Chinese authorities are again putting millions of people under strict lockdowns as the omicron variant is driving local transmission of coronavirus cases to levels not seen since the first outbreak in early 2020.
On Monday, authorities in northeast China ordered lockdowns in Jilin province and in Shenyang, a city of over 8 million people in neighboring Liaoning province.
Further to the south, residents of Shanghai are worried that authorities could impose a city-wide lockdown, as daily COVID-19 case numbers have risen every day for nearly a week. On Monday, Disneyland in Shanghai said it would shut down the amusement park until further notice.
Since the beginning of March, more than 20,000 COVID-19 cases have been recorded in China. On Thursday alone, 4,500 cases were reported.
Sticking with zero COVID
While the scale of the outbreak remains small by global standards, the outbreak is nonetheless testing the limit of China's "dynamic zero-COVID strategy."
China was praised at the beginning of the pandemic for its efforts in almost completely stamping out the virus.
However, two years later, the strategies needed to keep case numbers at zero are being challenged by the more contagious, vaccine-dodging omicron variant.
However, especially in vaccinated individuals, the variant has been shown to cause less severe illness. This has called into question the draconian methods needed to maintain zero COVID.
"On the one hand, viruses are becoming more transmissible but less lethal, leaving health authorities with even less time to maintain zero COVID," said Xi Chen, an associate professor of health policy and economics at the Yale School of Public Health.
"On the other hand, people have strong COVID fatigue. The economy has been hit harder than before, as infected cases are found throughout China. However, the current outbreak won’t fundamentally change the dynamic zero-COVID policy in the near term," he added.
Despite the growing pressure, Chinese President Xi Jinping has vowed to stick with zero COVID. Xi said last week that China should "continue to put people and life at the forefront, stick with scientific accuracy and dynamic zero, and curb the spread of the epidemic as soon as possible," reported China's CCTV state broadcaster.
Xi also urged authorities to boost vaccinations, rapid testing and drug research, and make virus curbs more targeted, while asking local authorities to swiftly control local clustered outbreaks.
To ensure provinces across China have enough capacity to deal with the rising number of cases, Chinese authorities have advised each province to set up temporary hospitals to treat patients.
China's National Health Commission has also instructed local health authorities to reserve established hospitals for people with serious symptoms.
"While it will take more time and affect larger areas, incurring more economic and social costs, China in this current stage has to buy time to optimize its vaccination strategies and health care systems to better prepare," Chen said.
Will China ever learn to 'live with the virus?'
Although Chinese authorities have freed up large medical resources for more efficient use in fighting coronavirus, Chen said the Chinese public and authorities are not "mentally and psychologically prepared for major changes" in their response to the pandemic.
"The return from using the heavy-handed zero-COVID policy to 'living with the virus' requires a salient shift for such official messaging and public health education, and also learning from both successes and failures of other nations' response to COVID," he added.
Chunhuei Chi, director of the Center for Global Health at Oregon State University, told DW that China won't make any fundamental changes to its zero-COVID strategy at least until after the Chinese Communist Party’s 20th Party Congress this fall.
"Before Xi Jinping's third term is confirmed at the 20th Party Congress, it's very unlikely for China to abandon its zero-COVID strategy," he said.
Hong Kong a grim reminder
China's case surge comes after Hong Kong experienced its worst coronavirus outbreak since the start of the pandemic, with deaths among the unvaccinated elderly having surged. As a result, Hong Kong's coronavirus death rate has become the highest in the world.
Although case numbers have begun to decline this week, and officials have announced a series of steps to loosen pandemic control measures, experts say China has paid close attention.
"China is closely following what's happening in Hong Kong as there are a lot of parallels and some important lessons," said Karen Grepin, an associate professor at the University of Hong Kong's (HKU) School of Public Health.
"Hong Kong has demonstrated that when omicron spreads in a previously unexposed, poorly vaccinated elderly population, you can still have a lot of deaths. That's definitely a lesson that China will have to take on board," she added.
On March 18, health officials told a press conference that only about 51% of Chinese citizens over the age of 80 have received two doses of a vaccine, while only around 20% of the same group have received booster shots. Data shared by officials also shows that China's vaccination rate drops with age.
Additionally, a study released by scientists at HKU this week shows that two doses of China's Sinovac vaccines offer only a moderate level of protection against severe symptoms or death caused by coronavirus infection while a booster shot can enhance the protection significantly.
"If people are not vaccinated yet, any vaccine right now is a priority," said Grepin. "I hope what they are internalizing here is the need to push people to get vaccinated in the short run as this is a turning point for them in their pandemic."
Edited by: Wesley Rahn