China signals a new phase of COVID control
China signals a new phase of COVID control
“People First,” not "Epidemic Control First”
(Allow me to repeat, all views are personal here.)
It’s become increasingly clear this week that China is entering a new phase of COVID control.
Vice Premier Sun Chunlan: conditions have been created for further optimization
Sun is in charge of COVID control in China. Xinhua reported on Thursday, Dec. 1
Vice Premier Sun Chunlan, on December 1, in the National Health Commission, held a symposium to listen to the prevention and control work of the front-line representatives on the optimization and improvement of prevention and control measures.
She pointed out that insisting on seeking progress in a stable manner, taking small steps forward without pause, and taking the initiative to optimize and improve the prevention and control policies is an important experiences in the prevention and control of the epidemic in China.
…With the full vaccination rate of the entire population reaching more than 90%, the public's health awareness and literacy significantly improved, and the pathogenicity of the Omicron virus weakening, conditions have been created for further optimization and improvement of prevention and control measures.
Xinhua reported on Wednesday, Nov. 30, Sun listened to experts' opinions and suggestions on improving epidemic containment measures in the National Health Commission. She said
Epidemic prevention and control in the past three years, the Party Central Committee and the State Council always put the safety of people's lives and health in the first place, optimizing and improving prevention and control measures in response to the situation, has issued nine versions of the prevention and control plan, introduced twenty optimization measures…
With the weakening of the pathogenicity of the Omicron virus, the popularity of vaccination, and the accumulation of experience in prevention and control, China's epidemic prevention and control face a new situation and new tasks. To thoroughly implement the spirit of the important instructions of General Secretary Xi Jinping…we need to seek steady progress in prevention and control work and continue to optimize prevention and control policies, take small steps forward without pause, and constantly improve the diagnosis, detection, treatment, quarantine, and other measures, strengthen the vaccination in the whole population, especially among the elderly people, accelerate the preparation of treatment drugs and medical resources…
Note that the “20 measures” have just come out on Nov. 11 and were seen as a landmark move, and now the authorities are talking about “further optimization and improvement.”
Yang LIU, who writes the Beijing Channel substack, was talking about the editorials in the People’s Daily on or near Oct. 12 under the pen name 仲音 Zhong Yin, which supposedly means “important voice.” That was just less than two months ago.
Changes on the ground
Guangzhou and Chongqing, two megacities, significantly rolled back control measures, DESPITE the rise in infections.
Caixin reported on Thursday, Dec. 1
Authorities lifted Covid restrictions in parts of the southern China city of Guangzhou, prompting a surge in online searches for flights and train tickets.
The government announced a series of easing anti-pandemic measures Wednesday afternoon. They include dropping temporary control orders in about half of the districts across the megacity of 15 million people and allowing close contacts of Covid patients who meet certain conditions to undergo quarantine in their own homes rather than in centralized facilities.
Guangzhou also ended mass nucleic acid testing. Starting Monday, 10 of Guangzhou’s 11 districts eased Covid testing, sparing people with no need to leave their homes from the requirement and allowing them to be tested on demand.
The capital of Guangdong province is among the worst-hit cities in China’s latest outbreak, reporting 7,690 news cases Tuesday. The manufacturing hub carried out multiple rounds of mass testing since the surge in cases began in October. School teachers and students were required to take daily tests.
Bloomberg reported Beijing Eases Covid Curbs, Letting Some Patients Isolate at Home
Beijing will allow some virus-infected people to isolate at home, starting with residents of the city’s most-populous district, a landmark shift that reflects the pressure officials are under from a record outbreak and public opposition to Covid Zero.
Low-risk patients can do home isolation for a week if they choose, people familiar with the plans said, dialing back a nationwide policy that has seen everyone with Covid sent to government quarantine sites regardless of severity, to halt transmission chains.
The shift has already begun in Chaoyang district -- home to some 3.5 million people as well as foreign embassies and company offices -- and it will act as an example for other districts to follow, the people said, asking not to be identified discussing an order that’s not yet public.
The most interesting case is 石家庄 Shijiazhuang, the capital of Hebei province which borders Beijing.
After the “20 measures to optimize COVID controls” were published on Nov. 11, Shijiazhuang was the first big city to cancel mass PCR testing on Nov. 14 and made it into trending topics on Weibo, China’s Twitter-like platform.
However, Shijiazhuang put six districts back into mass PCR testing on Nov. 20 and ordered residents in high-risk areas not to leave their homes, and advised residents in other areas should stay home unless they absolutely had to.
And starting Thursday, Dec. 1, Shijiazhuang “will gradually resume normal production and life order.” China Daily reported
"Positive cases detected from the community level have been reduced continuously, but there's still a small number of cases being detected at the community level," Mayor Ma Yujun said.
According to Ma, the city has undergone five rounds of mass nucleic acid testing in six major districts during the past 10 days, a period when residents were advised to stay at home.
As of 5 pm on Wednesday, a total of 10,357 positive cases were detected, he said.
"As for the number of new infections, there was a peak during the second round of testing, while from the third round there has been a gradual decrease, especially at the community level," he said.
“Omicron isn’t very serious.” “There is no evidence for Long Covid.”
Global Times today:
this is arguably the most watched tv channel in China these days
What’s next?
Beijing aims to ramp up vaccination for senior citizens
Caixin reported exclusively on Thursday, Dec. 1
财新从多方信源获悉，老年人新冠疫苗接种已下达工作指标：2023年1月底前，80岁以上人群新冠疫苗第一剂接种率达到90%，符合条件的目标人群全程接种率和加强免疫接种率均达到90%；60-79岁符合条件的目标人群全程接种率和加强免疫接种率均达到95%。
Caixin learned from multiple sources that targets had been issued for COVID vaccination for the elderly: by the end of January 2023, the first dose for people over 80 years old will reach 90%, and both the full vaccination rate and the booster (3rd-shot) vaccination rate for eligible target groups will reach 90%; the full vaccination rate and the booster vaccination rate for eligible target groups aged 60-79 will reach 95%.
Vaccinating the old is a paramount job because China still lags far behind, say, Japan and Singapore here. It’s not that China hasn’t made some effort, so what new tools it will use this time - and how effective they will be - is crucial.
Since we are nearing the end of the first half, all this doesn’t mean China is dropping COVID control overnight - or anytime soon. Sun Chunlan, the Vice Premier in charge, characterized it as “走小步不停步” taking small steps forward without pause.
Significant inconveniences due to COVID control measures remain here. But I have grown confident in making a call
Finally, a long article from the WeChat blog of the Department of Publicity, Zhejiang Provincial Committee, Communist Party of China, which instantly went viral on Tuesday, Nov. 29.
The title says it very well, though I imagine subscribers to this newsletter will raise many objections to its content and narrative. Some of its numbers have been challenged. But in case you are interested in finding out what sort of official narratives could resonate with urban elites in the Chinese mainland, this is a very good example.
“人民至上”不是“防疫至上”
“People First,” not "Epidemic Control First”
by the Department of Publicity, Zhejiang Provincial Committee, Communist Party of China
Nearly three years have passed since the outbreak of COVID-19 in late 2019. As the epidemic has taken longer to be prevented and controlled, many people have been approaching their limit of tolerance and endurance, even losing them little by little. As some netizens say: the first year was a panic, it was with a little bit of joy to be able to rest at home; then the second year would be a mixture of confusion and hope for a quick end; now comes the third year, with some complaint, people are wondering when is the end.
Some places have “intensified the restrictions on a layer-by-layer basis,” abusing their power and making things difficult for the masses, resulting in the deformation of the policy. Some, on the surface, do not say they are implementing a lockdown, but are actually enforcing it, ignoring the interests of the masses and people's aspirations, interrupting the normal order of production and life at will, and some even put the lives of the masses in disregard, taint the image of the Party and the government, and hurt the hearts of the masses. There are even some people who take the opportunity to make money from the epidemic. These stung more than the outbreak itself. The ensuing helplessness, boredom, and even anger are understandable.
Epidemic prevention and control is about keeping out viruses, not about keeping out people. It has always been about "people first,” not any so-called "epidemic prevention first.” Whatever prevention and control measures are taken, they should aim at bringing society back to normal and life back on track as soon as possible. All options are "bridges" and "boats" that lead us to this goal, rather than simply defending people and doing things blindly and without considering the cost.
Part I
The World Cup in Qatar is in full swing, and the crowds in the auditorium are maskless and enjoying themselves utterly as if they are living before the pandemic. Some voices are asking: Many countries worldwide have everything going as usual now. Even if they had been “lying flat” through COVID-19, haven’t they eventually crossed the bridge? Why can’t we?
To answer this question, look at a few sets of data.
Let's look at confirmed cases first. Up to now, there are 636 million new confirmed cases and over 6.6 million cumulative deaths worldwide, with 230,000 new confirmed cases and 428 deaths in a recent day. In Japan, with a population of 126 million, 98,000 new cases are diagnosed daily; in South Korea, with a total population of over 50 million, 47,000 new cases are diagnosed daily.
As for medical resources, this year China has 6.7 medical beds per 1,000 people, compared to 12.65 in South Korea, 12.63 in Japan, and 7.82 in Germany in 2020. In 2020, China had 4.5 ICU (intensive care units) beds per 100,000 people, compared to 28.2 in Germany, 21.6 in the U.S., 16.4 in France, and 13.8 in Japan, and the global average is 10. At the beginning of this year, 32.7% of the total ICU capacity in the U.S. was occupied by patients with COVID-19, and about 7 ICU beds per 100,000 people were occupied by patients with severe COVID, which exceeded the total number of ICU beds available per 100,000 people in China.
Finally, on the aging population and children. By the end of 2021, China's population aged 60 and above has reached 267 million, and the population of children exceeded 250 million. This is a very large group. According to the latest data from Singapore, the 感染死亡率 infection fatality rates for the vaccine-protected elderly aged 60-69, 70-79, and 80+ are 0.014%, 0.064%, and 0.54%, respectively, while the 感染死亡率 infection fatality rates for the unprotected elderly in the three age groups are 0.19%, 0.29%, and 2.5% respectively.
The number of elderly people in the three age groups who have not completed vaccination in China is about 22.64 million, 16.16 million, and 14 million, respectively. If we were to completely give up prevention and control now, based on Singapore's estimated infection fatality rates, the number of deaths in our country for those aged 60 and above alone would be around 600,000.
[Pekingnology: quite some numbers have been challenged by a Ph.D. publicly.]
Death cases are not just cold numbers but are borne by every family. Can we stand by and accept the reality of the loss of those around us? Obviously, it is unacceptable. Our country’s social system, history and culture, values, and moral ethics do not allow us to stand by and watch our father and grandfather’s generation and children face the threat of death. In a Western country, hundreds of people have died in only one nursing home because of the pandemic, which would be unacceptable if it happened in our country. From this, one may also understand the efforts our country has made to contain the epidemic.
A paper published in The Lancet stated that during the COVID-19 pandemic, there were an estimated 18.2 million excess deaths worldwide, with an excess mortality rate of 120.3 per 100,000 people. In the U.S., the excess mortality rate was 179.3 per 100,000 people; while in China the excess mortality rate was only 0.6 per 100,000 people.
One cannot talk about the results without talking about the process. Today's "business as usual" in the West is actually based on the loss of lives and the breaking up of families. The latest figures show that the number of deaths from the COVID-19 pandemic in Europe has surpassed 2 million, and the U.S. has nearly 1.08 million, the highest number of deaths from the COVID-19 pandemic in the world.
According to statistics from Johns Hopkins University, as of 6:21 pm Beijing time on 28 November, the cumulative number of COVID-19 cases in the US reached 98,568,849, and the cumulative number of death cases reached 1,079,197. It is unfair to envy the freedom and the current feast in the West while ignoring the painful price they have paid. To talk about "controlling" and "relaxing" the epidemic in isolation from China's national conditions and development reality is thinly based in reality.
If we compare the epidemic to a rough river, to reach the other side, some countries choose to go into the water with their bare shoulders to select the superior and eliminate the inferior, allowing some people to be sacrificed. At the same time, China chooses to ride out the storm together, using a big ship to give everyone a chance to survive. When the ship struggles to make its way to the other side, if one blindly envies the swimmers who have already made it to shore and chooses to jump off the ship instead of rowing together, much of the previous effort may be wasted.
Part II
From the very beginning, the path China took in the fight against the epidemic was different from that of the West, and the general logic throughout was "people-oriented, seeking truth from facts, and adapting to the times.”
Back in late 2019 and early 2020, the COVID-19 pandemic was raging. When the virus was at its strongest, we closed down the departing travel channels from Wuhan and Hubei and fought a full-scale battle to defend Wuhan and Hubei, stopping the spread of the epidemic in a very short time. As the number of new local cases gradually dropped to single digits, we took stock of the situation, coordinated the prevention and control of the epidemic with economic and social development, and pushed ahead with the resumption of work and production in an orderly manner. All of these enabled China to take the lead in turning economic growth from negative to positive and made China the only major economy in the world to achieve positive economic growth.
Later on, as the attack of the virus [transmission] waned and the overall epidemic spread singly in the country, we adopted the standing prevention and control strategy to “外防输入，内防反弹“ prevent the SARS-CoV-2 from entering China overseas and from re-rise domestically,” acted on regular epidemic prevention and control, and concentrated our superior forces on tackling the outbreak one by one in their respective location, thus delivering remarkable achievements on epidemic prevention and control and economic development.
Now, in the face of the gradual weakening of the pathogenicity of the virus and changes in the transmission, we insist on the “dynamic zero-COVID” policy and give more prominence to “scientific and precise” (control), formulating and implementing the ninth edition of the prevention and control plan, introducing the “20 measures to optimize COVID controls”, and constantly iterating our prevention and control measures.
Every adjustment is made in accordance with objective laws, seeking optimal solutions in a multi-objective balance.
As a country with a population of over 1.4 billion, the cumulative death toll from the epidemic on the mainland was only over 5,200. 2021 saw our GDP grow by 8.1%, with an average growth rate of 5.1% over the two years 2020 and 2021, making us the top performer among major economies.
We are doing our best to keep people alive and save millions of lives while promoting economic and social development, taking advantage of China's system and resource allocation methods. We have indeed made great achievements that can stand the test of history.
Part III
Recently, when implementing the “dynamic zero-COVID” policy, some local governments have deviated from and deformed the policy due to the lack of understanding and capability, faulty implementation, and even interest [hinting at corruption] behind the scenes. In some places, avoidable tragedies have even occurred. And all of these are due to the following reasons:
First, local policies and responses are not in line with central policies. The central government's “dynamic zero-COVID” policy and the “20 measures to optimize COVID controls” were interpreted differently in some places, which greatly reduced the authority of the central government's policy. In the eyes of some people, the prevention and control of epidemics is just a matter of managing their respective regions rather than a joint effort to manage the whole country. This is why some local government rolled out the so-called “liquidity management” (of people), where that government wanted to be in charge of “liquidity” （of people) and wanted other local government to be responsible for “management,” leading to the inevitable consequence of a wide spread of the virus.
Second, implementation is unstable. For implementing “20 measures to optimize COVID controls”, either hesitation or overzealousness is dangerous. Some local governments have dramatically reduced their prevention and control measures and then had to retreat in the reduction, causing the situation to get out of hand and seriously undermining the public's desire for stabilizing expectations. Some local governments veer between the extremes of total blockade and laissez-faire. They are far from forming a combination of rules and regulations to take small steps without stopping, achieve precise control, and allocate resources more rationally and effectively.
Third, putting “epidemic control put at first” instead of the people’s well-being first. Some local governments use epidemic prevention as an excuse and ignore people’s livelihood and economy. Some even tacitly agreed that “COVID is the only relevant disease,” distorting the concept of 生命至上 “Life First.” (Pekingnology: a popular political slogan in China in the past several years.) Some of them have “intensified the restrictions on a layer-by-layer basis,” losing sight of the laws and rules and even coming up with various tricks to “deal with” the masses, letting the people down.
These problems cannot be ignored, but blaming them on the “dynamic zero-COVID'' policy is not rooted in facts. The current epidemic prevention and control is more like a balance of interests and harms, which requires not only an understanding of livelihood, political, and economic aspects but also seeking an optimal solution. We must adhere to the general policy of “dynamic zero-COVID,” center on periodical objectives, highlight scientific and precise prevention and control, and ensure that local implementation doesn’t deviate from the central policy. All these test the capability of the Party committees and governments at all levels and also test the wisdom and commitment of Party members and officials.
Of course, for us ordinary people, we should not deny our epidemic prevention and control policy and the general policy of "dynamic zero" just because individual local governments have gone astray. That would be unreasonable, seeing only the small logic of one place at a time and ignoring the big logic. Certain epidemic prevention workers have revealed deficiencies in their competence and style. We should, of course, point out these shortcomings and urge them to correct them. But we must not assume that all epidemic prevention workers are bad or even that they are on the opposite side of the public. We should also not make or spread false news by splicing together videos and pictures without actually going to the site or holding any real proof, or being anxious to see China in disorder.
Part IV
To get out of the haze of the epidemic is something much more complicated than making a single decision on removing the restrictions or not. Arguments will not automatically solve the problem. The most crucial thing is to start from each specific link, quickly improve the ability to identify and deal with problems and strive to manage the epidemic in a soft-landing way. This is what we should strive for.
Why can't we immediately "liberalize"even though the death rate is low? In the case of vaccination, the booster vaccination rate for people over 80 years of age is only 40%, the vaccination rate for children is not very high, and the overall immunization level of the population is not high either. In the event of a widespread infection, our medical resources could be at risk of being blown away in an instant. At this time, instead of dwelling on whether to “reopen” or not, we should first urgently raise the level of our vaccines, prepare our drugs more adequately, build more intensive care beds, and have "reserves." If we have "reserves," we will be able to face any potential risks without panic.
Why is there “one-size-fits-all approach” “intensification of the restrictions on a layer-by-layer basis”? In some cases, what appears to be an innovation is actually “intensification”, and what does not appear to be “one-size-fits-all” is actually “one-size-fits-all” under a new name. In the end, the awareness of seeking truth from facts is too weak, the spirit of taking responsibility is too weak, and the ability to go with the times is too weak. Each decision and each initiative must be introduced after a careful study and judgment. Regarding policy implementation, it is even more important to adhere to the people-oriented approach. Those who are not effective enough and who are “intensifying the restrictions” shall be held seriously accountable.
Why do some local governments seem to be working very hard to prevent epidemics, but in reality they are still "struggling with the situation"? They have all kinds of (health) "codes'', but those codes just won’t work. These codes seem to be the result of big data, but in reality they are still operated manually. Different provinces, different cities, and even different counties are developing their own “codes,” and when one goes to a place, they must change to another code, which can be exhausting. We need to unify the health code standards across the country as soon as possible, interconnect the nucleic acid test results across the country, and replicate and extend the experience of the advanced regions' precision smart control practices to more places as soon as possible. We must not allow protectionism, bureaucracy, or even interest groups to hinder the spread of technical experience. We must find ways to make data flow more, viruses spread less, and people less weary.
Why is it that sometimes what should be said is not said and what is "right" is not said well or understood? Some Party officials are less able to work in the spotlight. They either dodge the public's concerns, or they say many things at press conferences that are not what the public wants to hear and what ordinary people cannot understand. We need to bring to light those who evade their responsibility in not saying what they need to say, and get those who can't or won't say out of the press conferences. Those who are qualified to speak well should be invited up to speak more often to give more certainty and let the authoritative and professional voice stand up.
Behind each of these capabilities is a common value consideration: people come first, life comes first. The public's voices and aspirations have always been the basis for adjusting and optimizing our anti-epidemic policies. There is only one purpose for fighting the epidemic, and that is to benefit the people, to protect everyone's health and safety. If we stick to this point, our steps will not be disorderly, and our actions will not be sidetracked.
The epidemic has developed to the point where prevention and control are no longer a "mystery box"” Any adjustment is in fact an iteration of policy, an optimization of prevention and control, a step closer to success. It is not about self-abandonment or self-denial, nor should it be about conformity or self-imposed limits. For us, epidemic prevention and control are like driving a giant ship, where neither slowing down nor making a sharp turn can be allowed. It is for this reason that the prevention and control plan has evolved from the first edition to the current ninth edition. Along the way, it is believed that there will be more precise 10th and 11th editions ......
The "big ship" of epidemic prevention and control is ultimately designed to carry more than 1.4 billion people to the other side. When the ship is in turbulence, we need to be united. We must be confident that we will not be in the water forever, and that as long as we are united and keep a steady pace and rhythm, we will be able to get off the ship safely in the near future. (Enditem)
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Thank you for the wonderful post. I was particularly intrigued by “People First,” not "Epidemic Control First”. Overall, it was both frustrating and refreshing to hear the argument that China can't immediately "liberalize" because "the booster vaccination rate for people over 80 years of age is only 40%". It is important to identify this as an exit condition so that there are clear goals.
However, it also makes me wonder why, after nearly 2 years of vaccine availability, more has not been done. If the leadership has been unable to achieve high vaccination rates after 2 years, why should anyone believe they can do it effectively now?
The second frustrating point were the comments about not being able to exit zero-covid because the vaccination rate in children was low. There is ample evidence (as pointed out in the challenge to the piece) that COVID mortality for children is very small indeed. The fact that this part was included in the original post makes me question the organizational structure and planning of the zero-covid pivot. Is vaccinating children really a necessary condition? If it is, then whoever is making decisions does not seem to be taking into account science.
If it is not, why write it? The obvious explanation is that the conditions to "liberalize" in the article are the opinions of a small group of individuals in Zhejiang who are not particularly scientifically informed. This in turn suggests that they themselves have not been informed, by central leadership, of the conditions that would need to be fulfilled in order to "liberalize". This would essentially mean that local governments are and have been flying in the dark all this time. Sometimes, we try to figure out what the plan is, and in doing so, assume that one exists. I suspect the authors of the piece are in the exact same position as us, only they are the ones tasked with carrying out the "non-plan" - and that is worrying.