Learning from Shanghai: what not to do in an Omicron crisis
- The financial hub kept Covid-19 under control without mass testing and mass lockdowns – until it didn’t
- Other cities are taking their cues and moving faster
For Shanghai, the worst appears to have passed.
“Shanghai was potentially a test bed for a more flexible zero-Covid strategy – one that would allow China to live with the virus,” said Nicholas Thomas, an associate professor at City University of Hong Kong.
“Unfortunately, logistical and communication gaps prevented that ambition from being successfully realised.”
The more granular strategy gave the city’s 25 million residents more flexibility and freedom while keeping occasional outbreaks largely out of the community – until it didn’t.
Authorities persisted with the playbook even after amassing thousands of cases and did not impose a lockdown for citywide testing to minimise impact on society and economy until the end of March, when community spread of coronavirus was already rampant.
By then, the number of cases had risen to more than 20,000 a day – driven by the highly transmissible Omicron variant – and the health system was stretched to breaking point.
Vice-Premier Sun Chunlan was sent in to oversee epidemic control and more facilities were built but it still took weeks to see a turnaround.
So far, seven out of 16 districts and some neighbourhoods in the Pudong New Area have managed to clear their communities of infections, but some are still being reported elsewhere and the risk of a renewed outbreak persists.
Virologist Jin Dong-Yan, from the University of Hong Kong, said Shanghai showed at least one thing.
“The experience in Shanghai shows that imposing lockdowns at a late stage does not work that well. It can take a very long time and is difficult to achieve ‘dynamic clearance’,” Jin said, referring to the severing of transmission chains.
Throughout the crisis, President Xi Jinping has insisted that the country will stick to its zero-Covid path of using lockdowns, mass testing and contact tracing to keep the coronavirus at bay, citing the uneven access to medical care and uncertainty of the virus’s evolution as reasons.
In Shanghai’s aftermath, other cities have apparently decided to take no chances.
Shaoyang in Hunan province went into lockdown on April 18 when one Covid-19 case was found. The city reopened 10 days later after no new infections were detected outside a quarantined area.
On April 25, Baotou in Inner Mongolia banned residents from leaving their homes and ordered citywide testing when two Covid-19 cases were identified. The city reopened on April 29, in time for the Labour Day public holiday.
In Hebei province, the small city of Baoding also imposed a three-day lockdown for citywide testing after finding four asymptomatic carriers. The lockdown was extended for two days and lifted on May 1.
Jin said such early measures were not necessarily effective. Shenzhen was locked down for a week to achieve “society clearance” but continued to record new cases after the restriction was lifted.
“It’s difficult to judge the perfect timing for measures under Omicron,” he said. “Cases continue to show after such a lockdown as we have observed in Shenzhen.”
Other cities have sought to avoid tough lockdowns while also trying to contain the spread at an early stage.
Xian in Shaanxi province decided to confine most of its residents to their residential areas for three days for citywide testing after finding cases outside quarantine areas in mid-April. Shops remained open and people could walk around outside their homes.
Guangzhou started to test residents overnight after finding positive cases in routine tests of hospital staff. Travel restrictions were put in some areas but most of the city remained open.
Some residential areas are under restrictions and everybody in the city has been through repeated rounds of testing but the toughest rules are limited to Chaoyang district, where most cases were found.
Thomas, from City University, said more targeted lockdown approaches had been successfully implemented in cities like Guangzhou, Xian and Zhengzhou, and they seemed to have learned from Shanghai’s experience.
“The ongoing experience in Beijing also shows that this response can be successfully implemented, particularly when coupled with the provision of financial support for people adversely affected by movement restrictions and food aid, for people unable to leave their flats or compounds,” he said.
Cui Ernan, an analyst with Gavekal Dragonomics, said it was now possible to see an end to the current wave of lockdowns but the risk that new outbreaks or a new variant would result in another wave was still there.
That risk would remain until China made a more fundamental shift in its Covid policies, Cui said.
“There is certainly no political signalling of this sort, with government officials defending their record and silencing dissenting views,” Cui wrote in a report on Friday.
Liang Wannian, a senior adviser on China’s Covid-19 response, said Omicron demanded authorities be quicker and more decisive in prevention and control while also being “scientific” to balance containing the spread with maintaining socioeconomic development.
“In the early stages of an epidemic, when the chain of transmission is clear and the risk is manageable, there is no need for citywide ‘static management’,” Liang said on Friday, using a coded term for lockdown.
“However, when there is widespread community transmission and the transmission chain is unclear … stricter measures such as citywide static management need to be considered.”
Jin from Hong Kong University said the most valuable lesson other cities should learn from Shanghai was to improve the vaccination rate, especially among the elderly, to prevent death.
By Thursday at least 81.6 per cent of the population above 60 years old, or 215 million people, had been fully vaccinated and 162 million had had a booster shot, according to the National Health Commission.