Can China’s zero-COVID policy succeed?

A man in blue medical scrubs and mask talks to residents from outside of a Shanghai apartment building using a white megaphone.
Chen Jianli/Xinhua via AP
In this photo released by China’s Xinhua News Agency, a volunteer uses a megaphone to talk to residents at an apartment building in Shanghai, China, Tuesday, April 12, 2022. Shanghai has released more than 6,000 more people from medical observation amid a COVID-19 outbreak, the government said Wednesday, but moves to further ease the lockdown on China’s largest city appeared to have stalled.

China has stated a zero-COVID policy to address the COVID-19 pandemic within the country. This means that the Chinese government is willing to impose any actions necessary (widespread testing, contact tracing, vaccination, isolation) to eradicate the virus that causes COVID-19, effectively working to eliminate it from the country.  As a result, it has locked down several areas, including Beijing and Shanghai, to stop the spread of the virus and bring new cases down to zero. They have reported a significant drop in the number of new cases within the quarantined area, and no new cases outside of it. China’s President Xi Jinping has reiterated his commitment to a zero-COVID policy, despite criticism and resistance. 

Is such a policy optimal? Is it even feasible, given the contagiousness of the constantly evolving omicron variant, even in a country like China with an authoritarian political system? 

After over two years of SARS-CoV2 virus spreading across the globe, with new variants emerging unpredictably, containing the virus has proven futile at best and simply impossible at worst. Mitigation strategies have proven to be effective in suppressing virus transmission, but once relaxed, case counts rebound. In the United States, we are nearing 1 million COVID-19 deaths reported to the Centers for Disease Control and Prevention (CDC), something that would have been considered unthinkable back in March 2020. 

A zero-COVID policy has too many unintended consequences to be optimal, and too many defects to be feasible. Here are some of them: 

Unintended consequences

One thing that the United States learned during the early part of the pandemic is that focusing solely on stopping the virus may be too narrow to be effective. Stay-at-home orders, which were designed to keep people separated to suppress virus transmission led to other undesirable consequences. For example, during the first year of the pandemic, drug overdoses and automobile fatalities surged. Mental health issues also increased. Although no one can establish with certainty the causality of such negative outcomes, the fact that they occurred simultaneously is disturbing.    

Global economy 

A global economy means that goods and services are delivered across borders. No matter how tightly China attempts to shut down cities and area, there will be viral leakage that will keep transmission alive. Moreover, the economic consequences of shutting down such areas impacts not only China, but other parts of the world that rely on products from China.   

Global supply chains exist because of the economic advantages they offer. They are, however, less robust and more susceptible to disruptions when any one or more critical links are broken. China, and the countries that rely on China for products, will be subject to global supply chain risks as shutdowns continue and mount. How this will impact the global economy remains to be seen. Given that global inflation is hitting 20-year highs, the complexity of the global supply chain makes it highly unpredictable, adding a new uncertainty into an already fragile network.   

Endemic phase

The virus appears to be transitioning from a pandemic into an endemic phase in the United States. Tools like vaccines, effective therapeutics, natural immunity, face masks and enhanced ventilation appear to be providing protections to moderate hospitalizations and keep deaths rates down, even as case counts continue to climb, with the seven-day moving average close to tripling since it reached a low in late-March 2022. Precautions continue to be necessary for the most vulnerable, like those over 50 years old and the immunocompromised. These precautions are also highly desirable for everyone else whose altruism drives them to contribute to the public good and limit transmission. Improved vaccines and therapeutics will continue to emerge to keep people safe, while allowing society to function in a manner that supports everyone’s well-being.       

Putting blinders on and focusing solely on stopping the spread of the virus sounds good in theory, but its feasibility is questionable, and its practical implications may be undesirable. In a world economy with global travel and commerce, seeking a zero-COVID policy appears naïve.   

At some point, China may recognize the limitations of a zero-COVID policy, and work toward a strategy that is feasible and supports the well-being of its people and its global partners. As we have learned in the United States, the virus has no politics and obeys no government orders. Until this is realized in China, it will continue to conduct a massive public health experiment for the world to observe and learn from.   

Sheldon H. Jacobson, Ph.D., is a founder professor of Computer Science at the University of Illinois at Urbana-Champaign. He applies his expertise in data-driven risk-based decision-making to evaluate and inform public policy. 

Tags China COVID COVID-19 endemic Pandemic Sheldon H. Jacobson Xi Jinping

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