Endless tests for millions come at a price

China is entering a new normal of “dynamic-zero” Covid-19 policy, in which citizens are subject to frequent nucleic-acid tests regardless of a person’s likelihood of contracting the coronavirus.

Under the current arrangements in Shenzhen, Hangzhou and Beijing, a negative test result within 48 or 72 hours is now a prerequisite for getting on the subway, visiting a crowded place, or entering an office building. Thousands of government testing stands are being set up across communities to cater to tens of millions of residents.

Compared to the draconian lockdown in Shanghai that has been going on for some five weeks now, this new approach has the clear advantage of allowing commercial and social activities to largely continue. People can go to work, shop, or even enjoy some types of indoor entertainment, as long as they can provide timely negative test results.

To some extent, this is an expanded and stricter version of what schools in Hong Kong are doing these days, requiring students and teachers to undergo daily rapid antigen tests before heading to class.

The difference is that Shenzhen, Hangzhou and Beijing are mandating coronavirus tests for anyone who wants to travel around, and only professional reverse transcription polymerase chain reaction (RT-PCR) tests are accepted, not at-home test kits.

Given the influence of those three cities, more parts of China are likely to follow suit. Nucleic testing, which was previously a requirement for cross-province and international travel, may soon become an established part of urban life that is as ubiquitous as security checks, which quickly became a routine once security booths were set up.

Municipal authorities have not said how long the nucleic testing requirement will last. But given the investment into testing stands, it seems the practice will exist as long as dynamic zero remains the goal. Of course, there can be flexibility in how frequently tests are done – a 24-hour requirement may be relaxed to 48 or 72 hours, for instance, if infection risks in certain places are low.

At the end of the day, however, the cost-effectiveness of this approach is open to debate. While the direct costs are lower than outright lockdowns, repeated and endless testing can put huge financial pressure on China’s public healthcare system and municipal governments, especially in less affluent cities.

It is also likely to create another annoyance for urban dwellers.