When nearby neighborhoods went into lockdown, Liu Li started stocking up. The 42-year-old magazine worker bought vegetables, fruit, medicine and other supplies, adding to stores of basics she had maintained since the COVID-19 pandemic began.
On March 13, a resident in the community where Liu lives with her mother in Changchun, China, tested positive for COVID-19. Everyone was ordered inside.
The fresh lockdown had, so far, been OK, Liu said.
Illustration: Mountain People
“I live a normal life,” she said. “I work when there are tasks for me. If there aren’t any, I talk to my mother, watch TV or play with my cat.”
Liu is luckier than some — she works from home and was well prepared.
However, there is also a risk. Her mother is a cancer patient, but is unvaccinated against COVID-19.
They are among the 37 million people under lockdown in China, as authorities battle the country’s biggest outbreak of the pandemic.
China has successfully contained every outbreak before this one, through a resource-heavy response, including mass testing, transportation shutdowns and localized lockdowns.
This time Omicron, a milder, but much more virulent variant of SARS-CoV-2, has challenged the old strategies.
On Friday, China reported 4,130 confirmed, asymptomatic cases across more than 20 provinces, including 2,626 in Jilin Province, where Liu lives.
On Saturday, the country’s first two COVID-19 deaths in more than a year were recorded in the region.
Forecasters at Lanzhou University have predicted that 35,000 people would contract the virus if it is not contained by early next month.
State media says that 95 percent of cases are mild, but of acute concern is that an estimated 17 million people aged 80 or older — about half of the age group — are still not fully vaccinated, an analysis of vaccine and population data showed.
Just 19.7 percent have had a booster, health authorities said on Friday.
They are among about 52 million people aged 60 or older who have not been vaccinated.
Unlike in many other countries where health professionals have almost uniformly encouraged vaccination, many Chinese who have not been inoculated say they are following their doctor’s advice.
“Because she is a cancer patient and has undergone two operations, she cannot be vaccinated,” Liu said. “The doctor suggested that it should be decided according to our physical condition and living environment.”
One Chinese social media user wrote: “My mother has a lot of syndromes, so she can’t be vaccinated. We have been to the hospital three times and they wouldn’t vaccinate her, so we gave up.”
Fear of adverse reactions is a common reason among unvaccinated elderly people.
“My father and mother-in-law have high blood pressure, so they didn’t dare to be vaccinated,” another social media user wrote.
Instead, Liu has taken other precautions to protect her mother. Before the most recent lockdown, she did not go out much, but when she did, she avoided crowds and wore a mask.
“As long as I pay more attention in daily life, things will be fine,” she said.
Low vaccination rates among this vulnerable demographic have also emerged in Hong Kong — where unvaccinated elderly people are disproportionately among the sick and the dead — and Taiwan, which is rushing to convince its residents to get the jab before it has an outbreak.
University of Oregon Global Health Center director Chi Chun-huei (紀駿輝) calls the hesitancy the “paradox of the zero COVID policy.”
“When there was an extended period without any domestic outbreak, the risk of infection was close to zero,” he said. “When people in China assess the benefit versus risks of COVID vaccination, the perceived benefit is nearly zero, while the perceived risks [of side effects and complications] are relatively high.”
A study of China’s vaccine hesitancy in November last year also listed price as a top three concern, despite the Chinese government announcing in January last year that vaccinations would be free.
“Either free vaccination was not completely universal, or the free program was not well-communicated to the public,” Chi said.
Some residents have grown weary with the life interruptions brought by the “dynamic zero” policy of dealing with outbreaks.
On Friday, footage went viral of protection equipment-clad workers fighting with residents in a Chinese parking lot.
Online, people sniped about Shenzhen, Shanghai and Hong Kong “dragging down” other areas with less restrictive responses.
The government remains committed to “dynamic zero,” but there are signs of concern that the cost is becoming intolerably high.
Goldman Sachs last week estimated that a month-long lockdown of 30 percent of China could see GDP drop by 1 percentage point.
At a closed-door meeting of the Chinese Communist Party (CCP) Politburo Standing Committee on Thursday last week, Chinese President Xi Jinping (習近平) appeared to acknowledge the toll of the policies when he demanded China strive for “the maximum prevention and control at the least cost, and minimize the impact of the epidemic on economic and social development.”
It is easier said than done.
However, there are signs that authorities recognized this outbreak was different.
For the first time, China approved the use of at-home rapid antigen tests, and added the use of antiviral pills made by Pfizer to pandemic guidelines.
It also declared an end to mandatory hospitalization of all COVID-19 cases, saying that asymptomatic and mild cases would be sent to centralized isolation facilities.
In Shenzhen, Apple supplier Foxconn was among the businesses that went back into operation just a few days into a citywide lockdown, enacting a “closed loop” system similar to that which ran during the Beijing Winter Olympics to minimize economic disruption.
However, Chi said China was unlikely to abandon “dynamic zero” any time soon.
Dozens of local officials have been fired or punished over the outbreak.
The Hong Kong government has drawn the ire of Beijing for its mishandling of an Omicron outbreak that health authorities estimate has infected about half the population.
“The CCP’s political legitimacy hinges on its capability to provide Chinese people with a stable and safe life, for which containing the COVID-19 infection is critical,” he said.
The outbreak has put China at a crossroads. If containment does not work, the caseload among a population of 1.4 billion people would be huge, and analysts predict major disruptions to the economy and global supply chain.
If containment works, it prompts the question: What comes next?
“Zero COVID-19” strategies rely on closed or heavily restricted borders and travel, and the virus is expected to be in the world for the foreseeable future.
When does China reopen?
University of Geneva Institute of Global Health director Antoine Flahault said that Omicron means “dynamic zero” is no longer an effective or sustainable option, citing the economic effects of lockdowns, which he said feel increasingly disproportionate to people who experience mild COVID-19.
Chi said he expects China to contain the outbreak, but added that continuing spread in a well-prepared setting might not be the worst thing, as recent studies have showed that natural immunity gives stronger protection than vaccines.
“Omicron with high contagiousness and low severity/fatality is a good candidate to achieve this strong population immunity,” Chi said.
For now, Liu is comfortable in her lockdown, but said that she sees a future envisioned by Flahault. She is confident China would prevail over the outbreak, through the current measures and with greater immunity and improved treatment options.
“I’m not worried,” she said. “On the contrary, I think things will get better.”
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