As outbreaks happened in country after country this year, China kept the coronavirus at bay. This gave China valuable time to get ready for what was going to happen: a version of the virus that was so unpredictable and contagious that even China would have trouble keeping it under control.
But instead of preparing for this, China made a stronger commitment to “zero Covid” by putting in place snap lockdowns and contact tracing. In the meantime, the number of daily vaccinations dropped to a record low. Even though people were building testing booths and isolation facilities, there were still not enough beds for people in critical care. Research on mRNA vaccines made at home couldn’t keep up with how quickly the virus changed.
Now, the costs of this way of doing things are adding up, putting China in a tough spot from which it doesn’t look like it will be easy to get out, scientists said in interviews. Even though the number of new Covid cases is at an all-time high, people have taken to the streets to protest lockdowns that have stopped life in many cities. Officials have started to loosen rules because they are worried.
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Researchers are worried that China might not be able to reopen the country and ease the pressure on its economy without putting a lot of people at risk of dying. A huge disaster like this could be a big problem for the people in charge. “We often pretend that China has a choice in terms of ‘zero Covid’ versus opening up,” said Dr. Siddharth Sridhar, a virologist at the University of Hong Kong.
In China, dissatisfied with covid restrictions burned a quarantine camp🤷🏻 pic.twitter.com/B61ClhGtc6
— Rendeiros#Silva (@rendeiro_silva) December 1, 2022
“There never was a choice. The simple fact is that China is not ready for a wave on that scale.” China’s preparations have been slowed down the most by how hard it is to vaccinate older people. Two-thirds of people 80 and older have been vaccinated, but only 40% have gotten a booster dose. This is a big problem because the Pfizer-BioNTech and Moderna vaccines offer better protection than the Chinese vaccines.
In a study done during the Omicron outbreak in Hong Kong, two doses of Sinovac, China’s main homegrown vaccine, were only 58 percent effective against severe Covid or death in people aged 80 and up. On the other hand, two Pfizer-BioNTech doses worked 87 percent of the time in the same group. In a previous study in Brazil, it was also found that two doses of Sinovac only stopped 61 percent of Covid deaths.
Scientists now think that the Chinese shots, which use killed viruses to make the immune system respond, are more like a three-dose vaccine than a two-dose vaccine. Even worse, China’s last big vaccination push was in the spring, which means that many people haven’t had a shot in at least eight months.
That could hurt their body’s ability to fight off sickness. A study done in Malaysia found that the Pfizer-BioNTech vaccine protected against intensive-care admissions pretty steadily three to five months later, while the Sinovac vaccine’s effectiveness against intensive-care admissions dropped from 56 percent to 29 percent over the same time period.
Dr. Paul Hunter, an expert on infectious diseases at the University of East Anglia in England, said that the Chinese vaccines compare well to the other non-mRNA Covid shots in the world. But it could be bad to reopen the country so long after the last round of vaccinations.
“I think that’s more of an issue than the quality” of China’s vaccines, Dr. Hunter said. China as a whole has a pretty high vaccination rate, which makes the gaps in older people’s vaccinations stand out even more. Nearly 90% of the people have had a primary vaccine series, which usually includes two doses of Sinovac or Sinopharm, another shot made in China.

Andy Chen, a Shanghai-based analyst at the consulting firm Trivium, said that the difference is partly due to an out-of-date idea that older Chinese people would be safe as long as younger, more active Chinese people were immunized.
Mr. Chen said that older people in China tend to avoid health risks, so the possibility of even minor side effects from the vaccine may have seemed scary to many. Other experts said that these worries grew because China didn’t share information about the effectiveness and side effects of its vaccines. On Chinese social media, there was a lot of false information about side effects.
And even though health officials have told older people with chronic illnesses to get shots, vaccine givers are often hesitant to do so without knowing their medical histories. The “zero Covid” plan only made it harder to get people vaccinated. It saved lives by cutting down on infections, but it also made many older people feel less urgent about getting a shot.
The vaccination campaign lost even more attention when people were told to swab their throats instead of getting shots. After a surge in the spring, China put up tens of thousands of testing booths in cities like Shanghai and Beijing and built huge facilities to keep millions of people apart. The rate of vaccinations stayed the same.
Xi Chen, an associate professor of public health at Yale University, said, “There is always a lack of staff in the health care system.” “People told me at the time they were told to focus on mass testing.” China said this week that it would try again to vaccinate its oldest citizens.
A statement from the country’s National Health Commission said that the country would use mobile vaccination stations, bring shots into nursing homes, and go door-to-door to reach the most vulnerable. But some experts, like Yanzhong Huang, an expert on global health and senior fellow at the Council on Foreign Relations, doubted that the move was more than just words.
“It is about tinkering with the current approach,” he said. “But that approach fundamentally doesn’t make any sense from a public health policy perspective anymore.” The government didn’t give a detailed plan for the new efforts and didn’t force people to get shots. Experts say that forcing older people to get shots could be an overreach on the part of the government, which could lead to a backlash from the public.
“From a local government official’s perspective, if even just one person dies from the adverse effects of vaccines, that’s blood on your hands,” said Mr. Chen, the Trivium analyst. “It’s really hard to recover from that.” If the number of cases keeps going up, gaps in vaccine coverage could add to the stress on hospitals, which may also have to deal with a cold and flu season in the winter. Many Asian countries have more intensive care beds per person than China does.
The Chinese Covid restrictions are increasingly opposed by many in China. This is in Wuhan and people are tearing down the blue fences used to quarantine the citizens. #Wuhan #China pic.twitter.com/U1NNjNPdTr
— (((Tendar))) (@Tendar) November 27, 2022
When a virus broke out, the country moved health workers from one province to another to make up for the lack of doctors and nurses in rural areas. A flood of Omicron infections across the country would make that impossible. In May, a study from Fudan University in Shanghai said that if China stopped its “zero Covid” policy, there would be a “tsunami” of Covid cases and about 1.6 million deaths. China now has more antiviral treatments to choose from.
Ben Cowling, a professor of epidemiology at the University of Hong Kong, said that if “zero Covid” restrictions were suddenly lifted, it would still cause a health crisis because the number of hospital beds is so small. Yang Yang, an associate professor of biostatistics at the University of Florida, said that “preparing the medical system” was the most important thing to do because the number of cases will rise when China reopens.
He also said that there are already some signs that the government is shifting its focus from building quarantine centres to strengthening its best hospitals. The way China got out of the emergency phase of the pandemic is different from how places like New Zealand and Taiwan did it.
There, lockdowns gave people time to breathe while the population was being vaccinated. When the restrictions were lifted, the number of deaths went up, but not as much as in places like the United States. Scientists say that China’s strategy has so far cut down on Covid deaths, but it hasn’t thought about how to get out of the restrictions.
1. China is set to ease Covid restrictions as widespread protests and anger over the world’s toughest quarantine protocols shatter the nation’s fragile economy and citizens’ livelihoods.
This includes a reduction in mass testing and allowing infected individuals to stay at home. pic.twitter.com/yG1TwZEuv4
— The Futurizts (@TheFuturizts) December 2, 2022
“Restrictions and lockdowns can help buy time to get crucial public health measures in place and save lives, but they are not an exit strategy by themselves,” said Jeremy Farrar, the director of Wellcome, a global health foundation. China has turned down vaccines from Pfizer and Moderna, but it seems to be putting its hopes on locally made mRNA vaccines as an alternative.
Experts say that the government has been testing more than a dozen new vaccine candidates, some of which are mRNA doses, against each other. Indonesia recently gave China permission to use its mRNA shot, and some vaccine makers seem to be getting closer to asking Chinese officials for permission.
“The formulation of getting an mRNA vaccine correct might have taken a few shots on goal, but early data suggests it’s heading in the right direction,” said James Bellush, a medical science expert at RTW Investments in New York. China’s top leaders have shown that they know their “one-size-fits-all” approach to controlling the virus is hurting the country’s economy and society more and more.
They have called for changes to this “one-size-fits-all” approach. After a wave of large protests in recent days, several cities have eased some of their strictest rules. But it seemed like there was still some disagreement about whether giving up on Covid’s restrictions was the right thing to do. In China’s Liaoning province, in the city of Jinzhou in the northeast, officials said they had already started to loosen some rules, but they still didn’t want to give up on the “zero Covid” strategy.
“There’s no need for us to abandon our defenses when we can reach zero, avoiding large-scale infections,” officials said. Follow us only on Lee Daily for more news like this.