Lessons of 'Zero Covid' From China

"Ever since China adopted its policy of stamping out every Covid-19 infection, outsiders have wondered whether it could last. With each new, more infectious variant, "zero Covid" has required more vigilant and frequent crackdowns on daily activity.

Yet it has lasted. And seen from inside China, the results are remarkable. Foreigners in Beijing for the Olympics may be confined to a dystopian bubble in constant fear of being quarantined.

But outside the bubble, life looks close to normal, with stores, museums and offices operating, and subway and road traffic in line with this time of year in 2019. Americans only now are moving on from the coronavirus. Most Chinese did so back in 2020.

It's difficult for Westerners to evaluate China's Covid-19 response dispassionately. Mistrust runs high over China's muzzling of information about the virus in late 2019, its refusal to accept that the pandemic originated there and failure to cooperate more with international investigations. China's measures for tracking, tracing and isolating infected people are seen as an extension of a surveillance state. Indeed, the Chinese Communist Party touts its Covid-19 success as proof its governance is superior to American-style democracy.

And yet this geopolitical tension tends to muddy zero Covid's achievements and its lessons. It appears to have delivered what every country sought two years ago: low deaths with the least possible economic disruption. While there are questions over the reliability of China's official Covid death toll, it appears to rank among the world's lowest per capita, and its gross domestic product finished 2021 roughly where pre-pandemic trends predicted.

It's true, as critics claim, that zero Covid can't be sustained indefinitely. China will eventually have to coexist with a virus that is permanently entrenched in the human population. Hong Kong's spreading outbreak illustrates how difficult test, trace and isolate becomes once infections are widespread enough.

Yet it's worth studying how mainland China has sustained zero Covid. China put enormous resources behind it, most importantly on testing capacity: A city of fewer than five million people is expected to screen every inhabitant using PCR tests in two days, and a city of more than five million in three days. By contrast, testing became backlogged or unavailable for many in numerous U.S. cities in the Omicron wave.

Beijing also has made zero Covid less disruptive. Under a targeted approach dubbed "dynamic clearing," restrictions typically cover a district, a neighborhood or a building. "Some localities endure tough restrictions and disruption for a short period of time so that most of the country can exist without restrictions most of the time," Cui Ernan of Gavekal Dragonomics, a China-focused research service, wrote last month.

It hasn't been costless. China's consumer spending has been hurt by lockdowns and travel restrictions. Yanzhong Huang, a health expert at the Council on Foreign Relations, said 4.4 million small businesses closed in the first 11 months of last year while 1.3 million new ones registered. China, he estimates, spent nearly $100 billion on domestic vaccines that are far less effective than Western mRNA shots that it won't approve. Those under lockdown have suffered inconvenience, disrupted travel and family separation, he said.

Yet life was much less affected by Covid-19 than in other countries last year, according to an index of restrictions and mobility developed by Goldman Sachs. Elsewhere, waves of the pandemic have hurt business, closed schools and triggered mandates while incurring steep, unquantifiable costs in illness and death.

Disruptions and deaths will no doubt mount when China eventually lifts zero Covid, but it has bought time to build up vaccines, therapies and healthcare facilities.

Of course, citizens deprived of their freedom or livelihoods can't vote out the Communist Party or protest in streets. Still, ordinary Chinese appear to support and cooperate with zero Covid.

That suggests there's more to China's success than an absence of democracy. A study in Lancet sought to explain why some countries had lower Covid-19 infection and death rates through last September. It controlled for factors such as population density, per capita income, age and pre-existing conditions. One finding: "There is no relationship between democracy and performance that we could find," said Thomas Bollyky, one of the authors and director of the global health program at the Council on Foreign Relations.

What did make a difference, the study found, is trust. The more citizens trust the government, or each other, the more effectively a country dealt with Covid-19. Intuitively, citizens who trust the government are more likely to comply with social distancing, contact tracing and mandates. Where trust is lacking, citizens are less likely to comply and governments less likely to ask. Interpersonal trust encourages citizens to do things that protect others.

According to the World Values Survey, trust in government is high in China and low in the U.S. Mr. Bollyky acknowledged survey respondents in autocratic countries may censor their views. But leaving out China, he said the results held. Covid-19 outcomes generally are better where more people trust the government (New Zealand, South Korea) or each other (Denmark, Canada)." [1]

 

1. U.S. News -- Capital Account: Lessons of 'Zero Covid' From China
Ip, Greg. Wall Street Journal, Eastern edition; New York, N.Y. [New York, N.Y]. 17 Feb 2022: A.2.