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China’s transition out of zero Covid could be potentially catastrophic

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Beijing faces some unique challenges in making the shift.
China is the only major country which, until now, has continued to enforce a zero-Covid strategy. Other countries, including Australia, New Zealand and Singapore, also sought to eliminate Covid entirely earlier in the pandemic. But all eventually abandoned this approach because of the mounting social and economic costs and the realisation that local elimination of Covid was largely futile and only transient.
China’s strategy, which has relied on measures including mass testing, shutdowns of entire cities and provinces, and quarantining anyone who may have been exposed to the virus, has increasingly become untenable. The harsh and often arbitrary enforcement of zero Covid has fuelled growing resentment among the population, culminating in large public protests.
The restrictions have also shown their limits in the face of omicron. This variant has a shorter incubation period than previous Covid lineages, and largely bypasses protection against infection conferred by the original vaccines.
It’s logical that Chinese authorities are now moving to ease restrictions. However, the transition out of zero Covid has been painful for any country that’s done it. And China faces some unique challenges in making this shift.
China has successfully suppressed widespread Covid transmission since early 2020. Although figures differ between sources, close to 10 million cases have been reported to the World Health Organization since January 2020. This represents only a tiny fraction of the country’s population, numbering 1.4 billion. So the Chinese population has acquired minimal immunity to Covid through exposure to the virus to date.
Vaccination rates in China are largely in line with those in western countries. But an unusual feature of China’s vaccination rates is that they decrease with age. Older adults are by far the demographic at highest risk of severe Covid, yet only 40% of people over 80 have received three doses.
Vaccine efficacy against transmission has been severely tested, especially since omicron started spreading in late 2021.

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