COVID-19 Coronavirus

Could someone let @CDCgov know that it's December and the last data they have provided for Covid hospitalizations vs vaccination and boosters is from July?https://t.co/M2Bu9r1YTe pic.twitter.com/x3ReungQk5

— Eric Topol (@EricTopol) December 1, 2022

There are a lot of mysteries about co-circulating respiratory viruses & how they compete with each other but one thing is certain: we know how to decrease their impact on us. We should do that. Fantastic article from @florian_krammer @ @AubreeGordonPhD👇🏻https://t.co/MeCMxsVQk0

— Dr. Angela Rasmussen (@angie_rasmussen) November 28, 2022

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Some communities in Chinese cities where COVID is still spreading are easing off on testing requirements and quarantine rules ahead of an expected shift in virus policies nationwide after widespread social unrest https://t.co/aJQ2Yh2yCA pic.twitter.com/nOUYEiKakz

— Reuters (@Reuters) December 2, 2022

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From a long thread:

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And as cases are rising, I had to go to four different PCR testing sites this morning to find one that was open. Most people don't have time for that before work- but are still being asked to show 24hr codes.

This is going to be a needlessly rough off-ramp from Zero-COVID…. https://t.co/1BaOX7xAMY pic.twitter.com/BIVoVCsvLl

— Naomi Wu 机械妖姬 (@RealSexyCyborg) December 2, 2022

With Sinovac, the time gap between a base dose and the 1st booster dose has usually been recommended to be 6 months. Now that it’s being reduced to 3 months in a rushed and poorly planned manner, I wonder how much that’s gonna appease the anxiety of the hesitant elderly…

— C Nguyen (@CNguyenEc) December 1, 2022

#India recorded a single-day rise of 275 new coronavirus infections, while the count of active cases has dipped to 4,672, according to Union Health Ministry data updated on Friday.https://t.co/qRTS8FOL70

— The Hindu (@the_hindu) December 2, 2022

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No let up in Japan@OurWorldInData pic.twitter.com/DTo8HmS5or

— Eric Topol (@EricTopol) November 30, 2022

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If deer & people are swapping the ‘rona back & forth, we are indeed never going to successfully eradict it. (H/t commentor MikeS)

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Moderna Inc's top scientist said on Tuesday that the vaccine maker has learned how to better recruit from diverse populations for its clinical trials from running its COVID-19 vaccine studies. https://t.co/6ZowtZm0Kd

— Reuters Health (@Reuters_Health) December 1, 2022

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One new estimate has #LongCovid costing the U.S. economy $3.7 trillion, a figure rivaling costs of the Great Recession. Already, as many as 23 million people in the U.S. may be affected https://t.co/2EOWUkYW6J pic.twitter.com/7SkmfhqBTQ

— delthia ricks 🔬 (@DelthiaRicks) December 1, 2022

Twitter is no longer enforcing its Covid-19 misleading information policy.

This addendum to the policy (highlighted in orange below) spotted overnight by some eagle-eyed Twitter users.

Twitter says 11,000 accounts were suspended under the policy.https://t.co/VkiJYBBPq5 pic.twitter.com/pPx3pXR1wr

— Donie O'Sullivan (@donie) November 29, 2022

Who lives through a pandemic and makes war on the cures? https://t.co/neD10QnhHn

— Charles P. Pierce (@CharlesPPierce) November 30, 2022

Lies like this are why Republicans died at like a 3 to 1 rate from COVID since the vaccines came out https://t.co/O63OG71jy8

— Grudgie the Whale (@grudging1) December 1, 2022

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The charitable interpretation of the incoherent guidance from Beijing is that the CCP regime has a fragmented authoritarian system. How it works is that Beijing sent up the goals, and the local authorities have a lot of flexibility in execution to reach those goals; there is great disparity in the level of development, governance capacity, financial wherewithal, and demographic/ethnic makeup across China, and no one-size-fits-all solution is feasible. A responsible exit from DZC does require balancing of immediate public health & socioeconomic consequences (they had not been in such tension before Omicron). The cynical interpretation is that Xi & the CCP leadership knows that the exit from DZC will inevitably be very messy & involves a lot of suffering in both public health & socio-economic spheres — they wanted to distance themselves from these consequences so that the inevitable popular backlash are aimed at local authorities. As is often the case with China, both dynamics are likely at play.

The weeks leading up to 11/25-27:
There have been several notable events in Nov. that have reached international media, which often mischaracterized by the same international media.

Guangzhou Protests
Guangzhou in Guangdong Province had been struggling to suppress an outbreak there since late October. Case incidence rate had reached high quadruple digits and has remained high. The local policies has been successful in containing the outbreak to Haizhu District and parts of Tianhe District, keeping cases low in the other districts and exporting few to the rest of the province or the rest of the country. However, the centers of the outbreak in Haizhu and Tianhe Districts are the densely packed and somewhat decrepit “urban villages”, with narrow lanes and often shared kitchens and bathrooms. Stopping transmission or supervising lockdowns in such environments proved too challenging for the local authorities. According to my colleagues living in Guangzhou, the authorities cordoned off these “urban villages”, home to hundreds of thousands, stopped trying to prevent in community transmission there, and ceased regular mass screenings.

The residents of such “urban villages” are typically migrant workers from elsewhere in China, working in service jobs or menial labor, or as gig workers. They live on the margins of society. The shift enraged these residents: being locked down meant they were cut off from jobs and sources of income, and they could not return to their homes elsewhere in China; on the other hand, they perceived the authorities to have abandoned them to COVID-19, by allowing in-community mitigation measures to lapse. All at the same time, as they watched other Guangzhou residents in other districts slowly return to normal. The anger led to several protests, with residents breaking the COVID-19 control barricades, and forcing some changes from the municipal government.

The Foxconn Protests
There were two rounds of of the worker protests at the huge Foxconn complex (where 70% of iPhones are assembled) in Zhengzhou, Henan Province. The first round was at the beginning of November, as an outbreak occurred in the complex operating under “closed loop”. Poor handling of the “closed loop” operations by the company caused a major exodus of workers. Workers complained about not feeling safe from infection (due to information opacity, not knowing who among the coworkers might be infected or are close contacts), and inadequate food supply to the dormitories whenever they were not working on the assembly lines. After a couple of days of tense confrontation, Foxconn agreed to let anyone who wanted to leave go, facilitated by local governments in Henan Province.

Both Foxconn and governments of Zhengzhou and Henan then scrambled to find new workers so the former would not fall behind on the deliveries of iPhones to Apple. (For context, the Zhengzhou complex employed ~400K workers during annual peak. Foxconn is probably more important to Henan Province than Samsung is to South Korea, or Boeing to Washington State.) Many were lured by the sizable bonuses for short term contracts. Once in, they were dismayed by the continued poor management of the “close loop” operations, where healthy workers were housed in the same dormitory building as diagnosed positive cases (presumably not in the same floor or rooms), and had to work on the same production lines as traced close contacts. They were further angered when Foxconn said there would be delays in disbursing the promised bonuses. That led to the protests that made international headlines a week ago, which sometimes turned physical. (For context, the level of violence was nothing like the rioting in Hong Kong in late 2019, the gilets jaunes protests in France in 2018, or indeed the most recent football riots in the Netherlands). Foxconn once again backpedaled & promised to pay the bonuses immediately, as well as allowing anyone who wishes to do so leave immediately with their bonuses. There have not been any protests since.

In essence, both protests were about labor disputes, not against DZC restrictions, even though international media often portrayed them as such. To the extent the Foxconn worker protests concerned COVID-19, it was because they felt the company did not implement enough mitigation measures, or that the measures were implemented poorly. Right now, a large percentage of the large manufacturing plants in China are operating in “closed loops”, and so are many logistics parks. Yet Foxconn type protests have been very rare throughout the pandemic. No one wants to work in a “closed loop”; however, many are willing to do so for a period of time if they feel safe, supported, and adequately compensated.

Policy Reversals in Quick Succession at Shijiazhuang
The city of Shijiazhuang in Hebei Province had been struggling to suppress an outbreak since early November, with much of the urban areas under soft lockdown, causing rising popular discontent. When the “20 Rules” where announced, Shijiazhuang was among the most enthusiastic in rolling out — notably by halting bi-daily mass screenings, even as significant community transmission remained evident. Many other cities in China with larger area soft lock downs quickly followed suit. Unsurprisingly, case counts quickly escalated, along with signs of rapidly widening community transmission. Hospitals quickly reached the precipice of being overwhelmed, not because they were running out of regular or ICU beds, but because of rapid nosocomial transmission causing large percentage of medical staff to be isolated or quarantined. Streets remained empty because people were afraid to venture out due to rising spread. After a week, Shijiazhuang reversed course again, under some popular pressure, resumed regular mass screening & reimposed soft lockdowns. Other cities in China, facing the same dynamic, again quickly followed suit.

The Fire at Ürümqi & the Protest There
In the evening of 11/24, there was a fire in an apartment on the 15th floor of a building in a residential complex in Ürümqi, Xinjiang “Autonomous” Region. Incidentally, the complex is in an area of the city primarily populated by Uyghurs. It looks to be a middle class neighborhood, the compound was built in 2005, so not dated and decrepit. Despite firefighters reaching the scene within 5 minutes, it took nearly 3 hours to put the apartment fire out, resulting in tragedy. Footage taken by residents showed that the water from the fire engines initially could not reach the apartments on fire, as they were parked too far away. Officials reported 10 dead and 9 injured, most from inhalation of toxic fumes. Rumor quickly spread on Chinese social media that residents in the compound had either been sealed in their apartments or building doors were padlocked due to COVID-19 controls. Other rumors said barriers put up for COVID-19 control prevented the fire engines from coming close enough to the building. Still others claimed that the community workers would not allow firefighters into the compound unless they tested negative on rapid antigens kits. Finally, there were rumors that the death toll was actually 44.

Municipal officials deny that any doors had been locked, claimed that the residential compound in question had been designated as Low Risk (in accordance with the “20 Rules”) since 11/12, and that residents had been allowed free movement within the compound since 11/20. Official accounts claim that residents of the apartment where the fire started were able to escape with the help of a property management worker who had came up, and that the residents above on the 16th floor were rescued by firefighters, seemingly in the nick of time before they were overwhelmed by smoke. Officials conceded that fire engines had trouble reaching the building in question, as roads within the compound were filled with parked private vehicles, whose batteries had drained during the months of lockdown. Other state media accounts described how the other residents in the building escaped, mostly from the lower floors. In the new conference, the city’s fire chief blamed poor electrical wiring for the fire and poor fire safety awareness for the deaths and injuries. (As bad that that looks in print, it was much worse in video. Yes, it is true that fire safety awareness is nonexistent across China.)

The official accounts are plausible, but certainly do not represent the whole truth. There is no timeline of events, from when the fire started from an extension cord, to when the residents of the 15th floor apartment were able to escape, or when the residents of the 16th floor apartment were rescued. There is no explanation why an apartment fire took nearly 3 hours extinguish. There is no information about the dead and the injured, where they lived in the building, or why the rescuers were not able to reach them in time. Some of the rumors are implausible. The temporary partitions put up for movement control are not that strong — protestors across China have toppled them with relative ease, they will not stop fire engines or any vehicles. I cannot imagine any community worker wanting to take the responsibility of delaying firefighting missions for testing, or any firefighters for acceding to the request.

Nevertheless, whether the rumors for the fire are true is no longer the point. It is plausible/believable to everyone in China. We have all read accounts of inhumane/unscientific/overzealous execution in pursuit of DZC that caused tragedies: the overturned bus transporting residents from Guiyang in Guizhou Province to a quarantine site 200km away, killing dozens. The young children, elderly and pregnant women refused entry to hospitals for urgent medical care because they lacked recent negative PCR test results. The people already suffering from depression committing suicide after prolonged lock down, people starving during lock down because they were not supplied (the vast majority of such cases in 2022). We have read about or even experienced fire escape doors being locked in locked down buildings or quarantine hotels, creating hazards. These may not be common occurrences — the tragedies are in fact pretty rare considering the size and population of China — but it is all very relatable to everyone.

Xinjiang in particular is a powder keg with respect to discontent toward COVID-19 related restrictions, and the tragic fire provided the spark. You read on international media that Ürümqi has been under lockdown (sometimes soft, sometimes hard) for 100 days, since the region-wide outbreaks caused by summer tourist season in August. That is far from all of it. In May, large parts of Ürümqi were locked down for a few weeks due to spill over from the Shanghai outbreak. In October 2021, there was a sizable Delta outbreak in Kashgar Prefecture in the far west of Xinjiang, which led to movement restrictions across the region. In October 2020 there was a major outbreak in Ürümqi, that resulted in a region wide lockdown for two months. Between Spring 2020 and Spring 2022, the vast majority of China had experienced no lockdown, or just one. Xinjiang is one of the unfortunate exceptions. (The others being Ruili in Dehong Prefecture, Yunnan Province, and Dongxing in Fangchenggang, Guangxi “Autonomous” Region, both major border crossings.) By late November 2022, all residents of Ürümqi, and likely all of Xinjiang, were at the ends of their patience. The arrogant and insensitive display by the municipal leaders on TV seemed to have triggered them to protest.

Countrywide Protests of 11/25 — 11/27

Note: I have not been present at any of the protests, so I can only summarize what I have read on Chinese social media, international media and social media, and conversations with family, friends and colleagues, for what it is worth.

Ürümqi and Rest of Xinjiang 11/25 – 11/26
Not that many details have emerged from Xinjiang, but protests started in Ürümqi in the evening of 11/25, spreading to at least a few other cities in the region by the evening of 11/26. From the sparse video footage that made it outside the Great Fire Wall, the vast majority of the protestors were presumably Han Chinese, or at least people who spoke fluent Mandarin (which can include Hui Muslims, Mongols, and young urban Turkic peoples for that matter). They waved Chinese national flags, sang the national anthem and the Internationale. It is much more dangerous for Uyghurs to protest, even if they brandish the same symbols and behave in the same manner.

Rest of the Country 11/25 – 11/27
The Ürümqi fire and subsequent protests quickly spread on Chinese social media, despite the best efforts of the most technically advanced and sophisticated censor system in the world, and found resonance across the country. I won’t go into details about the protests, as they are well covered by international media, except into the aspects I think Western MSM and commentators/analysts have overlooked.

The first to respond were students on university campuses, dozens across the country. Besides being young and idealistic, one important motivation is that campuses in most Chinese cities have been under lockdown for major stretches of the past three semesters, ever since the arrival of Delta. The students (in theory) were restricted to campuses, while the world outside the campus moved about without restrictions (in most places in China even through the second quarter of 2022). The teaching, admin. and custodial staff entered and left as they pleased, as could their families if they lived near by and had a pass. The unfairness was and is blindingly obvious, as I have repeatedly remarked to my wife, who is a university admin. She says it has been the number one complaint from her students for the past year. Students at a number of universities mounted protests in the Spring semester that got their lockdowns lifted, which probably encouraged them to protest at this moment. Sometimes the campus lockdowns were relaxed to virtually “in name only” after protests. Furthermore, with significant economic slowdown in China in 2022, where DZC (until October/November) is only one of the contributing factors and perhaps not the most important, university graduates have been facing high unemployment rate of 15—20%. As is the case elsewhere, young people are bearing the brunt of the economic turmoil.

In at least a dozen cities, people gathered in numbers from several hundred to several thousand, first to memorialize the victims of the Ürümqi fire and protest local execution of COVID-19 mitigation measures, often waving the Chinese national flag, singing the Chinese national anthem, Internationale, or other revolutionary songs. Some of them then shifted to protesting DZC in general (which was still sometimes extolled in state media), then on to making overtly political demands for free speech and free press. Some among the crowds at Shanghai and Chengdu were even chanting “Down with the CCP! Down with Xi Jinping!”, in front of ranks of police, which is pretty extraordinary.

Several thousand people protested at the Hanzheng Commercial Street in Wuhan, mostly small businessmen and service workers whose livelihoods have been deeply impacted by the recent lockdowns. They tore down the barricades that were restricting movement, marched down the street, brushing aside the police blockades that were trying to slow them down. Ultimately they had very specific grievances that they sought relief from the local government. I have a relative that runs a restaurant in another part of the city — she can attest to the difficulties the service industries have faced.

The Nature and Dynamics of the Protests *to Date*
Western media have understandably focused on the arresting scenes of the protestors chanting overtly political slogans, but that focus is distorting the overall picture. The numbers of protestors still pale in comparison to the populations of the cities, or even neighborhoods, where they were protesting. Protests are still concentrated in wealthier First and Second Tier cities.

The overwhelming majority of the protestors were targeting their ire against the socioeconomically disruptive wide area soft lockdowns and movement controls, or the regular mass screenings (tied to the restrictions on movement). A minority were targeting other surveillance state aspects of COVID-19 mitigation infrastructure, such as the various tracking QR codes. Those making explicitly political demands were a small minority even among protestors. The most political tend to be university students.

There is broad sympathy to the sentiments expressed by the protestors — nobody enjoys being under lockdown, soft or hard. Whatever the size of the active protest, there often is a crowd of curious onlookers who are generally supportive; people driving by would often honk horns in support. The overtly political chants have much less resonance. The Initium (Chinese language Hong Kong internet media that decamped to Singapore after the imposition of the National Security Law in 2021) has published a series of articles on the protests at Beijing and Shanghai, based on interviews with participants, that have shown this dynamic.

It is important to note that most people who protest against lockdowns are not necessarily against all other mitigation measures, that most people who are against DZC are not necessarily against the CCP regime, and that most people who have gripes against the CCP regime are not looking to overthrow it. There remains little appetite in China for a revolution.

The protests have been peaceful, and can be very savvy, especially for those making more political demands. The blank sheet of paper has become the most prominent symbol of the protests. People are waving Chinese flags, singing the Chinese national anthem and revolutionary songs. “Waving the red flag to oppose the red flag”, as Mao Zedong once said. There is a millennia long traditions among Chinese literati in employing the most oblique and yet cutting language to register their protest to power, and that tradition remains alive and well.

Given the sophisticated and ever present surveillance capabilities of the state, certainly on the university campuses and major thoroughfares where protests have taken place, those participating have no illusion (and should have no illusion) of remaining anonymous. People taking a stand, especially those being the most vocal and most demonstrative, are doing so on the record. That takes incredible bravery, or incredible naiveté. Perhaps both. It is very striking how young women are often at the center of these protests, in the campuses and on the streets.

The State Responses *to Date*
Very cautious so far. The police forces that respond to the protests are not in riot gear, and have tended to allow the protestors to chant to their hearts’ content. They have waited until well after midnight, for the protestors to dwindle, before attempt to disperse them. Minimal force has been employed to disperse the crowds, no tear gas or batons. They have used human chains to break the remaining crowds into smaller groups, and to push them away from protest areas. Some of the plainclothes have been rougher. A number of people have been detained, but a very small percentage of protestors.

There are several reasons for the so-far muted state response to the physical protests. The CCP regime has the world’s most extensive and sophisticated surveillance system at its disposal, and both the police and the Ministry of State Security can compel the APP platforms to share personal information in case of public security or state security events, which these protests would be, with no need for ‘backdoor’ tech searches. For small to moderate sized, relatively stationary protests, the authorities can capture images and videos of each protestor at leisure, for identification later. Chinese people tend to be very protective of their elders and their young. Arrogance by central leaders toward student protest leaders in 1989 was one of the reasons support for the students swelled in Spring of that year. So, both the police and university administrators are acting with restraint. They could afford to wait out the protests, and see if the they dissipate during the work week.

The protest at Shanghai on Ürümqi Road is on a stretch full of bars, cafés and restaurants frequented by expats, 500 meters away from the US Consulate. The protest at Beijing at Liangma Bridge is in the embassy district. Both had foreign media present. The CCP regime certainly does not want to have violence broadcast across the world. Xi is scheduled to meet a number of foreign dignitaries this week, and is scheduled to travel to the Middle East next week. He is also looking to stabilize relations with the US, the EU, Japan and South Korea, while enhancing relations with Southeast Asia and the Global South in general, after 3 years of absence of face to face diplomacy. Now is definitely not the time for bloodshed.

To those making specific demands against specific COVID-19 mitigation policies, local governments have been making rapid concessions. Ürümqi government suddenly announced that they have achieved zero community transmission, and is lifting the lockdown in phases. Given the still high reported numbers out of Xinjiang and the increasingly opaque data from there, I am very skeptical whether that is indeed the case. However, locals nonetheless are reporting things opening up over the weekend. Many residential compounds in Beijing have their soft lockdowns lifted.

The mayor of Wuhan met with representatives of protestors at Hanzheng Commercial Street, and promised to push through financial relief to the small businessmen (including rent holidays and waiver of fees), and was made to sign a pledge document listing the promises. Many locked down compounds in parts of Wuhan north of the Yangtze River are opening up. It seems local authorities, especially where there have been protests, are pivoting back to the letter of the “20 Rules”. The pivot is very uneven. Where we are in Wuhan, is still under soft lockdown, even though the reported cases here are far fewer than parts of the city that is opening up. Our area is full of white collar wage slaves and programmer drones, with a lot to lose, so residents here self-deprecatingly quip that we don’t have the guts to protest.

Most of the soft lockdowns are delivered by verbal command from district pandemic response commands to sub-districts, then relayed to community offices, so as to not violate the “20 Rules” admonishing against wide area lockdowns. However, community offices and sub-districts do not have the legal authority to impose lockdowns, and such lockdowns require official written command. Enterprising Beijing residents have resorted to calling the police to challenge the community offices for overstepping their authority. After reviewing the letters of the law and regulations, the police often agree with the residents, and order the community office lift the lockdown.

In the meantime, the control side of the regime’s apparatus is also kicking into high gear. Police have been reported stopping random passersby near sites of recent protest to examine if their mobile phones have encrypted communication apps such as Signal and Telegram (neither of which are secure in China), demanding the apps to be deleted, and taking down their personal information. Securities services are clearly monitoring discussions on social media (encrypted or otherwise) that are coordinating new protests, and gathering large presence at the planned locations to preempt the protests (not in riot gear, though).

University admins in Wuhan are asked to go to visit the students in dormitories for chats. While the chats are friendly, the purpose is to gauge student sentiments. Universities across the country are also offering students transportation to train stations and airports to return home early, and the Fall semester will likely end early as well. Many students will take up that offer, since being locked down on campus has been one of their top complaints to begin with. The purpose is to disperse the students so that any new protests are less likely to reach critical mass. My wife shared a video taken by one of her students, confront a few men who are clearly plainclothes police, loitering at night near the football field (potential site for demonstration). When challenged, the plainclothes cops acted at arrogant thugs, though the exchange was only verbal.

Indeed, things have been relatively quiet across China on Monday and Tuesday. Weather across northern China has also turned much colder and wetter in the past two days.

State media has been completely silent on the protests, and has been silent on the Ürümqi fire after initial coverage on 11/24 – 11/25. On social media, it is a battle royal between the censors and the netizens. Despite the CCP regime possessing the most extensive, technologically advanced and sophisticated internet censoring system in the world, the censors are being challenged. Chinese netizens are coming up with ever more ingenious ways to get the message out. The events are being discussed, albeit somewhat obliquely, in WeChat groups for family and work.

What Happens Going Forward?

COVID-19
DZC is truly over, in my opinion. Even if the state propaganda are still sincere (which I don’t think they are), DZC is no longer tenable, not with so much community transmission in dozens of cities across China, and with a substantial portion of the population no longer willing to be so compliant. That DZC was so successful in 2020 — 2021 is due to both organization capacity of the Chinese government at all levels, and a high degree of compliance by the population. The mishandled lockdowns in Xi’an and especially Shanghai greatly reduced the population’s enthusiasm for DZC, and many have reached the ends of their tolerance with the development in October/November.

It is, however, important to note that there are very different popular opinions in China with respect to DZC, opinions that are not being spotlighted in the current moment of protest. Most of my family, friends and colleagues are exhausted with the restrictions, but also fear rampant spread, especially for their children and elders. Not many people want lifting of all mitigation measures, as some of the protestors are advocating, but only the latter voices are magnified by western media. People in rural areas still strongly support DZC. There are many villages and townships that still have not registered a single positive case since the beginning of the pandemic. Rural population in China skews old and vulnerable. It is common to see villages with only the elderly and the pre-school young. The school aged children are off to boarding schools in the townships, while the able-bodied adults are off working in the cities.

Many commentators are suggesting that Xi may find it politically difficult to exit DZC, having staked his reputation and the CCP regime’s credibility to the strategy. I disagree: the writing has been on the wall since the “20 Rules” were rolled out when cases were rising and geographically dispersed. The protests against COVID-19 mitigation measures actually help the regime to pivot politically. All he needs to do is to give clear guidance that “20 Rules” are to be resolutely followed. Since the protests, I’m suddenly seeing interviews with renowned health care experts on Toutiao (Chinese news aggregator app), explaining that the latest variants are relative mild, the risk to most individuals is low, and that China will learn to “live with” the virus. State media is now showcasing attacks against parts of the DZC apparatus, such as prosecutions of fraudulent players in the massive PCR testing industry that has sprung up, as well as arrests of community workers that attempted to lock exits of buildings under lockdown. All subtle signs pointing toward opening. Perhaps it is the belated communication campaign.

The political challenge is in balancing the impossible desires by most of the population to loosen controls and not to have rampant spread. Some people are protesting to open up restrictions now. When the inevitable exit tsunami hits, other people (or some of the same people) will be protesting that the hospitals are full and their children and parents cannot be admitted. That is the corner the CCP regime is in. However, that is the corner it would always have been in whenever China exited DZC, whether it was Spring 2021, Spring 2022, or Spring 2023.

I am sure the Chinese government would have preferred a staged opening, accelerating after Mar. 2023, well after the Chines New Year migrations. Unfortunately, I do not think that is in the cards anymore. Instead, we will have an exit wave in winter, leading up to Chinese New Year, without recent booster shots for the population (one of the failings I wrote about in the previous guest post). It is the worst possible circumstances for the exit.

China’s ICU beds per capita is pretty good by middle income country standards, but worse than most of the developed world. However, before the ICU beds are full, the heath care resource likely to run out first are the medical workers, as they become infected and have to isolate, which we have already seen at Shijiazhuang in Hebei Province. ICU capacity is not something that can be dramatically increased in a few years, either, and the training of doctors and nurses take even longer than that.

What China will experience in the coming months will be familiar to those who have experienced exit waves of former ZC countries, or earlier waves in non-ZC countries. Healthcare system may be overwhelmed quickly, and there will be horror stories of people desperately ill with other diseases unable to receive medical care. The number of deaths may well be in the hundreds of thousands, excess mortality even higher. Many people will stay home for fear of infection. Factory workers will rush to their rural homes to care for their sick elderly parents and grandparents. The factory workers who remain will have to be isolated when they are infected.

I have not found many analysts who have come to grip to huge hit to the logistics and global supply chain, and to Chinese and world economies. From both public health and economic perspectives, the next few months will probably be terrible. I am sure some in the West will again call this the CCP’s “Chernobyl Moment”. While the Chinese government has made some grievous and befuddling errors, mainly with vaccination and public communication, there was nothing it could have done to avoid an exit wave. Since a truly very mild variant did not emerge, none of the current vaccines are good at blocking transmission, and there are no silver bullet therapeutics, then a massive exit wave is unavoidable, with or without imported mRNA vaccines, even if China had magically doubled ICU capacity over the past year.

At least the pain period will be short, given the transmissivity of the latest Omicron variants (possibly the most transmissive virus ever?), possibly shorter than the exit waves experienced by South Korea, Hong Kong and Taiwan.

The only glimmer of relief is the possibility that the current variants are indeed milder than BA.1/2/5. The BA.2 outbreak in Shanghai saw hundreds of thousands of reported infections, many thousands of reported serious/critical cases, and hundreds of reported deaths. On the other hand, the current wave across the country has registered over half a million cases in a month, yet the count of active severe/critical cases have consistently remained < 150. Only 7 reported deaths in this wave so far. Of course, that was the trend in Shanghai early on, as well, but deaths started to climb after several weeks. Still, Guangzhou has not recorded a single severe/critical case, despite adding over a hundred thousand cases in the current wave. (Given the current social media environment, if a person was diagnosed with severe/critical COVID-19 and later died, but was not recorded as a COVID-19 death, the family would make a stink.) In any case, if the government is under-reporting serious/critical cases and deaths, then that makes it more difficult to justified continued restrictions, and points toward preparing the population for further opening. We have not heard any reports of hospitals running out of ICU beds in any of the cities seeing sustained sizable outbreaks, even the third/fourth tier cities with less resources. I suppose we shall have to see. As SARS-CoV-2 wash across 1.4B Chinese for the first time, we may find new variants emerging. Politics and Geopolitics
It is impossible to predict how things will evolve in China in the coming weeks, months and years. On the one hand, the Arab Spring was sparked by a fruit vendor getting beaten up in the streets of Tunis. On the other hand, it is hard to see how the current wave of protests will force significant change, in face of such lopsided advantage enjoyed by the CCP regime.

A few things to keep in mind: 1) the massive urban protests in 1989 were preceded by smaller nationwide student protests in the mid to late 80s, and 1989 saw months of nationwide protests before events culminated in violent tragedy on 6/4; 2) while protests are actually pretty common in China, this is the first nationwide protest movement focused on a common grievance, and thus a challenge the CPC regime has not faced in decades; 3) this is the first reemergence of political and civic expression in Chinese society in quite some time. The protests have yet to have the opportunity to coalesce into a true movement (there was another opportunity at the beginning of the pandemic, but it was snuffed out by later developments in China and the world).

A few more things to keep in mind: First, there is still very little appetite in China for courses of actions that might bring instability and threaten the wealth and comfort most people have accumulated into preceding decades. A lot of people have a lot to lose, it’s not a situation where a lot of people have nothing to lose. Second, while the younger generation at the forefront of protests lean toward political liberalization, they are also quite nationalistic; they are proud of China’s economic development and technological advancement, they are largely supportive of China’s assertive foreign policy and Taiwan policy, and they are sick of sanctimony from the West. Third, the CCP regime has become very practiced at monitoring, channeling, suppressing, and just as importantly accommodating / addressing popular discontent.

Managing the consequences of the exit wave remains the big wild card for the regime in the short term, and the great power competition with the US the big wild card in the longer term.

Since the Reform and Opening of the late 1970s, the CCP regime has drawn legitimacy from delivering development — “performance legitimacy”. As economic growth slows, performance legitimacy becomes more difficult to sustain. Xi and the CCP leadership saw this development coming in the early aughts, hence the pivot to nationalism, ideology (as in increasing the relevance of the CCP in people’s lives) and “Common Prosperity” in the mid to late aughts. Regime legitimacy took a blow at the beginning of the pandemic, due to the mismanaged Wuhan outbreak, but it quickly recovered (and indeed strengthened) after China eliminated the domestic outbreak while the rest of the world succumbed. Mismanaging the exit from DZC could again threaten regime legitimacy, while structural economic headwinds continue to erode performance legitimacy. The years ahead will see slower economic growth, as China tries to pivot from real estate and infrastructure investment to consumption led growth, and that transition will be years-long and tricky to manage. Popular content will continue to build up, constantly seeking outlet. The CCP regime will have to find alternative sources of legitimacy, such as restoring the environment, continued technological advances, reducing the wealth gap, and minimizing the impacts of Climate Change. Nationalism alone as the source is brittle.

On the other hand, heightened great power competition could cause most of the Chinese population to circle the wagons around the CCP regime. Whether the Biden Administration says so or not, whether it believes it or not, the semiconductor restrictions announced on 10/7 is widely interpreted (including by US-based China analysts) as technological and economic warfare, aiming to limit China’s economic development by restricting its access to advanced technology. The CCP regime has yet to hype the threat in domestic propaganda, but it could play that card at any time. All those young people protesting now, who are so proud of China’s technological advancement, will view the US actions as hostile, and will likely respond with equal hostility. The White House has so far responded sensibly, but I have little confidence members of Congress (Democrat or Republican) can have the same discipline, and refrain from inserting themselves into the story to vie for the limelight.

In the immediate short term, we shall have to see if protests resume and regain momentum in the coming weekend and following weeks. If they peter out, we’ll see if they reemerge in the coming months and years, with greater force and better organization each time.

Closing Thoughts

Naomi Wu has said that China could not lose compared to the rest of the world when it comes of DZC, and she is in large measure right. No matter what happens now, the vast majority of people in China experienced 2 years of normal life while the rest of the world was in turmoil; people in China will always have fewer cumulative infections than people in the rest of the world. The vast majority of Chinese will face their first infection with 2 or 3 vaccine shots, and with a milder variant than Delta. The intense pain of the exit wave will be shorter than the rest of the world has experienced, certainly shorter than without DZC. China is now well equipment to handle the emergence of the next pandemic, may even be able to contain it to within its borders should it emerge here again. You can bet there will be massive investment into health care in the future, just like after SARS in 2003. Exit from DZC was always going to be messy, though the Chinese government certainly could have made it somewhat less messy with a more sensible vaccination strategy and better public communication (something it typically does not deign to do). If the latest variants do prove to be the mildest Omicron, then perhaps Xi Jinping can plausibly claim victory’s after all.

Recent events, and going back to the beginning of the pandemic as well, have shown that the CCP regime is more fragile than its propaganda (or the people hyping the “China Threat” in the US) portray, but also more resilient than is often appreciated. Whether the fragility or resilience continue to have the advantage going forward is anyone’s guess.

I wrote in my previous guest post that I find the China discourse in the US sorely lacking in nuance. I tend to write long missives because I strongly believe in getting the analysis right (or as “right” as I can given the limitations of my knowledge and expertise), and recognizing the limitations of one’s analysis. Graham Webster at Stanford (who studies digital governance in China) once said on Twitter: Whatever one thinks of the nature of the China threat/challenge, it is critical to get the analysis right to respond appropriately and effectively. To do that, one needs to get the details right and appreciate the nuances.

The US has gotten the China analysis wrong often in the past decades, often remarkably so during Trump and Biden years. Unfortunately, I see little sign that US politicians, policymakers or media particularly care to get the China analysis right; they are wedded to their self-comforting narratives and memes.

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COVID-19 Coronavirus Updates: Monday / Tuesday, Nov. 21-22Post + Comments (22)

"When Republicans take control of the House of Representatives .. they’ve made it clear that probing President Biden’s response to the pandemic will be their top priority. Holding the majority gives them new powers to subpoena officials." – @rachelcohrshttps://t.co/MrX0Z1pZu3

— Martin Kulldorff (@MartinKulldorff) November 18, 2022

… Republicans across the country campaigned on anti-science rhetoric, lobbing intense criticism of the Biden administration’s vaccine and mask mandates and its spending on the pandemic response.

Rep. Cathy McMorris Rodgers (R-Wash.), who is set to chair the Energy and Commerce Committee, has signaled particular interest in probing the origins of the pandemic, along with research funded by the National Institutes of Health, and remote schooling recommendations.

After his vilification on the campaign trail, National Institute of Allergy and Infectious Diseases Director Anthony Fauci could be another target, and health officials including health secretary Xavier Becerra, and Centers for Medicare and Medicaid Services administrator Chiquita Brooks-LaSure could also face more heat from the House in oversight hearings…

House Republicans’ power will be limited, however, now that Democrats managed to retain control of the Senate. Divided government will force Republicans to focus more on oversight and bipartisan bargaining than they might have otherwise.

It will be a radical change from House Democrats’ approach to the pandemic. During their four-year tenure in control, they unilaterally passed billions of dollars in Covid-19 relief funding, backed Biden administration officials, and broadly supported more public health spending…

Another #coronavirus wave could be coming. Here’s how to factor #Covid into your holiday plans. It's our 3rd #pandemic winter & some experts say you can mitigate risk without missing out https://t.co/Do9RlyR7mf

— delthia ricks 🔬 (@DelthiaRicks) November 16, 2022

As he faces the possibility of increased scrutiny from what is likely to be a Republican-controlled House, Anthony Fauci on Tuesday signaled he is willing to go to the mat to justify the government’s response to the Covid-19 pandemic and viral research programs.

“I’d be more than happy to discuss anything that we’ve done over the last several years with this outbreak, since I have nothing to hide and I can defend everything we’ve done,” Fauci said at the annual STAT Summit…

Branswell asked Fauci, 81, who has led the National Institute of Allergy and Infectious Diseases for nearly four decades, if there was something he could have done differently early in the pandemic to avoid being cast as a political figure.

Fauci, without naming former President Donald Trump in the answer, said that couldn’t be avoided once he challenged Trump and other administration officials who undersold the threat from SARS-CoV-2 or who hyped therapies like hydroxychloroquine even after multiple studies showed they didn’t work.

“I had to, I didn’t like the idea, but I had to, to preserve my own scientific and personal integrity and to fulfill my obligation, which is not to any president, which is not to any party, it’s to the American public, so I had to do something that was very uncomfortable — to publicly disagree with and contradict the president of the United States,” Fauci said. “When he says this drug is a wonder drug, and it isn’t, or this virus is going to disappear like magic when it’s not.

“That triggered such a pushback on the part of the extremists that I became public enemy No. 1,” Fauci continued. “I didn’t decide and wake up one day, ‘I think I’m going to be public enemy No. 1.’ But I had a choice, I could either go with the flow of misinformation or push back. I pushed back, and now I’m in the position I’m in where I have to have federal agents guarding me because people want to kill me.”…

“I welcome oversight,” Fauci said. “I have no problem with oversight. I’ve testified before Congress literally without hyperbole hundreds of times over the last 38 years, and I think the oversight process is a very healthy part of the government.”…

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COVID-19 Coronavirus Updates: Thursday / Friday, Nov. 17-18Post + Comments (21)