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Illustration: Lau Ka-kuen

China’s sudden shift from Covid-zero raises more questions than answers

  • People who were grateful for the precautions are asking why the time wasn’t used to prepare for the current surge
  • Officially, daily infections are in the thousands and deaths are minimal but social media outpourings paint a different picture
“It all happened suddenly,” said Wang Guohong, his voice still hoarse from Covid-19. Within days, the 46-year-old Beijing resident had gone from relief at seeing China’s stringent pandemic controls dismantled to helplessness, with his entire family infected by Omicron.

Wang, who lost his job as an IT engineer when his multinational employer divested from China during zero-Covid, did not expect the lifting of the policy to throw his life into further disarray.

Four days after China’s December 7 pivot away from zero-Covid, Wang took his family out for lunch. It was the first Sunday in months that Beijing’s restaurants were once again accepting dine-in customers.

The next day, Wang and the family became sick, with his two daughters running fevers as high as 40 degrees Celsius (104 Fahrenheit). After months of strict government controls on the sale of cold and flu treatments under Covid-zero, there were no fever medicines at home.

The sight of Beijing caught off guard by a Covid-19 surge has many local governments in China scrambling to organise their response efforts. Photo: AFP

Wang rushed to chemists and online pharmacies, only to find their supplies of ibuprofen and paracetamol – popular fever and pain reducing drugs recommended for Covid-19 patients – had been snapped up.

“For the first time in my life, I felt desperate,” Wang said. “I rode my scooter and searched drug stores one after another for two hours. And I got no pills.”

A neighbour came to the rescue, with six ibuprofen tablets. As the family recovered over the coming days, the relief was transient. On Saturday, Wang learned that his parents – 1,500km (930 miles) away in his hometown Chengdu in the southwest – had also tested positive for Covid-19.

“They are over 70 with hypertension and diabetes. They are running a fever now, and without any medicines,” said Wang, who is planning to fly to Chengdu if their condition worsens.

During his sleepless nights, when his constantly running nose made breathing difficult, Wang’s thoughts turned endlessly on a single question: “China has had more than two years to learn from other countries and prepare for the exit. How come it has turned out to be such a mess?”

One thing seems clear to him. “If the government prepared properly, the disaster would have been avoided.”

Wang’s woes are shared by hundreds of millions of people in China, where the easing of restrictions has coincided with surging infections in the past few weeks.


Body bags fill corridors at Chongqing funeral parlour as China battles Covid surge

Body bags fill corridors at Chongqing funeral parlour as China battles Covid surge

Officially, there have been a few thousand new infections each day since mass testing ended and asymptomatic cases were excluded from statistics. The true picture is appalling.

People in various parts of the country have been sharing their stories and their grief on social media. They report a dearth of medicines, overstretched hospitals and emergency services, acute blood shortages and paralysed delivery services.

There have also been accounts of overwhelmed morgues and long queues at crematoria of people waiting to farewell their loved ones.

In a brief statement, the National Health Commission (NHC) said it would stop releasing daily Covid-19 caseloads from Sunday, without giving an explanation. But estimates of daily infections released by local health authorities have shed some light on the situation.

China stops declaring daily Covid cases as wave strains hospitals, funeral services

In Qingdao, in the eastern province of Shandong, between 490,000 and 530,000 people – from a population of 10 million – are becoming infected each day, Bo Tao, the head of the city’s health commission, said on Friday.

At manufacturing hub Dongguan, in southern China’s Guangdong province, new daily infections are estimated at 250,000 to 300,000 people. In the eastern province of Zhejiang, health authorities estimate the daily number at over 1 million and project it to surge to 2 million around New Year’s Day.

Using regional Chinese data, British-based health data firm Airfinity has calculated that more than 5,000 people are probably dying each day from Covid-19 in China, an estimate “in stark contrast to the official data which is reporting 1,800 cases and only seven official deaths over the past week,” it said last Thursday.

Only Covid-19 patients who die from pneumonia or respiratory failure are counted in the official death toll, a narrow definition which limits the number of deaths being reported as the virus surges.


Inside an overcrowded Beijing hospital struggling with Covid surge in China

Inside an overcrowded Beijing hospital struggling with Covid surge in China

In the absence of mRNA vaccines, and without lockdowns or other mitigation measures, China can expect as many as 500,000 Covid-related deaths by April next year, according to Ali Mokdad, a professor at the University of Washington’s Institute for Health Metrics and Evaluation.

Chinese experts are also raising alarms. Among them is Wang Guangfa, a respiratory expert from Peking University First Hospital, who told the state-run Global Times last week that Beijing faced a surge in severe Covid-19 cases in the next two weeks.

He urged the government and hospitals to expand ICUs and waste no time in preparing fever clinics, emergency and severe treatment resources.

Shanghai infectious diseases expert Zhang Wenhong last Thursday predicted that infections would peak in the eastern financial hub within a week, but that climbing severe cases were likely to strain the medical system.

‘What we need is paracetamol’: Beijing faces backlash over drive to hand out TCM

The sight of Beijing caught off guard by an infection surge – polls on social media platforms suggest roughly 80 per cent of the capital’s 21 million residents were infected over the past few weeks – has many local governments scrambling.

They are arranging second booster jabs, encouraging the elderly to get vaccinated, distributing ibuprofen tablets for free or at reasonable prices, and organising supplies of antiviral medications.

Alfred Wu, an associate professor at the National University of Singapore’s Lee Kuan Yew School of Public Policy, said the Chinese government “should have done better and taken actions earlier”.

“The chaos will become a big test for President Xi Jinping and the Communist Party’s rule in China,” he said.

China’s official narrative has portrayed the party as a good protector that shielded its 1.4 billion people from Covid-19 and its lethal variants for three years through mass testing, contact tracing, quarantine controls and self-developed vaccines.

All of these measures helped to win time for China’s fight with the milder Omicron variant, saving millions of lives, according to a series of commentaries in state media over recent weeks as the country wrapped up its zero-Covid policy.

The costs included mounting economic pressures and rising social discontent, culminating in widespread protests against the rigid curbs in November, just before the shift in official policy.

But, in interviews with the South China Morning Post – and echoed in social media commentary – people said they had been grateful for the zero-Covid precautionary measures, until they found the government unprepared for an infection spike.

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Questions they wanted answered included how the government had failed to secure supplies of fever-reducing medication, when China has the world’s largest ibuprofen production capacity.

People also wondered why China had not approved imports of mRNA vaccines as an alternative to China’s inactivated vaccine, despite their effectiveness and availability. And why had China spent so much time and money on mandatory PCR tests but not expanded intensive care facilities and vaccinated more of the elderly.

An article by social media commenter Xiaoyao Xianke – which called for the government to respond to public concerns about the timing of the reopening to the lack of preparation – circulated widely online, attracting tens of thousands of likes in five days when it was posted last week on news aggregation app Toutiao.


China summons retired medical workers in rural areas as country grapples with Covid surge

China summons retired medical workers in rural areas as country grapples with Covid surge

Only about 40 per cent of people aged 80 and over in mainland China had received a booster dose by the reopening earlier this month, official data showed.

And, according to data provided by the NHC on December 9, the total number of ICU beds on the mainland stood at just 138,100, close to 10 beds for every 100,000 people. This compares to 34.7 beds per 100,000 in the US and 29.2 in Germany.

Wu, at the National University of Singapore, said another misstep for China was the lack of a clear road map to exit from its zero-Covid policy. Nor had there been any effective communication with the public about the government’s plans, he said.

“Now the situation looks like more old people will pass away in the disaster. People are struggling with Covid-19. When it settles down and people look back on the disaster, the traumas will be remembered and their trust in the government will definitely be crippled,” Wu said.

Why has China struggled to vaccinate the elderly against Covid-19?

George Magnus, a research associate at Oxford University’s China Centre, said there was no question that the zero-Covid policy had protected people from illness and deaths.

But this has had costs which could have been minimised with more professional and better preparation, he said.

“China is now seen as having paid a heavy price for an unsustainable zero-Covid policy and also for an unprepared exit from it. The lack of preparedness is extraordinary and we can put it down to a combination of hubris and politics,” Magnus said.

“Hubris was that the party’s line was right, and science was secondary to politics. It beggars belief that officials did not take strenuous actions to prepare China at any time after 2020.”


Demand for Covid tests, medications in mainland China empties shelves in Hong Kong, Thailand

Demand for Covid tests, medications in mainland China empties shelves in Hong Kong, Thailand

Independent political scientist Chen Daoyin, formerly a professor in Shanghai, said there were mounting complaints about both the “brutal lockdown” under zero-Covid and the current “reckless exit”.

“The public discontent certainly will be a test to the legitimacy of Xi and the party, but not a crucial one, because there is no significant challenge within the party after Xi cemented his power in the 20th party congress,” he said.

According to Chen, Beijing has made the battle against Covid-19 a political task, intended to show the systematic superiority of Chinese socialism, which means it will not accept vaccine aid from the US or copy the exit routes of Western countries.

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“The change of Covid policy is in line with China’s new political focus. The top leadership would like to see a reinvigorated economy next year, when herd immunity is achieved, young people get back to work after the Chinese New Year and production resumes,” he said.

“Once the economy is on track, there will be no social unrest to threaten the rule of the party.”

Zhao Ying, 38, a marketing manager in Beijing who lost two relatives – aged 66 and 88 – to Covid-19, said she would never forget the current crisis.

“I’m beyond sorrowful. The ambulances came late in both cases. And we even paid tens of thousands of yuan to brokers in the black market to get the two relatives cremated in time,” she said.

“I don’t know whose fault it is. We can only accept it as destiny.”