Tag: health and medical

Hong Kong
CNN
 — 

As a new, deadly virus overtook the central city of Wuhan and spread throughout China in early 2020, the country’s ruling Communist Party and its leader Xi Jinping were faced with a crisis on a scale not seen in decades.

In Wuhan, there was chaos. The city shut itself off from the outside world, while hospitals were overrun with the sick and dying – but it was too late to stop the virus’ advance. Huge swaths of China, too, locked down, grinding the country to a halt. Online, public outrage over apparent delays in the official release of information – and the silencing of whistleblowers – lit up social media faster than the censors could repress it.

Outside China, observers watching the start of what would become the Covid-19 pandemic began to ask: could this be a catastrophe so big it calls into question the legitimacy of the Communist Party and its leader?

Nearly three years later, however, Xi is poised to cement his place as China’s most powerful leader in decades, when he is anointed with a likely norm-breaking third term as the party chief on Sunday.

In the months following that initial outbreak, Xi oversaw the assembly of a toolbox of brute-force lockdowns, enforced quarantines, and digital tracking. All that was used to bring the virus to heel and largely keep it outside China’s shuttered borders – an approach that initially appeared to earn broad public support as China lived largely virus-free and the pandemic raged overseas.

But, now, as Xi steps into an expected new era of his rule, that system – known today as the “dynamic zero-Covid” policy – is facing both social and economic pushback.

Public frustration – the true scale of which is difficult to gauge – appears to be rising over lockdowns that can shutter people in their homes for weeks on end with fleeting advance notice, digital health codes that dictate where people can move, and the constant threat of being sent to centralized quarantine. Meanwhile, the country’s economy is faltering, with both the IMF and World Bank recently downgrading China’s GDP growth forecasts, citing zero-Covid as one of the major drags.

As China’s Communist Party National Congress meets this week to approve the party’s priorities for the next five years, many are watching for signs restrictions could be loosened. But with Xi having personally tied himself to the policy, any change would need to come straight from the top – and from a leader, who throughout his rule, has sought to extend, not curtail, the party’s control on daily life.

China’s advanced online ecosystem – run on mobile phone superapps and ubiquitous QR codes – has offered arguably unrivaled convenience for consumers to shop, dine and travel. Now, those technologies play a role in constraining daily life.

Mobile phone health codes are the backbone of a system designed to track citizens and designate whether they are cleared to enter various venues, upping state control on people’s movement to an extent never before seen in China.

Across the country, basic activities like going to the grocery store, riding public transport, or entering an office building depend on holding an up-to-date, negative Covid test and not being flagged as a close contact of a patient – data points reflected by a color code.

Going out in public can be a risk in itself, as being placed under quarantine or barricaded by authorities into a mall or office building as part of a snap lockdown could simply depend on whether someone in the general vicinity ends up testing positive.

“(You see) all the flaws of big data when it has control over your daily life,” said one Shanghai resident surnamed Li, who spent a recent afternoon scrambling to prove he didn’t need to quarantine after a tracking system pinned his wife to a location near to where a positive case had been detected.

Li, who’d been with his wife at the time but received no such message, said they were eventually able to reach a hotline and explain their situation, ultimately returning her health code to green.

“If you don’t complain, the next step is your neighborhood committee seals up your door,” he said.

The clear message from Beijing is that these steps are necessary to prevent large-scale loss of life and overwhelmed medical systems.

“The essence of persisting with dynamic zero-Covid is putting people first and prioritizing life,” read a recent editorial in the People’s Daily – one of three along similar lines released by the party mouthpiece last week in an apparent bid to lower public expectation about any policy changes ahead of the Party Congress.

But as local officials pursue Beijing’s edict of stopping the spread of the virus above all other considerations – the system too, over and over again, has led to human tragedy.

The past year is marked by grim examples well-known across China: the expectant mother in Xi’an who miscarried after being denied treatment due to expired test results, the off-duty nurse who died from an asthma attack in Shanghai as a hospital branch was closed for Covid-19 disinfection, and, last month, the 27 passengers who died in a crash in the middle of the night as they were bussed into a different jurisdiction for compulsory quarantine.

“What makes you think that you won’t be on that late-night bus one day?” read a viral comment, which garnered more than 250,000 likes before it was censored – one of a number of glimpses into rising frustration with the cost of the policy.

Last week, a rare political protest in Beijing saw banners hung from a bridge along the capital’s busy Third Ring Road that zoned in on social controls under the policy.

“Say no to Covid test, yes to food. No to lockdown, yes to freedom. No to lies, yes to dignity. No to cultural revolution, yes to reform. No to great leader, yes to vote. Don’t be a slave, be a citizen,” one banner read, while the other called for the removal of “dictator and national traitor Xi Jinping.”

Speaking before some 2,300 mostly surgical-mask clad Communist Party members at the opening of the party’s five-yearly leadership reshuffle on Sunday, Xi gave a sweeping endorsement of China’s Covid controls, saying the party had “protected the people’s health and safety to the greatest extent possible” and “made tremendous, encouraging achievements in both epidemic and social development.”

The impact of those controls is becoming sharper, as lockdowns – which have repeatedly left people struggling for access to food and medicine and grappling with lost income and a mental toll – have become more frequent.

Last month, CNN counted more than 70 Chinese cities placed under full or partial Covid lockdowns in a period of a couple weeks, impacting more than 300 million people.

In the run up to the Party Congress, controls amplified – as local authorities around the country sought to tamp down on outbreaks coinciding with the major political event.

“Maintaining the zero-Covid strategy is now substantially more costly than it was a year ago, because the latest (viral) strains are so much more transmissible and outbreaks are occurring more frequently,” said epidemiologist Ben Cowling of the University of Hong Kong’s School of Public Health.

“At the same time, the threat posed by Covid is reduced because of the higher vaccine coverage and the availability of antivirals. Taken together, I think the point has already been crossed where continuing zero-Covid could be considered a cost-effective strategy,” he said, adding that maintaining high vaccine coverage was key for a planned transition away from zero-Covid.

Xi’s proclaimed success over the virus and China’s accompanying propaganda campaign is one reason why it may be difficult for China to change course.

“The issue is Xi Jinping already associated himself with the ‘successful’ model of fighting Covid, so the zero-Covid policy now is a de facto Xi Jinping policy,” said Alfred Wu, an associate professor at the National University of Singapore’s Lee Kuan Yew School of Public Policy, adding that China’s handling of the virus in comparison to other countries remains a point of national pride for many Chinese.

And backing away from the policy will come with significant consequences. Allowing the virus to spread within the country of 1.4 billion would likely increase Covid-19 deaths to unseen levels in the country, experts say – and China so far has staked its policy around preventing those outcomes at all costs.

Outside experts say that, since the virus will stay in circulation beyond China, keeping tight controls and closed borders is just delaying the inevitable, and the focus should be on preparing, for example through raising elderly vaccination rates and increasing ICU capacity, as well as getting or expanding access to the most effective vaccines and treatments.

While China backed a massive vaccination campaign since early 2021, it has relied on homegrown shots, which produce lower levels of protective antibodies than mRNA vaccines developed in the West.

So far, however, China has appeared most focused on bolstering the pillars of zero-Covid: mass testing capacity and mass quarantine facilities.

“The vaccines take time, the ICU expansion takes time – and if you don’t see effort to prepare for the change, that implies that they are not planning to change the policy any time soon,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations in New York.

And while experts say it’s possible economic and other considerations could see China loosen certain controls in the coming year, an eventual end to zero-Covid may not see an end to all of its vestiges – especially as Xi, including in his Sunday address, has made clear his focus on increasing “security” in China.

Already the health code system has been used to diffuse social protest – with petitioners who lost their savings in rural banks barred from protesting after their health codes inexplicably turned red.

“One scenario is that (China) might drop the zero-Covid policy, but some of the key components of the policy might be retained and repurposed,” said Huang, pointing to Xi’s focus on maximizing security in China, including via high tech means.

“Zero-Covid has provided a proof of concept – this actually works,” he said.