China Doesn’t Want to ‘Live With’ Covid. But It May Have To.
By Yanzhong Huang, 9/7/21, NY Times

China’s zero-infections policy is no longer working as
designed. At the outset of the pandemic, the policy success-
fully drove down cases — and was adopted by other countries
— but the Delta variant changed the game & shows that this
strategy no longer fits. It’s time for China to change tack,
as the socioeconomic and public health costs now outweigh
the benefits with this highly transmissible new variant.
If it doesn’t, China and its people will suffer.

While other countries were still in the grips of pandemic,
China by early April 2020 had managed to get the virus
under control within its territory. It implemented a zero-
infections policy, under which the identification of even
one local Covid case would trigger draconian measures in
order to reset local cases to zero. To fend off imported
cases, China imposed some of the world’s toughest inter-
national travel restrictions

China is not the only country to pursue a zero-tolerance
approach toward Covid-19. Other countries that did, like
New Zealand, are also now seeing less success. But few
would dispute that China’s authoritarian govt, with
unrivaled power & resources, is in a much better position
than almost any other nation to quickly eliminate new
cases and make the strategy work. So the fact that the
policy isn’t working as intended is bad news for China and
any other country aiming to fully stamp out the virus in
the same manner.

For over a year, the policy showed good results. Small &
sporadic outbreaks were usually quelled before cases
could spread to other regions. Local officials relied on
the extreme-measures songbook: They launched mass testing
for Covid-19, used QR codes to trace and control people’s
movements & rounded up entire neighborhoods for mandatory
quarantine.

Then came the Delta variant. An outbreak that started in
Nanjing, in China’s eastern Jiangsu Province, on July 20
quickly spread to at least 17 provinces, causing the worst
outbreak since Wuhan. Now over a month has elapsed since
the first Nanjing cases were identified — and the Chinese
govt still has been unable to completely break the domestic

transmission chain. As of Sunday, there were still 3 inter-
mediate-risk Covid areas nationwide, acc. to the govt’s
classification system. In Yangzhou, which became the new
outbreak epicenter in Jiangsu Province, residents were
prevented from leaving their homes for a month & underwent
at least 12 mandatory rounds of nucleic acid testing.

The failure of such high-profile & high-powered measures
to bring a speedy end to this outbreak highlights the
diminishing returns of the zero-tolerance approach.

There also are signs that this approach is becoming counter-
productive: Some 10% of the cases in Yangzhou were traced
to a site for Covid testing.

There are worrying long-term secondary effects, as well.
Increased absenteeism, drops in employee productivity and
disruption to supply chains threaten overall economic
growth in China. Newly released data from the National
Bureau of Stats suggests that strict lockdown measures
during the recent Delta variant outbreak have contributed
to a slowdown in the Chinese economy, sending nonmanufac-
turing activity into contractionary territory for the
first time since Feb 2020.

Some Chinese health experts have begun to question the
zero-tolerance strategy, though the govt has not looked
kindly upon it. A teacher in Jiangxi Province was detained
for 15 days in August for suggesting that Yangzhou
experiment with a different approach to epidemic control.
Dr. Zhang Wenhong — dubbed China’s Dr. Fauci — said China
should learn to coexist with the virus but backtracked.

One rationale for sustaining the existing approach has
been to buy time for China to reach herd immunity thru
vaccination. Delta makes this argument irrelevant. Zhong
Nanshan, a top public health adviser, said China can
achieve herd immunity with around an 80% vaccination rate.
But he appears to have used an unrealistically high
efficacy rate for Chinese vaccines. Based on my calcs,
reaching herd immunity is not possible with the existing
vaccine regimen in China. It’s likely there will continue
to be some cases, though vaccination can still prevent the
most severe impacts of the disease. It’s no wonder, then,
that a senior official with China’s C.D.C. admitted that
the country could continue to experience outbreaks even
after reaching 80% vaccination.

But sticking with the current approach would transform
China into a hermit nation that could be dangerous. If
there are low levels of natural immunity and vaccines are
less effective at protecting against new variants of the
virus, then reaching zero infections will not be possible
as the country opens up.

China can’t afford to keep its borders closed forever.
And the pandemic is not over. Given the still-low and
unequal coverage of Covid vaccines worldwide and the
rampant spread of the Delta variant, this pandemic may
last another two years or more.

Other govts already have shifted to policies aimed at
“living with,” not eradicating, Covid-19. Singapore
turned to a strategy of phased and contingent reopening
backed by mass vaccination. Even Australia, arguably the
most zealous liberal democracy in pursuing a zero-tolerance
strategy, now has proposed a road map to reopen. China
would be wise to take heed and pivot. A strategy focused
on preventing severe cases and deaths and administering
vaccines with high efficacy would be in China’s best
interest, both in the short and long term.

https://www.nytimes.com/2021/09/07/opinion/China-covid-pandemic-delta.html

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