China’s Covid lockdowns: Here’s what you need to know

Since March, China has battled its biggest wave of Covid yet, with Shanghai now the biggest hotspot. The 25 million residents are all in lockdown, with national health workers and the Chinese military dispatched to bolster the city’s response.

On Tuesday, the country recorded more than 20,000 new cases, well above Wuhan’s peak in 2020, at the start of the pandemic.

Although this number is still far lower than many other countries, it is a dramatic spike for China, which has adhered to a strict zero Covid strategy that aims to eradicate all epidemics and chains of transmission in using border controls, mass testing, rigorous quarantines and lockdowns.

The sustainability of this policy is now in question as new, highly infectious Covid variants continue to spread through the population.

Here’s what you need to know about the latest outbreak.

Which parts of China are affected?

In early March, cases began to rise in several provinces across the country, including Shandong in the east, Guangdong in the south and Jilin in the northeast.

By the end of the month, the virus had spread to 29 of China’s 31 provinces, according to the National Health Commission (NHC). 90% of all cases identified in March were from Jilin and Shanghai, the two biggest hotspots.

Several cities, collectively home to more than 37 million people, were placed under varying levels of lockdown in March. Many of those lockdowns eased in early April – leaving Shanghai as an outlier, as authorities struggle to get its cases under control.

So far, only two Covid deaths have been officially reported during this wave, both from Jilin in March.

What does life under lockdown look like?

The Shanghai measures were extended and extended as the situation deteriorated.

In late March, the Shanghai government denied having plans for a citywide lockdown – even saying the reports were “false” and disturbing “social order”. On March 27, the government announced that it would launch a staggered lockdown, first targeting half of the city, then the other half.

By March 31, the government had abandoned its phased approach, effectively imposing a citywide lockdown for the 25 million residents who were banned from leaving their neighborhoods except to get tested.

Mandatory citywide testing has detected a spike in cases, officials said – urging them to extend the lockdown until further notice while they ‘test more, review results, transfer cases positive and analyze the overall Covid situation”.

To enforce these measures and meet the demands of the entire confined population, more than 30,000 doctors and 2,000 soldiers have been dispatched to the city, according to official media and the People’s Liberation Army.

But the restrictions have also brought a rare outpouring of public frustration and criticism of the government, with residents describing difficulties in accessing basic supplies like food or medicine.

In China's 'zero-Covid' lockdowns, patients with other illnesses struggle to survive
Anger swelled last month after an off-duty nurse died in Shanghai after being turned away from an emergency ward at her own hospital that was closed for disinfection. Another Shanghai resident died after suffering a medical emergency at his home before he could get to a hospital.

“We are not being killed by Covid, but by Covid control measures,” noted a popular comment on the highly censored Chinese social media platform Weibo.

There has also been renewed outrage over Shanghai’s policy requiring all Covid-positive patients to be isolated in facilities – even young children and babies. A mother told CNN she was separated from her infected 2-year-old daughter on March 29 and only allowed into the isolation ward to stay with her daughter a week later. .

On Monday, a quarantine center in Shanghai launched a parent-child quarantine zone. And on Wednesday, Shanghai health authorities announced they would change the policy, allowing parents who test negative to apply for permission to accompany Covid-positive children with “special needs”. They did not specify which conditions would qualify as “special needs”.

Parents who test positive can also accompany their Covid-positive children to the quarantine facilities.

Which variant is widespread?

Omicron was behind this surge, with identified cases showing both BA.1 – the original Omicron – and other descendant lines including BA.1.1 and BA.2.

BA.2, which was first detected in January, is now the leading cause of Covid-19 worldwide and the dominant strain in the United States, according to the World Health Organization and US health authorities.
What we know about BA.2 - now the leading cause of Covid-19 in the US

Since its increase, the number of international cases – which had been falling since the first week of January – has increased again.

Studies also suggest that BA.2 is much more contagious – although researchers are still studying the severity of this variant. Some epidemiologists have said that its basic reproduction number can be as high as 12, meaning each sick person infects an average of 12 others.

That would put it on par with measles, which also spreads through the air. The base reproduction number for BA.1 is estimated to be around 8.

Will China stick to zero-Covid?

As the epidemic spreads, experts and international observers have speculated whether this wave, the most transmissible variant, and the mass vaccination campaign in China could lead to the end of zero-Covid.

As of Friday, about 78% of the country’s 1.4 billion people had been fully vaccinated, according to the NHC.

Before the outbreak, scientists and leaders had hinted they were re-examining the strategy, with a leading epidemiologist writing on Weibo in early March that zero-Covid “won’t stay unchanged forever”.

But that now looks like a distant future, with Chinese authorities making it clear that they are considering the alternative – the virus raging across the country, potentially overwhelming the healthcare system – the worst option.

Wu Zunyou, chief epidemiologist at the Chinese Center for Disease Control and Prevention, said on Friday that China would “continue to focus on an aggressive zero Covid policy,” according to state-run tabloid Global Times. The easing of restrictions and the opening of borders seen in other countries could “cause many problems such as (a compression) medical resources and the increase in the number of deaths,” he added.

And on Monday, Vice Premier Sun Chunlan said in Shanghai that the city needs “a more determined attitude, more powerful actions and more effective coordination” to achieve zero-Covid.

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