China's Covid disaster

A woman on a stretcher is wheeled into a hospital in Beijing, December 2022. Photograph: Andy Wong/AP

From The Guardian

In the chaos of China’s Covid exit wave, China’s supreme leader, Xi Jinping, has been curiously absent. His last public pronouncement on China’s “dynamic zero”-Covid policy was in his speech to the 20th party congress in October: “We have adhered to the supremacy of the people and the supremacy of life, adhered to dynamic zero-Covid,” he told delegates, “... and achieved major positive results in the overall prevention and control of the epidemic and economic and social development.” It was, he insisted, overwhelming evidence that the policy was correct and that the party cared deeply for the people.

Xi used his New Year Address yesterday to urge more effort and unity as the country enters a “new phase” in its approach to the pandemic. Until his remarks, the defence of his policy U-turn had been left to others. As distressing images of body bags stacked in hospital corridors, patients on intravenous drips by the roadside and hearses queueing outside crematoriums circulated on social media, hapless officials indignantly denied “rumours” of pandemic deaths, repeating claims that China managed the virus better than other countries, demonstrating the superiority of China’s political system, and insisting anyone who says otherwise is either an ill-intentioned foreigner, a traitor to the people or a paid provocateur. They insisted that the reversal was a rational, science-based and well-prepared decision or, as the nationalist mouthpiece Global Times put it last week: “The changing virus variant, accelerated mass vaccination and enhanced medical resources all laid out the foundation for a long planned and orderly Covid response adjustment.”

Within a breathtakingly brief interlude, China’s people have been asked to forget that the Covid threat justified draconian lockdowns, loss of livelihood and liberty. Now they must believe that it is no worse than a common cold, that traditional Chinese medicine is effective and that the death rate is negligible. Despite the double shifts in crematoriums and the lived experience of millions of people, Chinese officials continue to insist that all is well.

Even in a population accustomed to being told that black is white if the party says so, this has generated a mix of indignation and incredulity: indignation at three years of government failure to fully vaccinate a vulnerable population; at its failure to learn from the experience of other countries and territories such as Hong Kong; and incredulity at the manifest gap between propaganda and the evidence of their own eyes. In the black box of Chinese politics, the pressures that led to the decision are unlikely to be revealed, but the chaos of its execution is unmistakable.

There were good arguments for changing the policy. Long before November’s nationwide protests revealed the state of frustration and anger of a people who saw no end, the social and political costs of dynamic-zero Covid were evident. With the arrival of Omicron in China, the policy itself was failing in its primary purpose of containment and elimination: it had become an expensive exercise in futility.

But that does not explain the lack of preparation for an inevitable explosion of infection in a poorly vaccinated population that lockdowns had kept largely naive to the virus. Over the past three years, China focused its vaccination effort on the working population to keep the economy running, which left elderly people particularly vulnerable. As in Hong Kong, many elderly Chinese were also suspicious of the vaccines and, given the government’s promise to eliminate the virus, preferred not to take the risk. And because the government declined to license western mRNA vaccines in China, where they did opt for vaccination their choice was limited to China’s less effective product.

As people fell sick, they looked to pharmacies for remedies, only to discover that in a country that boasts the world’s second largest pharmaceutical industry, the shelves were empty of basic anti-viral drugs or fever remedies. Some desperate patients resorted to importing packets of ibuprofen at eye-watering prices or illegally substituting unlicensed Indian generics. In Japan, authorities imposed restrictions on the purchase of anti-viral drugs as Chinese customers stripped the shelves bare. Why was China unable to meet the surge in demand that the exit wave would inevitably create?

The answer appears to be an elementary planning failure.

In the now distant days of dynamic-zero Covid, access to an anti-viral drug such as Pfizer’s Paxlovid and the Chinese drug Azvudine required nucleic acid tests. Because testing positive meant the patient would be subject to enforced confinement in a state facility, sales plummeted, inventories crashed, production slowed to a trickle and distribution systems atrophied as companies restricted production of time-sensitive drugs for which the market had collapsed. When the policy was changed without notice, they were left completely unprepared.

Today’s censorship and denial recall the first appearance of the virus in Wuhan three years ago. Then, as now, the authorities punished those who told a different story, denied medical evidence and allowed huge social events planned for the annual spring festival to proceed as normal. As it approaches again, millions of Chinese hope to visit distant families and the wealthier plan to travel abroad – or to Hong Kong and Macau, where they anticipate the added bonus of access to western vaccines. Neighbouring countries, concerned, like the WHO, that the lack of data from China could conceal the emergence of new and potentially devastating variants, have imposed travel restrictions for Chinese travellers that China’s official spokesperson promptly denounced as unfair.

On the country’s heavily censored social media, citizens argue about who is to blame for the chaos. Some blame November’s protesters. Others, like the author of a now censored social media post, see it differently: “Shouldn’t they have thought of these things?” he wrote. “The end result is just… baffling. It’s like we’re dealing with a rebellious junior-high-school student who has no sense of responsibility, suffers from an extreme level of paranoia and is completely immersed in the fantasy that he’s the world’s most powerful superhero.”

As the virus rages, Xi’s supporters have defaulted to another familiar script: insist on the party’s wisdom, blame local officials for any failures, punish those who argue and hope to ride out the crisis. Xi’s supreme position in the party was secured at the 20th congress in October. His reputation in the country – and China’s image in the world – may not recover.