Why China is not abandoning its “zero Covid” strategy despite public protest

Why China is not abandoning its

After Shanghai, will Beijing in turn be put under glass? Since March, China has been battling an outbreak of Covid-19 linked to the Omicron variant of SARS-CoV-2 in at least 17 of its regions. Authorities reported 11,285 new cases on Thursday, April 28, including 9,791 asymptomatic cases. High figures for a country that aims for “zero contamination”. In Beijingmore than a hundred positive cases have been identified since the week of April 18, including 50 on Wednesday alone, and Beijingers fear that they will in turn suffer drastic confinement.

Since the discovery of the virus at the end of 2019 in Wuhan, the central power has applied a “zero Covid” strategy defined by the triptych “test, trace, isolate”. VSThis policy aims to prevent the circulation of the virus at all costs by identifying and isolating infected people as quickly as possible. Australia and New Zealand relied on this approach for a time, before abandoning it in the fall of 2021, overwhelmed by the progress of the Delta variant.

Today, most countries in the world have chosen to live with the virus, but China continues to impose confinement on millions of people in sometimes very harsh circumstances. “Perseverance will bring victory, hammered Xi Jinping on April 14. We must respect scientific rigor, the zero Covid strategy.” Because despite its increasingly high cost, this health battle is also political for the Chinese president.

Until the appearance of the Omicron variant, the “zero Covid” strategy allowed China to avoid a confinement of the whole country. By means of localized confinements, massive tests and isolation of the sick, Beijing has limited its total death toll to less than 5,000 deaths and 200,000 cases since the start of the epidemic in late 2019, according to official figures. who do not integrate the asymptomatic and remain much lower than international estimates.

But regarding vaccination, disparities exist within the population. According to data from Our World in Data*, 1.25 billion inhabitants have a complete vaccination schedule, ie 88% of the population, but the vaccination rate remains low among the oldest. By March 18, only 51% of those over 80 had received two doses and 20% had received a third dose, according to China’s National Health Commission, cited by The World (paid article). In Shanghai, authorities said on April 19 that two-thirds of those over 60 had received two injections and less than 40% had received a booster dose.

“‘Covid Zero’ doesn’t discriminate between severe and mild infections, which is why China hasn’t prioritized vaccinating the elderly.”

Yanzhong Huang, health policy specialist in China

in “The Lancet”

“The central government has favored the vaccination of people who work and travel, rather than that of vulnerable populations”, adds to franceinfo Valérie Niquet, China specialist at the Foundation for Strategic Research. Gold, the Chinese health system is ill-suited to these populations, who have more difficulty getting around or getting information, because most of the care is done in the hospital. “The vaccination rate is correct in the city, but in the countryside, we have very little information”continues Valerie Niquet.

The elderly population is also more reluctant to get vaccinated because of unfounded rumors that vaccines have adverse effects for them. “Many therefore refuse vaccination, especially since the belief in the virtues of traditional Chinese medicine is very strong in these age groups”analyzes epidemiologist Antoine Flahault with The Express.

The question of the Vaccination is all the more important as the only vaccines available in the country – the Chinese vaccines Sinovac and Sinopharm with inactivated virus – are less effective than those with messenger RNA, in particular against the Omicron variant and its BA.2 sub-variant.

According to an article in the scientific journal The Lancet* published on April 20, the phase 3 trial of the Sinopharm vaccine showed that two doses were 79% effective against symptomatic infection and Sinovac was 51% effective. In comparison, the Pfizer-BioNTech mRNA vaccine is 95% effective against symptomatic infection, notes the WHO. This relative effectiveness led French nationals in China in March to ask Paris for the emergency dispatch of mRNA vaccines to protect themselves.

Despite the situation, the central government does not intend to import Pfizer or Moderna mRNA vaccines for the time being. “Beijing wants to show that it is powerful and organized enough to manage the epidemic on its own”explains to franceinfo Jean-Louis Rocca, professor at Sciences Po and specialist in China.

“Maintaining the ‘zero Covid’ strategy is a question of political legitimacy with the population and of competition with foreign countries, in particular the United States.”

Jean-Louis Rocca, China specialist

at franceinfo

For the past two years, Chinese state media have been spreading propaganda about the West’s failures to deal with the virus’s circulation and instead praising China’s successes..

Does China even have the means to change policy and let the virus surge? By preventing almost any contamination since the start of the epidemic, the authorities have not allowed immunity to develop within the population. They fear finding themselves in a similar situation in Hong Kong, which is facing a devastating fifth wave since the emergence of the Omicron variant, despite its “zero Covid” strategy.

“China doesn’t have much of a choice. If it relaxes its restrictions, there will inevitably be a huge number of infections and deaths,” warns in The Lancet* Zhengming Chen, professor of epidemiology at Oxford University. For example, if the current death rates in Hong Kong were applied to the Chinese population, there would be more than 50,000 deaths a day in China, illustrates the Sunday newspaper (paid article).

An untenable situation for the Chinese health system, already saturated and characterized by very strong disparities. If the cities have large hospitals with doctors and resources, the countryside lacks centers and caregivers. In January, an eight-month-pregnant woman miscarried after being refused entry to a hospital in Xi’an (north), because she did not have a valid screening test. In a video* that went viral in April, but censored by the government, residents denounced the refusal to take care of non-Covid patients, for lack of space.

“The Chinese health system is unable to absorb the current epidemic. This is one of the reasons for the continuation of the ‘zero Covid’ policy.”

Mary-Françoise Renard, economist specializing in China

at franceinfo

Other voices have been raised against the “zero Covid” approach. Zhong Nanshan, the Chinese epidemiologist who received the Republic Medal from Xi Jinping in 2020 for his role in the fight against Covid-19, is now censored after he wrote that this strategy was not sustainable in the long term.

In a article published in the journal Nature*, chinese scientistss suggest developing remote consultations for milder infections and stocking more masks, gowns and respirators in community hospitals. An approach which, according to them, would make it possible to change trajectory by “April and May 2022”.

To date, it is unlikely that they will be heard by Beijing. China has been facing a slowdown in its economy since the beginning of the year caused by quarantine measures, and Xi Jinping has made economic recovery his priority. According to the American daily Wall Street Journal*the Chinese president has ordered his administration to ensure that the country’s growth will outpace that of the United States this year.

China intends to achieve GDP growth of 5.5% in 2022. Such a performance would allow Beijing to confirm the superiority of its model over that of Western-style democracy. But with the confinement of Shanghai, the economic engine of the country, and previously of the technological metropolis of Shenzhen, this objective seems increasingly hypothetical. “The economic situation is bad, transport is blocked, factories shut down, construction sites closed”, describes the researcher Jean-François Rocca.

“The legitimacy of the Communist Party is based on its ability to protect the population and ensure a good standard of living. With ‘zero Covid’, there is a contradiction between protection and prosperity.”

Jean-Francois Rocca

at franceinfo

Recognizing a failure in this strategy would mean that the Party is no longer the best possible government. An inconceivable admission, especially since the 20th Communist Party Congress is due to take place in the fall and Xi Jinping is playing for re-election. Relaxing containment measures, at the risk of facing a murderous wave, would severely weaken the outgoing president. For Jean-François Rocca, Beijing now faces “a turning point for his public policies, but also for his regime.”

* All links followed by an asterisk point to content in English.