abominable, which also reflects the terrible (and extremely irresponsible) domestic coverage.
Nowhere in the American press have I seen a model of what would have happened to China if they followed the USA/Republican policy of unlimited travel and denigration of masking. By my back-of-the-envelope guesswork, that would have resulted in at least 4 to 5 million deaths, severe and lasting damage to the health-care system, and tens of millions of cases of Long Covid. By contrast, Dynamic Zero Covid has saved that many lives already, although the exit strategy is going to be difficult to plan for, although nothing like the full-on catastrophe of the USA/GOP model.
YY_Sima Qian
@Citizen Alan: In China, they do not recommend against drinking any alcohol w/in 24 hrs of vaccination. Then again, much of the medical advise around vaccination in China is overly cautious/conservative.
YY_Sima Qian
@ColoradoGuy: The more reality & evidence based reporting/analysis on China do acknowledge the lives saved & the lessened impact on the economy for 2020 – 2021. My issue is that very little effort is made to consider the price China will have to pay to exit “Dynamic COVID Zero” now, even after the vast majority of the population have been vaccinated. It should not be difficult to analyze the experience of Taiwan, South Korea, Australia & New Zealand, & extrapolate to China’s population. Instead, all of the focus of the international coverage is on the costs of the current policy, but not on the costs of the alternatives.
Even if the only thing that “Dynamic COVID Zero” has accomplished is deferring the deaths until after the policy is ended, that is still 10s of millions of elders that lived the ends of their lives in relatively normal circumstances, as opposed to drowning in their own fluids w/ tubes stuck down their throats, isolated from their loved ones. Of course, China has also avoided mass infections before vaccinating the vast majority of the population, who are now no longer immunologically naive.
That brings up another of my peeves about Western media coverage of China – the persistent denigration of Chinese vaccines. Yes, all the data show the Chinese vaccines are less effective relative to the mRNAs (though the gap may be negligible after boosting), that does not mean they are ineffective. & other less effective Western vaccines (such as AZ-Oxford & J&J-Janssen) have not come under the same degree of scrutiny. After all, nearly 3 billion doses of Chinese vaccines have gone into arms worldwide, they gave the Global South countries the 1st measures of protection against the COVID-19 onslaught, before the mRNA vaccine became more widely available outside of the developed world.
Yet, some media coverage of China still describe the Chinese population as immunologically naive, ostensibly due to lack of widespread infection. Do they realize that they are implying (perhaps subconsciously) infection is the only meaningful path to immunity? Do they realize they are echoing anti-vaxxer talking points?!
ColoradoGuy
The political and economic resentments of the global pandemic have crowded out the rational pathways. The obvious scientific and technological response would have been worldwide patent pools and technology-sharing, but that’s not what happened, even though it would have saved millions of lives.
206inKY
Excellent post, thanks so much. My two cents are with point #8 stating that western mRNA vaccines would not prevent an exit wave.
This is true with the old shots, but the new omicron-tailored boosters should prevent infection as well as it did in Spring 2021, especially if China ordered monovalent shots for maximum efficacy against omicron.
The single biggest failure of the current administration was the resistance to rolling out BA.1 shots when Pfizer had them ready last February. It destroyed public confidence in mRNA technology, even though the trial data showed that the BA.1 shots would have been a resounding success. The administration never apologized and let Pfizer, Moderna, and BioNTech take the reputational hit instead.
YY_Sima Qian
@206inKY:
I hope this is true, but if they are that effective against infection Pfizer & Moderna would be shouting from the rooftops, & countries would be updating their public policy around that. I have not seen any evidence that this is the case.
Furthermore, the “Omicron-tailored” vaccines being rolled out now were developed targeting the BA.1 strain. Not sure how effective against infection they would be w/ the BA.4/5 or BA.2.25/76 strains. Some of these newer strains probably should have gotten their own Greek letters.
In any case, China has not announced any plans to roll out Omicron tailored vaccines, yet, & winter is not that far away, especially in the north. I find that more worrisome than the disruptions from “Dynamic Zero COVID” restrictions, which are temporary.
DBrown
The newest vaccine does offer protction from the BA-5 varient (besides the orginal.) So why doesn’t China mfg. that vaccine and use it?
Oh, and great post and explaination on the lockdown logic.
YY_Sima Qian
@DBrown: Nationalist politics & geopolitics. I am sure the CCP regime would prefer to roll out a domestically developed “Omicron” vaccine. A number of candidates are being worked on by a number of state owned & private pharmaceutical companies, but progress is very murky.
I think the G7 has agreed to share the IP of the Western mRNA vaccines w/ the developing world, but China is specifically excluded due it being classified as “developed”. I suspect that the US wants to see China publicly ask for access to superior mRNA vaccines, & China is absolutely loath to be seen doing so.
DBrown
China researchers were critical in developing all vaccines thanks to their essential work mapping the covid’s virus. Without this, vaccines would have been delayed a good bit (and lets not forget that researchers risk and their team doing that brave act w/o permission.) Using mRNA methodology isn’t something any company solely owns. I’d think China’s very capable researchers should be able to provide a superior new mRNA vaccine knowing how the Western one was mfg. That protects from the BA-5 and other current varients. And w/o infringing any direct licenses.
I was lost why China still followed the zero policy but your post cleared that issue up. Thanks for giving the detailed discussion
YY_Sima Qian
@DBrown: A lot of hope was placed on the domestic Abogen-Walvax mRNA vaccine, but no news since beginning of the year.
In terms of mRNA technology, Chinese pharmaceutical companies are still catching up. They were far behind in that area at the start of the pandemic.
Lest we forget, there were more than 2 mRNA vaccine candidates under development, but only BioNTech & Moderna made it to commercialization. Others failed at Stage I or Stage II of clinical trials.
Bard the Grim
This was the best-written, most informative piece I’ve read on anything in at least the past year. Thank you so much.
MDinPA
Thank you! Far and away the best lay survey of China’s Covid strategy and practices I’ve seen.
Laura Too
@YY_Sima Qian: I can’t begin to tell you how much I appreciate and have appreciated your comments and perspective from the very beginning. You and Anne Laurie do some of the best commentary anywhere. Thank you!
jl
@Bard the Grim: I agree. Thanks for a great piece. I notice that YY mentions that the Chinese vaccines, or at least one of them (IIRC from my reading, it’s Sinovac, but not sure) provides almost as much protection against severe disease as mRNA and Oxford/AstraZeneca, but only after a full course plus booster. I agree that the unwillingness or inability to achieve adequate vaccine coverage in the elderly is mysterious and tragic. Better vaccine coverage in the elderly would greatly ease the the dilemma China faces in balancing the immense costs of continuing its strict lockdown approach its zero COVID policy with those of an exit (which must come sooner or later).
I’ve read that there is great resistance to vaccines among rural and small town elderly, but China is good at propaganda, so not sure that is a good reason after 2 years.
Elizabelle
@YY_Sima Qian: This was a really informative post. Thank you.
Agree that most journalists don’t see the big picture on China’s Covid policies.
Jacel
Thank you so much for this extensive and clear report. I’ve wanted to know more about the different states of dealing with COVID in different parts of the globe.
YY_Sima Qian
@jl: The dilemma for China is the comparison w/ the “Dynamic Zero COVID” baseline. If China reaches South Korea’s level of vaccination, & using similar quality of vaccines, then it is facing the prospect of > 600K deaths over ~ 9 mos. after exiting the policy. I assume the death count will be higher if China exited now, due to lower vaccination rate of the elderly/vulnerable population & somewhat less effective vaccines. If China imports the Omicron targeting mRNA vaccines & manages to get > 90% of the most vulnerable population vaccinated/boosted, death count could be as low as 300 – 400K (this is purely a WAG). The problem is that is still 300 – 400K higher than the “Dynamic Zero COVID” baseline.
As for vaccine hesitance, the only reason there isn’t an anti-vaxx movement in China is due to censorship & suppression. Chinese people are not any more immune to rumor mongering & conspiracy theories. CCP propaganda is pretty effective is shaping opinions on issues that do not directly touch on people’s lived experiences, but not when it comes to issues that people feel intimately affected by.
Then there is the issue of overly cautious medical advise, as I mentioned.
YY_Sima Qian
Thank you all again for your kind words!
DB11
Realize this is a dead thread, but just catching up on a couple of days worth of news and posts.
Non the less I wanted to add my voice to the choir in thanking YY for his highly-informed commentary on the situation in China. There’s no substitute for his combination of personal experience, broad knowledge and global perspective.
Very much appreciated.