China digs in for permanent zero-Covid with expanded testing and quarantine regime

Lockdown measures return in parts of Shanghai just a week after being lifted

A health worker takes a swab sample from a woman by the entrance of a residential area under Covid-19 lockdown in the Xuhui district of Shanghai. Photograph: Hector Retamal/AFP via Getty Images
A health worker takes a swab sample from a woman by the entrance of a residential area under Covid-19 lockdown in the Xuhui district of Shanghai. Photograph: Hector Retamal/AFP via Getty Images

China is building hundreds of thousands of permanent coronavirus testing facilities and expanding quarantine centres across many of its biggest cities as part of its zero-Covid policy, despite the economic and human toll on the world’s most populous country.

Residents of Shanghai woke up on Thursday to an announcement that lockdown measures and mass testing would be conducted in the Minhang district, home to more than 2 million people, for at least two days. The directive was issued just a week after president Xi Jinping’s administration declared victory in defending the city from the pandemic after a punishing two-month lockdown.

Tough restrictions in scores of cities have driven the country to the edge of recession for just the second time in three decades. But even though measures have been eased in many areas, experts believe the government’s virus infrastructure programme is designed to sustain the mass-testing and quarantine policies through 2023.

Officials are racing to execute instructions to be able to test entire city populations within 24 hours. Bigger metropolises must now have testing sites available within no more than a 15-minute walk of residents’ homes, and temporary facilities are being replaced with permanent booths sourced from private medical companies.

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The country’s 31 provinces and regions are also following orders from Beijing to prepare new hospitals and quarantine facilities in the case of a Shanghai-style surge in infections.

Yanzhong Huang, a senior fellow for Global Health at the Council for Foreign Relations think-tank, said such measures demonstrated Beijing’s commitment to zero-Covid “despite this growing social, economic cost associated with this approach”.

“The government believes they could outrun the virus. But we know for the Omicron variant this is not realistic. And for an even more transmissible variant, that will make it even less feasible,” he said.

As of April, China already had 400 makeshift hospitals completed or under construction with a capacity of more than 560,000 beds, according to public comments by National Health Commission officials. Authorities in cities with more than 10 million people have been told to have at least 1,500 hospital beds available in centralised quarantine facilities, in addition to back-up centres that can be put into use with a few days’ notice.

“The capacity for admission and isolation should be further strengthened, and designated hospitals ... and centralised isolation points should be planned and prepared in advance,” Ma Xiaowei, a senior official of the NHC, wrote in Qiushi, the flagship Chinese Communist party journal last month.

In one example of rapid progress, Ningbo, a city of 8 million south of Shanghai, opened its first centralised Covid-19 quarantine facility last month with 4,356 isolation rooms, including 200 for families to quarantine, as well as 880 rooms for staff.

Most large Chinese cities have already instituted requirements for regular Covid-19 tests, regardless of symptoms. The Beijing city government requires residents of the capital to show a negative Covid-19 test taken in the previous 72 hours to travel freely, including on public transport.

Shanghai has established about 15,000 testing sites for its 26 million people and Lanzhou, a northwestern city of 4 million, has the capacity to test close to 150,000 people daily.

China’s zero-Covid policy has been successful in containing the Omicron variant and keeping the death toll low, compared with countries such as the UK and the US. Daily case numbers have been near three-month lows with a seven-day average of about 150, down from a peak of about 30,000 in April.

But many people are frustrated at the prospect that the zero-Covid policy could be extended into a fourth year. “The Covid zero policy is a total madness: it’s inhumane and not very successful,” said a Beijing-based art curator. “The governments in Shanghai and Beijing lie to people’s faces. In Shanghai, they said they wouldn’t lock down ... then at the end it was 60 days,” the person added.

People try to break out of quarantine fence during a protest in Shanghai on Monday. Photograph: Alex Plavevski/EPA-EFE
People try to break out of quarantine fence during a protest in Shanghai on Monday. Photograph: Alex Plavevski/EPA-EFE

Eight cities in China and 74 million people are now under full or partial lockdown, compared with 133 million people a week ago and 355 million people in April, according to research from Japanese bank Nomura.

Authorities are also allocating huge amounts of resources to enacting the zero-Covid policy, with some local governments forced to divert funds from other priorities such as poverty alleviation and infrastructure.

The potential economic costs are significant. If every city were to adopt Beijing’s 72-hour testing requirement, 814 million people would need to be regularly swabbed at a cost of 1.7 per cent of national gross domestic product, according to a Nomura analysis.

China has already cancelled two big international events in recent weeks. Organisers of the Shanghai International Film Festival said this week that the event, scheduled to open on Friday, would be delayed to 2023. The announcement followed China’s decision last month to pull out of hosting next year’s Asian Cup football competition due to Covid concerns.

Jane Duckett, director of the Scottish Centre for China Research at the University of Glasgow, said mandatory regular testing consumed resources “that might be better used to improve the vaccination rates among older and more vulnerable groups”.

But Andy Chen, an analyst at consultancy Trivium China, said Beijing would revise its policy after Xi was confirmed for a third term as the country’s leader late this year.

“These measures ... are a reaction to the mismanagement of the recent outbreak in Shanghai, where targeted and precision-guided containment measures early on let the spread of Omicron get out of control. The set-up of regular testing sites in big cities is meant to detect and catch infections early,” he said.

But Huang was adamant that “this zero-Covid approach will be sustained, maybe through 2023″, despite the lack of epidemiological benefits.

“It’s not going to eradicate the virus,” he added. “New variants continue to rise and spread ... [and] when you seal the population from the virus, you also sustain the immunity gap between China and the rest of the world.” — Copyright The Financial Times Limited 2022