Why China clings to the zero-COVID strategy?

Two entire years have passed since the first global outbreak of the COVID-19 pandemic. Many countries have recently changed the COVID fighting policy by switching from a zero-COVID strategy to a living-with-COVID strategy, whereas China is still sticking to its stringent zero-COVID policy. Some Chinese intellectuals speculate that China will soon lift its strict control measures, copying the western pattern. However, slapping them on the face, Sun Chunlan, a Vice Premier of the State Council, reiterated three days ago the necessity of the zero-COVID policy. This blog post will identify the rationale behind Sun Chunlan’s speech.

Zero-COVID vs. living with COVID-19

First, we need to understand the difference between the underlying goals of the zero-COVID strategy and the living-with-COVID strategy.

The zero-COVID strategy aims at eliminating the virus. By promptly singling out every infected, the government wants to wipe out SARS-CoV-2 and makes it disappear from the world. This strategy was relevant at the early stage of the epidemic when the risk of the novel virus was unknown. A virus with unknown danger implies unbounded risk, so the zero-COVID strategy can be regarded as a rational risk-averse strategy. In addition, the small number of people then infected made the elimination still possible. A temporary lockdown can save years of trouble, so the zero-COVID strategy is economically cost-efficient.

The living-with-COVID strategy, on the other hand, acknowledges the impossibility of eliminating the virus and, instead, aims at mitigating its impact on the country’s economy and people’s well-being. With the prevalence of SARS-CoV-2 and its various variants, such as Delta, Omicron, and those yet to come, it has already become unrealistic to eliminate the virus. The only sensible attitude is to prepare to coexist with the virus. Furthermore, the virus is no longer as dreadful as it first appeared with its decreasing morbidity and our increasing knowledge and treatment. Therefore, a long-term, cost-efficient strategy is necessary for this situation.

The living-with-COVID strategy now is just as reasonable as the zero-COVID one at the beginning of the epidemic. They both take into consideration the risk and the economic cost. With the rebalancing of the risk and the cost, different strategies are adopted in different situations.

Why China continues the zero-COVID strategy

Since the living-with-COVID strategy is both reasonable and economical, it begs the question of why the Chinese government stubbornly sticks to the old policy. To answer this question, we need to understand the living condition of the Chinese.

Despite China’s status as the second-largest economy, the Chinese live in poor conditions. Unlike western college students, each having a single unit in the dormitory building, Chinese students have to share a tiny room equipped with multiple beds. It is not uncommon for a group of four or six students to sleep together in a $10 m^2$ room, even in the most prestigious universities. The same happens to those young people coming to big cities in search of a better life, who live in a collective dormitory provided by their employers. This situation does not turn much better even after the marriage. Many couples, some having children, have to be content with a small flat because of the rocketing housing price. These minuscule rooms provide an ideal transmission condition for viruses.

In addition to the limited space, the defective ventilation system is also a contributing factor. If someone smokes indoors, the smoke will propagate to the whole building via the ventilator in the bathroom and the smoke detector. Airborne viruses can use this very path to transmit from one person to all residents in the building. With the intimidating housing price, I dare to claim that 90% of real-estates were built with a defective ventilation system to cut costs.

The crowded living space and the defective ventilation system determine that viruses in China have a higher basic reproduction rate than in developed countries. Confronting the more threatening virus in China is a shortage of medical workers. In 2017, the OECD average was 3.5 doctors per 1000 population, while China had only 2 doctors per 1000 population. Although Chinese people are the most hardworking creatures ever, Chinese medical workers probably have been exhausted by this point after two years of non-cease battle with COVID-19. Once a new outbreak happens, I don’t think the Chinese medical system would be as responsive as the western one.

Based on the higher basic reproduction rate and lower medical resources in China, it is only reasonable for the Chinese government to adopt a different strategy from the western countries.

Political and economic considerations

Apart from the aforementioned epidemic reasons, there are also political and economic considerations behind the Chinese government’s decision.

The zero-COVID strategy has magically worked for China, so no government officials dare to take the risk to change the status quo. If a regional head changes the policy and then an outbreak occurs, he will lose his political career prospect, which is disastrous to him and his superior. If it is Xi who makes this choice, he will lose his 3rd mandate immediately. China’s reluctance to live with COVID-19 is similar to the US’s reluctance to retreat from Afghanistan. Both China and the US are frustrated with their respective conundrums, and neither dared to break the stalemate. Now you realize how brave Biden is.

China’s hostile attitude towards COVID-19 is also due to the face-work. The Chinese government has lost its face on the issue of the origin of SARS-CoV-2. Now they desperately want to regain their face by showing off their success in preventing further outbreaks. If they succeed, they probably can even dispel others’ suspicion that China is the origin. I don’t know how the westerners think, but this is at least what the Chinese government has planned or fantasized about.

In addition to political benefit, a zero-COVID policy can also bring economic benefit. A better epidemic situation than the rest of the world can attract foreign capital and improve the export, both of which are vital to China’s GDP growth. The Chinese government is using the zero-COVID policy as makeup to make China more attractive, just like Jewish women in Auschwitz concentration camp making up themselves with blood from their fingertips to make them appear more healthy and thus delaying their destiny in the incinerator. China’s growth relies on the outside world, and the Chinese government fears being deserted.

All other countries need only respond normally to COVID-19, but the Chinese government has to deal with extra requirements because of China’s particular status. These special requirements keep the Chinese government away from living with the virus.

A third choice?

This post analyzed the rationale behind China’s zero-COVID policy. Chinese people’s poor living conditions and China’s particular political and economic situation exclude the choice of living with the virus.

However, this rationale does not justify the suffering Chinese people have to experience under the zero-COVID policy. Nor does it justify its destructive impact on economy. Is there a third choice apart from living-with-COVID and zero-COVID, which can stop SARS-CoV-2 without hurting too much the economy and people’s well-being? This will be the subject of a future post.

Written on March 15, 2022