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China Doubles Down on Zero-COVID Policy

The lockdown of Shanghai’s 25 million residents enters its 7th week of what was initially promised to be less than 7 days.   This is part of China’s “Zero-COVID” policy in which any community, regardless of size, that is found to have COVID cases goes into complete lockdown until no further cases are identified.  Under the policy, residents are not allowed to leave their homes except for the purpose of being COVID tested every two days or to go to a hospital for an emergency.  This includes not being allowed to leave to get food, seek non-emergent medical attention or attend to other needs.  The region’s health care workers have been diverted from usual duties such as staffing hospitals, to going house to house to administer the mandatory nasal swabbing.  As a result of these steps, deaths from non-COVID related problems have risen.  Cases of starvation are being reported.  With Omicron’s much lower mortality rate, there are concerns that deaths from starvation and lack of healthcare for non-COVID issues may exceed those from the virus. Unrest in Shanghai and other communities being placed in lockdown is beginning to rise, with some viewing the mounting tension in the country to be similar to that seen after the 1989 Tiananmen Square incident.

The Zero-COVID policy was first used with success in Wuhan when the outbreak of the pandemic first began there.  The policy also had success over the first two years of the pandemic as China contained the virus and showed remarkably low numbers of cases and deaths.  However, a number of factors have changed the equation, including the highly contagious nature of Omicron.  As I discussed in the Miller Report of April 11th, the current outbreak began in Hong Kong, a major port of entry into China.  It quickly spread to Shanghai which, like New York City in the United States, is the nation’s largest city and economic hub.  From Shanghai it has spread to China’s capital, Beijing, and to over 40 other large metropolitan areas.  

According to the World Health Organization’s (WHO) recent report on China’s Zero-COVID response to the current situation, approximately 30% of China’s 1.4 billion people are currently under some degree of lockdown.  The report raises concerns about the health impact outside of COIVD as well as what it sees as human rights problems.  This led WHO Director-General Tedros Adhanom Ghebreyesus to call the policy “unsustainable” in a press briefing last week in which the WHO findings were discussed.    That remark angered senior Communist Party leaders who are not used to tolerating criticism and who claim that the situation in Shanghai is an example of the success of the government’s policy.  

“The Shanghai outbreak has stabilized and the situation is improving,” Ma Xiaowei, head of the National Health Commission, wrote in an article in the Communist Party publication Qiushi on Monday.  “According to the guidance of dynamic zero tolerance, we have withstood the most severe challenge since the Wuhan battle and we have made progress.”  In the article, Ma promised to build more permanent quarantine centers and rejected suggests that people who turn positive be allowed to quarantine in their own homes. 

Indeed, instead of relaxing the tenets of Zero-COVID, the government appears to be increasing the strict nature of its crackdown.  Reports have appeared on social media that entire apartment buildings have been cleared with all inhabitants being taken to quarantine centers just because a single resident turned positive.  These reports go on to claim that the government is sending in teams dressed in hazmat suites to spray disinfectant on the contents of the apartment, allegedly ruining people’s personal belongings, clothes, and food.  If true, then this certainly is not a practice supported by science research which has shown that the virus does not remain viable on most surfaces outside of the human body and that surfaces are not a significant source of transmission.

Fearing criticism by senior government leaders, local leaders have imposed their own additional levels of strictness.  In Qian’an, a city east of Beijing that is in lockdown, the local administrator ordered residents to hand over the keys to their homes so that they can be locked inside as a means of enforcing the lockdown.

The Financial Times reported this week on the economic impact that the lockdowns are having as many involve major financial and industrial centers.  It reported significant downturns in all sectors including manufacturing, retail sales and the housing market.  The article concludes that adhering to the zero-COVID policy of Chinese President Xi Jinping has become a sort of loyalty test for Chinese government officials.  Meanwhile, Xi is up for reelection for a third term at the Communist Party Congress later this year.  The success of his zero-COVID policy is thought to be a significant factor in his reelection and he appears to be willing to sacrifice the economy of his country to prove that the policy works instead of having to admit that it has problems.


Miller Report for the Week of May 16th, 2022; by William Miller, MD

You can access all previous Miller Reports online at www.WMillerMD.com.

Dr. Miller is a practicing hospitalist and the Chief of Staff at Adventist Health Mendocino Coast hospital in Ft. Bragg, California.  The views shared in this weekly column are those of the author and do not necessarily represent those of the publisher or of Adventist Health.

One Comment

  1. Charles B. May 18, 2022

    If America had the same size population as China do you really think we would have done better than them at governance during pandemic. Dr. Miller, you don’t know shit about China, just what you see and read on news. You write well but you don’t have any depth of knowledge to put down another country’s efforts when our crappy governance has lead to the death of over 1 million Americans. Write about that, not things your ignorant about.

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