A New Year concert in a shopping mall in Urumqi, Xinjiang Uygur Autonomous Region, on January 2 (VCG) 

Entering the first weeks of 2023, Chinese society seems to be rapidly restoring its vigor and vitality. Crowds are everywhere, whether in shopping malls, restaurants or theme parks. As the Chinese New Year, or Spring Festival, approaches, the annual travel rush is expected to be made up of roughly 2.1 billion passenger trips, reaching 70 percent of the 2019 levels.    

But at the same time, hospitals across the country are still operating at full capacity and funeral parlors, especially those in the northern regions that are in the midst of the cold winter, have had to reduce the time and scale of each funeral due to the obvious increase in the number of deaths. These are a reminder that the pandemic is not over.    

All of this is occurring in the country with the third largest land area in the world and a population of more than 1.4 billion. The sorrows and joys of each township and each family vary greatly. To understand the real situation, one needs to listen to the stories of those individuals and also remove oneself from the discourse system of ideological confrontation and review China's efforts in the past three years to combat COVID-19 from a more macro perspective. 

A main road in Wuhan, Hubei Province, on January 26, 2020 (XINHUA) 

Lockdown 

On January 23, 2020, or the Chinese New Year’s Eve, Wuhan, capital of the central province of Hubei and with a population of more than 12 million, became the first city in the world to adopt measures to cut off the transmission of the then unidentified virus. After the first cases of unexplained pneumonia were reported there in December 2019, medical experts realized that the disease caused by the novel coronavirus was capable of spreading quickly from person to person. Since Wuhan is one of China’s major transportation hubs, where tens of millions of passengers were set to arrive or leave during the 2020 Spring Festival travel rush, it was highly possible the virus would spread from the metropolis across the country. 

The control measures were criticized by Western media at the time, but they soon proved to be effective at preventing a nationwide epidemic. The main impact of the virus was confined to Hubei. Medics from all over the country and medical supplies from the whole world gathered in Wuhan and the outbreak was soon brought under control. On April 8, the closure of Wuhan ended. Many Chinese expected this outbreak, like severe acute respiratory syndrome (SARS) in 2003, would be history by summer.    

The Labor Day holiday on May 1, 2020 was extended from three to five days, one of the major reasons for this was to boost consumption. Chinese people were traveling and shopping as usual, and people in many cities had begun to take off their masks. On May 22, the Chinese mainland achieved zero new infections for the first time, but the number of confirmed COVID-19 cases worldwide exceeded 5.2 million.     

China's COVID-19 response measures gradually began to shift focus to preventing inbound infections from abroad and the strict entry quarantine policy, introduced then, lasted until January 8 this year. Residents of some border cities and international aviation hubs made sacrifices for the benefit of the country as a whole, experiencing rounds of lockdowns lasting several months over the past three years. However, the vast majority of Chinese did not experience lockdowns or mass nucleic acid testing until the emergence of the Omicron variant in 2022.   

One piece of data provides a snapshot of the time: On October 15, 2020, the Chinese mainland overtook North America to become the world's largest box office market for the first time in history. At a time when cinemas in other parts of the world were closed due to the pandemic, life in China appeared to be getting back to normal.   

People line up for nucleic acid testing during a COVID-19 mass screening in Beijing on March 21, 2022 (XINHUA)

Zero-ing 

Another focus of China's COVID-19 response was its dynamic zero-COVID policy. In Western media reports, China was engaged in a meaningless battle against the invisible enemy of COVID-19 with Don Quixote-style madness, with its people suffering unspeakably and its economy on the verge of collapse.   

China's emphasis on dynamic zero management did not set the goal of completely eliminating the virus, but aimed for the rapid control of small-scale outbreaks by quickly identifying people and places potentially at risk. One figure of speech likened China's pandemic prevention and control to a game of whack-a-mole. Once sporadic outbreaks of COVID-19 were found, they were quickly knocked down. 

China was not the only country that pursued dynamic zero-ing. Australia, New Zealand, the Republic of Korea, Singapore and some other countries also implemented similar policies and achieved the expected results. However, the emergence of the more contagious Delta strain in 2021 forced many that had previously declined to live with the virus to change strategies, and China became one of the few countries that continued the original approach.   

Chinese authorities were vigilant in the face of the onslaught of the Delta strain. This wave of infection began in July 2021 and quickly spread to more than half of the 31 provincial-level regions on the Chinese mainland, but only around 1,200 individuals were infected. On August 23, China once again returned to zero new locally transmitted cases. 

Workers set up a temporary COVID-19 hospital in Shanghai on April 8, 2022 (XINHUA)

Thanks to the dynamic zero-COVID policy, the vast majority of Chinese people had little chance of coming into close contact with the virus over the past three years. The most recent set of data that is often mentioned is that before the outbreak of the pandemic, in 2019, the average life expectancy in the U.S. was 1.5 years higher than in China, but that the figure in the U.S. dropped from 78.8 in 2019 to 76.4 in 2021, while the average life expectancy in China rose from 77.3  to 78.2 in the same period. 

The Chinese economy grew in a relatively stable environment. In 2020, China's GDP grew 2.2 percent, making it the only major economy to achieve growth in that turbulent year. In 2021, its economic growth was 8.4 percent, the fastest in nearly 10 years, exceeding the expectations of the International Monetary Fund and the target of the Chinese Government; China's annual import and export volume exceeded $6 trillion for the first time, a year-on-year increase of 21.4 percent, with imports soaring 21.5 percent.  

Additionally, China has not suffered from an inflation crisis similar to those in the U.S. and some European countries. On December 2 last year, Yi Gang, Governor of the People’s Bank of China, the central bank, said at an international seminar that China's inflation rate was about 2 percent. This figure is even lower than at the beginning of the pandemic. 

An 87-year-old COVID-19 patient and his doctor watch the sunset on their way back from a CT scan at a hospital in Wuhan, Hubei Province, on March 5, 2020 (XINHUA) 

Adjustment 

On January 8, 2022, Tianjin, a municipality in northern China with a population of 14 million, saw the first batch of domestic cases of Omicron infection. This new variant has a stronger ability to dodge immunity and is the most contagious strain to date. Many of those infected with Omicron have no obvious symptoms and are more difficult to identify. The arrival of this strain was one of the greatest tests of China’s adherence to the dynamic zero policy.   

In the following March, Omicron began to spread rapidly in Shanghai, and the city’s 25 million residents were required to stay home and take daily nucleic acid tests. More than 50,000 medical workers from other regions traveled to Shanghai to support containment and treatment efforts. On June 1, Shanghai authorities announced that the outbreak was under control and that normal business and life could resume. 

In the face of the new and more contagious strain, the cost of zero-ing was enormous. Beginning with the outbreak in Shanghai, China’s public heavily discussed the dynamic zero-COVID policy. The general demand was that the government should be more accurate in its implementation of response measures and formulate specific plans according to the characteristics of the latest strains.   

Doctors in protective suits communicate with a COVID-19 patient in Changchun, Jilin Province, on March 15, 2022 (XINHUA)

On June 28, the ninth edition of the COVID-19 control protocol was released, becoming an authoritative guiding document. It clearly stated that the government should optimize management protocols and duration for at-risk people and standardize the management of high- and medium-risk areas. 

However, executing precise and targeted prevention and control measures, rather than simply locking down affected areas and enforcing large-scale nucleic acid testing, placed extremely high requirements on local governments.  

Since the second half of 2022, the previously rare lockdowns became more frequent and the reliability of nucleic acid testing services, mainly operated by private companies, was constantly questioned by the public. Some cities hastily built centralized quarantine and treatment facilities with poor sanitary and living conditions. For many patients, the fear of being quarantined in harsh conditions was far greater than the fear of COVID-19 itself. 

More importantly, after several months of coping with the Omicron strain, its characteristics of lower pathogenicity and tendency toward upper respiratory tract infection were verified, and medical staff had accumulated experience in its treatment. At the same time, China’s full vaccination rate had exceeded 90 percent, and the coverage rate for people aged over 60 and 80 had exceeded 85 percent and 65 percent, respectively. Progress had also been made in the research, development and production of medication to treat COVID-19 infections. It became increasingly feasible for China to adjust its COVID-19 prevention and control policy by shifting its focus from preventing infections to beefing up treatment of severe cases.   

A COVID-19 vaccination site in Kunming, Yunnan Province, on August 4, 2021 (XINHUA)

The adjustments included 20 measures in November and 10 new measures in December 2022 to ease pandemic restrictions, changing the Chinese term for COVID-19 from “novel coronavirus pneumonia” to “novel coronavirus infection,” and downgrading COVID-19 management measures from January 8 of this year. Now, the priority is to, concentrate medical resources on high-risk groups such as patients with underlying illnesses and seniors, and improve the level of medical services in rural areas. 

Over the past three years, China has made great efforts to protect its people, and as the enemy has changed, the defense strategy has been optimized along with it. China’s embarking on a new phase of COVID-19 management, which was deemed sudden and unexpected as it was described by some Western media, is in effect very much a calculated move.  

(Print Edition Ttile: Portrait of a Pandemic) 

Copyedited by G.P. Wilson 

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