ince the outbreak of the Covid-19 pandemic in 2019, China has adopted a strict zero-Covid approach with control measures such as closing borders, mass testing, swift contacttracing and a strict quarantine regime, which effectively put the pandemic under control with minimal daily cases.
But as the Delta variant caused a new surge of cases across cities and provinces even as vaccination levels increase among China’s population, there are calls to shift the strategy to one of “living with the virus.”
On July 29, Zhang Wenhong, head of the Center for Infectious Disease at Huashan Hospital under Fudan University, one of China’s most influential health experts, said on social media that the recent outbreak is a reminder that despite China’s strict measures, the virus will always be there. Zhang said that as vaccination helps drive down death rates of Covid-19 to the same level as the common flu, China may start to adopt a strategy that allows it to resume connectivity with the world for a return to normalcy.
Zhang’s comments quickly drew a rebuke from Gao Qiang, former heath minister and chief consultant for the China Health Economics Association. In an article published on August 5, Gao rejected the idea of coexisting with the virus. Without directly naming Zhang, Gao said that China should “hold firm” to existing control measures to “be responsible for the people’s health and safety of the country.”
Gao’s article triggered heated debate among the public. Gao’s supporters accused Zhang and his supporters of intentionally sabotaging the effort to control the pandemic.
When it comes to policymaking, authorities should be open-minded to new realities. First, most health experts realize that the world has missed the chance to completely eradicate the virus. Like it or not, China can eliminate the virus from within its borders but not from the whole world. Unless China opts to close its borders forever, it has to face the reality that the virus will stick around for the long term.
Second, after months of vaccination roll-outs, a big proportion of the population in many countries such as China have been vaccinated. In China, by August 11, more than 1.86 billion doses of vaccines had been administered. While new variants, especially the much more infectious Delta variant, have considerably lowered the efficacy of vaccines, they still provide strong protection against serious symptoms and hospitalization, which makes “living with the virus” a far less fearful prospect than before.
Finally, as the control measures are prolonged, it has become increasingly costly in terms of economic, social, and mental well-being. In the latest outbreak of the Delta variant in Nanjing, which prompted 19 cities to conduct mandatory tests for millions of residents, the testing alone cost 1.9 billion yuan (US$293m), not to mention the number of jobs lost and economic opportunities missed. Due to the closed borders, families are separated, lives are on hold and disrupted, and ties are cut between China and the outside world. To put it simply, the current control measures are simply not sustainable in the long run.
This does not mean that China should drop its control measures overnight. But it does mean that China should be open-minded about the idea of living with the virus. Not all countries that opt to open their economies adopt the same policies. The UK, for example, adopted a so-called “big-bang” policy, while Singapore has chosen a more gradual and calibrated approach. China can take note of other countries’ failures and successes and formulate its own exit strategy, while making the necessary preparations in the meantime.