Civil disobedience virus. As China cancels lockdowns amid protests, the nation faces risk of epidemic

The pitfalls of lifting Covid restrictions

On December 7, a new nationwide easing of the Zero-COVID policy was announced. Citizens with a mild or asymptomatic course of Covid could now self-isolate at home instead of in special quarantine centers. Chinese residents no longer have to present a negative test result to travel between provinces. Also, those shopping for cold medicine no longer have to give their name and registration address, which were used to track potential cases of infection. Lockdowns will be limited to five consecutive days, which is a significant reduction from the 100-day quarantine in Urumqi, for one, and should be more specialized. On December 13, Chinese authorities stopped using the long-distance passenger tracking app, which was introduced in 2020.

Meanwhile, the Chinese government has repeatedly stressed the danger of new virus variants and their high level of contagiousness. Despite all the relaxations, the authorities are still not ready to completely abandon the Zero-COVID policy, and the restrictions may still be reintroduced.

The response of the general public and experts to their cancellation has been varying. On the one hand, the Chinese are happy about the success of the protests and the easing of the Covid restriction; on the other hand, they call on the authorities to take responsibility for those who suffered and died because of them:

“This is a definite victory for the protesters. But we still don't know the names of the 27 who died in the bus accident, or the 10 who died in the Urumqi fire, or all the many who died because they couldn't get treatment or committed suicide (because of the lockdown).”

The Chinese bureaucracy does not have time to adjust to sudden changes in anti-coronavirus measures. Thus, according to a Beijing resident, there are huge lines for Covid shots:

“Since we no longer have to present tests in many establishments, the number of testing sites has plummeted. However, you still need a 48-hour test to go to the supermarket. As a result, we now have to stand in even longer lines. I stood in the cold for more than two hours but never got the result, so I still haven't done my grocery shopping.”

Experts fear that an unplanned departure from the Zero-COVID policy, combined with low vaccination rates, will lead to a spike in infections because the Chinese healthcare system is not prepared for this turn. This makes a dramatic increase in Covid mortality almost inevitable. Yale University public health expert Xi Chen warns:

“Reopening too soon will crowd out resources, crush the medical system, and cause more deaths.”

Xi Chen's opinion is shared by some of his colleagues. For example, Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations in New York, believes that China is not ready for a complete repeal of the measures:

“(Is China prepared?) If you look at surge capacity three years on and the stockpiling of effective antivirals – no. If you talk about the triage procedures – they are not strictly enforced – and if you talk about the vaccination rate for the elderly, especially those aged 80 and older, it is also overall no.”

According to a model developed by a group of scientists from Shanghai and published in Nature last May, China's abrupt departure from the Zero-COVID policy without additional measures will cause the epidemic of Omicron and other Covid variants to overwhelm the PRC's medical system, with the shortage of ventilators once again presenting a challenge. The study suggests that the demand for ventilators would exceed the available stock fifteen-fold:

«Should an Omicron variant epidemic be allowed to spread uncontrolled in mainland China, we project 1.10 deaths per 1,000 inhabitants over a six-month period. By comparison, 187,372 deaths have been reported in the United States38 (that is, 0.57 deaths per 1,000 inhabitants) over the period from 15 December 2021 to 15 April 2022, roughly corresponding to the Omicron wave.”

The rise of a new infections wave may already have begun, considering that Covid clinics in major Chinese cities have been getting sixteen times the usual number of visitors in the last week. The rigid Zero-COVID policy has created many risks for the population: social, economic, and directly related to public health. The overemphasis on compliance with these measures has resulted in a dependency on them and vaccination deficiency. Therefore, abolishing restrictions will almost inevitably trigger yet another crisis.