In September 2020, President Xi Jinping awarded medals to heroes of China’s battle against the coronavirus and said his handling of the pandemic had, once again, proven the superiority of Beijing’s political system.
Just over two years later and far from overcoming the pandemic, China is suffering from record cases and lockdowns, its Covid-19 policy is confused and it has no clear path out given low rates of vaccination of the elderly and their health care vulnerabilities.
With the growing economic and social costs of conflicting policy guidelines, Beijing must establish explicit criteria for reopening based on vaccination coverage and the availability of intensive care units to handle an inevitable wave of case discharge, according to lead researcher Yu Jie. at Chatham House, a UK think tank.
Ultimately, such conditions must be put in place, she said, because it is no longer just a matter of public health, it is an economic matter.
Vaccinations against the coronavirus are one of Xi’s main challenges. According to the latest official data, a third of the 267 million people over the age of 60 in China have not received their third dose of the vaccine. The booster is needed to achieve high levels of protection against the Omicron variant.
A big problem is China’s culture, which is more risk averse than many other countries when it comes to diseases and vaccines, said Xinran Andy Chen, an analyst at Chinese consultancy Trivium.
While a relatively high rate of vaccine hesitancy among China’s elderly population predates the pandemic, the problem has been exacerbated by official messaging about the dangers of Covid over the past two and a half years.
Despite the Communist parties’ enormous powers of social control, ordering the elderly to get vaccinated is seen as a step too far, even for Xi, lest it spark dramatic social resistance.
They don’t want to impose a vaccine mandate [but] they can’t afford old people to die. That’s why strict Covid controls are still in place, Chen said.
This month, Xi attempted to ease zero-Covid restrictions. The State Council, China’s cabinet, has reduced quarantine periods and halted second-degree close contact tracing of confirmed positive cases. The measures were also aimed at easing pressure on the centralized quarantine system which now houses more than a million people.
However, Ernan Cui, an analyst with Beijing research group Gavekal, said the attempt to stabilize the economy had only created widespread political uncertainty and made the pandemic even harder to control.
A Beijing-based government adviser close to the Chinese Center for Disease Control and Prevention said the timing of the opening depended on better quality vaccines being produced and released on a large scale.
He highlighted more than a dozen new vaccines, including six using mRNA technology, in development. Beijing, however, cannot tolerate a 0.2% death rate for cases as seen in Taiwan and authorities will not rule out a return to Shanghai-style citywide lockdowns if epidemics are considered uncontrollable.
There’s no way we can open up right now, he said.
Experts believe that major vaccines made in China provide high levels of protection against serious illness and death with three doses. But they are less effective and disappear faster than the mRNA technology developed by BioNTech/Pfizer and Moderna, which are used throughout the west. The Chinese are also not tested in the event of a massive epidemic.
Chen, from Trivium, added that the Chinese government believes the benefits of foreign-made vaccines are outweighed by the political and economic risks.
From Beijing’s perspective, the cost of losing national pride, the cost of losing market share to a foreign competitor, is far greater than using a marginally better vaccine that doesn’t isn’t 100% effective at preventing infection, he said.
This despite the enormous economic pain. China’s growth has slowed to its lowest rate in decades, while youth unemployment has hit a record 20% as relentless lockdowns undermine consumer demand and hamper manufacturing.
As case numbers soar, there are growing signs of a central response in cities across China, meaning a return to mass testing and quarantine.
In one example, following an inspection this week of the southwestern megacity of Chongqing, Vice Premier Sun Chunlan, who is primarily responsible for carrying out Xi’s zero Covid, ordered officials to eliminate all community transmission within eight days.
That goal, a local official said, was impossible to achieve, meaning the situation risked mirroring events in Shanghai this spring when an initial two-day lockdown persisted for two months.
Another challenge for China to change course on zero-Covid would be the government narrative. Authorities need a different message to convince a fearful public that living with the virus is possible.
Hu Xijin, former editor of the Global Times, a nationalist newspaper, told the Financial Times that ordinary Chinese people are very worried about the risks of infection, especially the dangers for children and the elderly, as well as the threat quarantine.
Hu, who is himself in quarantine, said state media did not intentionally run campaigns to highlight the dangers of the virus. I never received such instructions in my last two years as editor, he said.
However, he said that after observing the handling of the pandemic in the United States and much of the west and the high death toll, many Chinese have gained a strong sense of pride in the zero-response. Country covid.
Liqian Ren, who manages China investments at US-based WisdomTree Asset Management, believes the move away from zero-Covid must be preceded by a step change in national messaging from the top: Xi himself.
The propaganda machine has to change, say it’s not a scary disease, say we have hospitals and that’s the success of the party, she said.
Highlighting shortcomings in China’s health system, the Asian Development Bank last month approved a $300 million loan to improve public health services in two of China’s poorest regions. Its experts noted that the pandemic had exposed gaps in the publicly funded healthcare system and shown that Chinese hospitals were particularly vulnerable to surges in admissions.
Ben Cowling, professor of epidemiology at the University of Hong Kong, said China’s health system risked being overwhelmed like Hong Kong’s earlier this year if it did not follow Singapore in preparing for a exit. This would involve radically changing the zero-Covid rules so that only severe cases are hospitalized.
In Hong Kong, there was no concrete exit plan; same beginning of March 2022 [at the height of a big outbreak], there was still isolation of very mild cases in hospital and in isolation facilities when resources should have been reserved for the more serious, he said. Preparation makes a big difference.
Others are less pessimistic. Ryan Manuel, chief executive of Bilby, a consultancy that analyzes Chinese government documents, said Beijing has signaled it will eventually embark on a phased reopening based on the ability to parachute in medical support teams from across the country. the country.
While that meant any reopening would be piecemeal, it also meant there would be no big letting go, Manuel said.
Additional reporting by Maiqi Ding in Beijing and Eleanor Olcott in Hong Kong
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