After preventing large-scale outbreaks in the first year of the pandemic, the Chinese mainland reported its highest number of daily new local COVID-19 infections last month. With a daily caseload of over 1,800, it was evident that the old formula could not counter the changing circumstances. Similarly, Hong Kong, the financial hub that China claims to be part of its own territory, reported the world’s highest number of deaths per capita in the same month, with more than 200 deaths per day.
This is despite both regions following one of the world’s strictest lockdowns. China’s zero-COVID strategy is characterised by maximum suppression methods and accompanied by an alert-level plan that includes restrictions on social gatherings and bringing home Chinese citizens from abroad, cancelling the visas of all foreign nationals, and, when necessary, stringent stay-at-home orders.
However, even these severe measures have failed to prevent the Asian giant from becoming a hotspot for active, symptomatic cases. The extreme policy has been met with concern internationally, with scientists arguing that the zero-COVID approach may not work and is only further straining the lives of locals.
A vast majority of the Covid-19 deaths in Hong Kong - which has one of the highest known pandemic fatalities in the world - occurred during the fifth-wave outbreak. Photo: GovHK. pic.twitter.com/UvKsehsKhB
— Hong Kong Free Press HKFP (@hkfp) March 31, 2022
In contrast, Western countries that have similar access to vaccines have reported lower infection and death rates and have been able to exercise more liberal social restriction policies. However, while cracks in the policy are beginning to show, why has Beijing refused to change course?
A primary reason for the lack of change is believed to be President Xi Jinping’s re-election bid at the 20th Party Congress later this year. Xi utilised last year’s party congress to rally for a third term as leader of the Chinese Communist Party after having previously abolished term limits in 2018. Counted among a handful of the most influential leaders in the nation’s history, in 2016, Xi was named a “core leader.” The coveted title has previously only been conferred on Mao Zedong, Deng Xiaoping, and Jiang Zemin. Moreover, Xi’s political ideology, Xi Jinping Thought, was also enshrined in the party’s charter in 2017, putting him at least on par with Mao and Deng in terms of the legacy he will leave behind.
Crucially, competency in handling the pandemic has become a key test for leaders around the world. Therefore, Xi is unlikely to change course on the current COVID-19 containment strategy, as it is inherently a risk that could damage his legacy and although highly unlikely, perhaps even undermine his bid to be re-elected. In fact, his strategy is seen by many as a sign of good governance and a prioritisation of public health.
Moreover, China was the only major economy to have reported growth while the majority of the world suffered economic lag. In 2021, China’s economy grew by a record 18.3% in the first quarter compared to the same quarter last year. This was the biggest jump in its gross domestic product since the country started keeping quarterly records in 1992. Similarly, despite battling the burgeoning Omicron cases this year, Goldman Sachs has forecasted that China’s economic growth in 2022 will be 4.3%.
Therefore, stepping away from an overly cautious strategy that has not significantly curtailed growth and may even have protected it would endanger the economic stability that Xi has sought to engender during these tumultuous times. A new wave of self-isolation would lead to even more acute labour shortages and supply chain disruptions than the current strategy has caused.
China’s Communist Party raised Xi Jinping to the official stature of Mao Zedong, paving the way for him to claim a third five-year term as the country’s leader. An intense propaganda campaign is sure to follow. https://t.co/014sVcJyEr pic.twitter.com/2zE64AbqRx
— The New York Times (@nytimes) November 11, 2021
China has asserted that the benefits of its repressive strategy are further validated by empirical studies. According to a study carried out by the Peking University, if China took inspiration from Western governments and adopted their hybrid strategies, it could experience a “colossal outbreak,” possibly recording more than 630,000 infections and 22,000 severe cases per day. Researchers argue that daily deaths could also possibly spike up to the hundreds or even the thousands.
To put things in context, the East Asia Forum compared China’s COVID-19 statistics with that of the United States (US). In the US, COVID-19 has killed over 900,000 people in a population of 330 million. During this time, the government followed a mixed strategy of liberal policies as well as lockdowns. In contrast, if the same strategy would have been applied to China, a country that is home to 1.45 billion people, it could have resulted in the deaths of more than 4 million people. In this respect, while the zero-COVID strategy has been inconvenient for citizens, it has also helped prevent a major public health catastrophe and offers a sense of what is at stake aside from just Xi’s legacy and re-election.
The government has been injecting money to expand the country’s medical infrastructure and capacity since the onset of the Wuhan outbreak. In 2020, it invested $7.2 billion in the public health system. But as the pandemic enters its third year and Omicron cases continue to multiply, China continues to face the challenge of uneven distribution of medical resources across its vast territory. In this respect, a significant spike in cases could overwhelm the country’s health infrastructure.
Aside from concerns over the capacity of public health infrastructure, the government has also essentially admitted to the ineffectiveness of the Sinovac and Sinopharm inactivated virus vaccines. In fact, the chief of the Chinese Center for Disease Control and Prevention, George Gao, admitted last year that the efficacy of Chinese COVID-19 vaccines is “not high,” especially when compared to mRNA vaccines like those produced by Moderna and Pfizer. Although the World Health Organization (WHO) has granted emergency use approval for both the Sinovac and Sinopharm vaccines, it has said that the Sinovac jab prevents symptomatic disease in just 51% of patients. Furthermore, a study conducted by Chinese researchers showed that the Sinopharm booster shot has “significantly lower” neutralising activity against the Omicron variant. According to the WHO, Sinopharm has an efficacy of 79% against symptomatic infection 14 or more days after the second dose, while its efficacy against hospitalization is 79%. In comparison, mRNA vaccines such as those from Pfizer and Moderna have an efficacy rate of 94% or higher.
Delivery of six mobile cabin hospitals 🏥, provided by the Chinese mainland, has taken place in #HongKong. The cabin hospitals will provide a boost to the region's battle against COVID-19. They will serve as temporary isolation and treatment facilities. pic.twitter.com/58YBxOn5Ee
— Chinese Embassy in Switzerland (@ChinaEmbinCH) March 26, 2022
The continuity of this strategy is helped in no small part by the absence of significant public disapproval. Although social media posts and anecdotal reports indicate that discontent is creeping into the local population, a handful of independent opinion polls published since 2020 suggest otherwise. Annual data collected for China in the 2022 Edelman Trust Barometer found that China’s zero-COVID policy has also coincided with increased public support for the government. Trust in Xi’s government increased by 9%, bringing it up to 91%. Mirroring the trend, the public’s trust in the country’s national health authorities rose by 12% to 93%.
These results also reinforce the findings of a study conducted by the University of California San Diego study back in July 2020, wherein researchers determined that urban Chinese citizens’ average trust in the government—on a scale of one to ten—grew from 8.23 in June 2019 to 8.87 in May 2020. In addition, the share of those who “preferred living under China’s political system as compared to others” climbed from 70% to 83%.
3. China relied exclusively on Sinovac and Sinopharm vaccines; there is a substantial gap of 1- and 2-dose protection vs Omicron deaths compared with an mRNA vaccine. This evens out with a booster shot pic.twitter.com/VfP93kW9IL
— Eric Topol (@EricTopol) March 29, 2022
Therefore, given the implications for Xi’s political legacy and economic stability, the potentially disastrous public health consequences, and the seemingly unbreakable public trust, is unlikely that the Chinese government will abandon its controversial zero-COVID approach. If any relaxation is to be considered, it certainly will not take place before the 20th Party Congress in the last quarter of 2022, when Xi is essentially guaranteed to be re-elected as the General Secretary of the Chinese Communist Party, the highest office in the country. Another turning point could be the introduction of a homegrown mRNA vaccine, a goal that is now nearing completion. Ultimately, what is clear is that China’s zero-COVID strategy is here to stay for some time yet.