A community worker uses a loudspeaker to organize residents to go downstairs for nucleic acid sampling at a residential community in Hohhot, Inner Mongolia, China, November 15, 2022.
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China bows to reality by relaxing Covid restrictions – but ushers in new risks

Authorities ease draconian rules, but hope containment will be as effective as before, write Vincent Brussee and Katja Drinhausen. But the changes come as cases are again increasing.

China’s National Health Commission (NHC) on November 11 stressed the need to reduce the impact on people’s lives and the economy as it issued 20 changes to its Covid-19 prevention and control rules. The cautious but publicly welcome adjustments include shortening quarantine for China-bound travelers and close contacts from “7+3” (seven days in official centers and three at home) to “5+3”, reducing testing frequencies outside risk areas, and ending the strict, but often arbitrary practice of quarantining contacts of contacts that has driven numbers ever higher.

Abandoning extensive testing brings policy closer into line with conditions on the ground – local governments were chafing under the expense of widespread testing. Shortening quarantine requirements and limiting who is affected recognize that the burden on the economy and personal incomes was not sustainable. According to media reports, from Monday onto Tuesday, residents in the southern city of Guangzhou clashed with police over being locked down and unable to work. In that sense, the new policies are less than a deliberate calibration than regulation snapping back into line with reality.

Lockdowns continue

But the changes come as cases are again increasing exponentially – authorities reported 16,072 new cases on November 14 – and not just in one area, as was the case with Shanghai earlier this year. Indeed, the NHC emphasized the country would “unswervingly” continue its infamous “zero-Covid” policy, which is focused on tough action to extinguish all outbreaks quickly. Lockdowns continue and MERICS estimates that the number of people under “risk area” restrictions remains similar to the week before – around 80 million or 6 percent of China’s population.

China’s leadership presented the adjustments as taking a “software update.” The aim was to “optimize” the existing zero-Covid strategy, not to throw it by the wayside. But its stance on mass-testing is a full 180-degree turn after mandating mass testing even in places without recent Covid-19 cases prior to the 20th Party Congress in October. Abroad, China’s zero-Covid policy is often seen as driven by ideology – and relaxation touted as pragmatic. Financial markets reacted positively to what to global investors saw as being good news for China and the world.

But this ignores real risks for the country and its leadership. Instituting a more targeted – and less socially and economically massively disruptive – approach throw up a new question: can China contain an ever-more infectious virus while testing and quarantining less? China’s zero-Covid strategy initially bought it time and helped save millions of lives, but the leadership failed to make use of this window of opportunity. As a result, as much as 61 per cent of the population aged eighty and above remains inadequately protected against the SARS-CoV-2 virus.

Health care resources are strained

While countries in Europe are starting fifth vaccination rounds with tailor-made vaccines against Omicron variant, most citizens in China have not received a booster shot in nine months. Health care resources are strained – China has eight times fewer intensive care beds per capita than Germany. Despite the party-state boasting about its superiority in protecting people’s lives, some estimates reckon a full opening-up would lead to 1.5 million deaths in the first six months.

New variants and lower-than-expected vaccination rates in China suggest these estimates may be conservative. Xi Jinping, recently made General Secretary of the Chinese Communist Party for a third time, needs to ensure three things happen to keep disaster at bay and make the best of the cautious loosening proposed by the NHC: keep outbreaks in check, source enough good vaccines and get these to the population (for which the new measures lay out steps).

Reducing arbitrariness is key

The recent shift in policy needs to be focus on reducing arbitrariness and on investing in continued and targeted contract tracing to keep case numbers down. A key task for Beijing will be to provide local governments with a clear roadmap and sufficient resources to prevent excessive measures and a loss of control. Only this will ensure that testing is effective.

China’s acquisition or development of high-efficacy mRNA vaccines have occupied international media. But scalability of production and speed of delivery are what matter most. China has the expertise to produce regular, non-mRNA vaccines, which require less specialized components, supply chains and production. Their efficacy may be lower than mRNA vaccines, but their overall effectiveness can be boosted through a mixed and regularly updated regimes of vaccines.

After that, Beijing needs to reallocate resources to bring vaccines to the population, boost general healthcare and conduct public-health campaigns that inform citizens about dealing with infections and convince a population rattled by pharmaceutical scandals that vaccinations are safe. Over the past year, significant government resources have been spent on measures lambasted by health experts, such as testing fish at markets or dousing streets in disinfectant. The officials and funds involved in these efforts should be more usefully redeployed.

Should China lose control over the virus, cautious re-opening could quickly revert to an even stricter zero-Covid regime. Even in countries with high vaccination rates, Omicron boosters and post-infection immunity, the loss of life and economic disruption due to acute illness and long Covid remain severe. There is no silver bullet for any nation – and China will likely have tough times ahead. How its new measures will play out is crucial. They will affect the economy and people’s livelihoods – and the legitimacy of the party that promised to keep everyone safe.