China might have to live with COVID

How lucky I was born in China,” a young Chinese scholar declared last month in his WeChat. He was proud: Following the worst domestic COVID-19 outbreak since Wuhan, China had brought daily new case counts down to a few dozen. The case numbers — when contrasted with the United States, which has less than a quarter of China’s population yet daily average cases above 130,000 — might not seem too concerning on their own. But they illustrate that China’s zero-infections policy is no longer working as designed. At the outset of the pandemic, the policy successfully drove down cases — and was adopted by other countries — but the Delta variant changed the game and 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 the 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 international 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 government, with unrivalled power and 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 more than a year, the policy showed good results. Small and 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 and rounded up entire neighbourhoods 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 more than a month has elapsed since the first Nanjing cases were identified — and the Chinese government still has been unable to completely break the domestic transmission chain. As of Sunday, there were still three intermediate-risk COVID areas nationwide, according to the government’s classification system. In Yangzhou, which became the new outbreak epicentre in Jiangsu Province, residents were prevented from leaving their homes for a month and underwent at least 12 mandatory rounds of nucleic acid testing.

The failure of such high-profile and high-powered measures to bring a speedy end to this outbreak highlights the diminishing returns of the zero-tolerance approach. Other governments 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. Huang is a global health expert specialising in China The New York Times