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China Is Imposing Strict Lockdowns To Contain New COVID Outbreaks. But There's A Cost

A community worker delivered daily necessities to a household in Ruili City in China's Yunnan Province during a July lockdown triggered by COVID cases. Ruili closed off its city proper and asked all residents to quarantine at home. Classes were suspended. Most establishments were closed with the exception of markets, hospitals and pharmacies. Restaurants could only offer takeout food.
A community worker delivered daily necessities to a household in Ruili City in China's Yunnan Province during a July lockdown triggered by COVID cases. Ruili closed off its city proper and asked all residents to quarantine at home. Classes were suspended. Most establishments were closed with the exception of markets, hospitals and pharmacies. Restaurants could only offer takeout food.

BEIJING – When Tom, an American businessman, got a dream job building up a multinational company in China, he happily moved his young family there.

Then the pandemic hit.

Tom and his family traveled back to the United States, but in March last year, China sealed off its borders. Later, it even stopped issuing new passports to its own citizens to curb travel. He made it back to China by receiving a special letter approved by the mayor of the Chinese city he works in, but his family were not able to get permission to enter. He applied again and waited for them in China.

"You think, let's just try for one more month, but eventually that breaks [down]," says Tom. "I'm depressed. The family's depressed. We just want to see each other."

He finally had to relocate, at least temporarily. As of last month, he and his family has moved to Thailand where, for the first time in more than a year and a half, they can live together.

Tom and his family are among hundreds of thousands of people stuck outside China, sometimes separated from loved ones or their livelihoods. Most of the people in this story, like Tom, asked us to use only their first name because they do not want to jeopardize their chances of getting back into China.

Within China, anti-virus measures are even more strict for residents than for international travelers entering the country. The appearance of a single delta case can get an entire city locked down. Traveling from a place with delta cases? That could be three weeks of hotel quarantine in a city such as Beijing.

These are some of the ways China has been keeping new daily coronavirus infections to sometimes single digits. But with the highly-contagious delta variant now spreading across the country, some public health experts have begun to question whether China's zero tolerance can contain the pandemic long term – and whether it is worth the cost.

When infections surface, China opts for large-scale lockdowns

China has excelled at identifying and isolating new infections while shutting down large swathes of the country if needed to block new clusters from growing.

These complete lockdowns are effective at reducing total infections and giving hospitals time to prepare, but they require heavy sacrifices from those stuck inside.

Socioeconomically vulnerable populations are hit the hardest. Two- or three-week hotel quarantines for close contacts or those traveling from a region with active COVID cases must be paid out of pocket, a heavy expense for most citizens. And many of China's migrant workers – who power the country's service and e-commerce industries – have been unable to see their families in other cities because they fear being locked down away from their jobs if they were to return for a visit and then end up in lockdown.

Moreover, lockdowns only work if they are absolutely enforced for long periods of time, says Tamer Oraby, a statistician at the University of Texas, Rio Grande Valley, who studies how outbreaks spread: "With short term lockdowns, the disease is probably going to keep spreading between individuals of a household for a while. If we suddenly remove the lockdown, those people are going to go outside again and start spreading the disease once more."

Such rigid methods can be problematic to maintain as new clusters emerge across China each week.

"I'm pretty confident that China can contain this wave of epidemic. But if it takes a long time to contain the epidemic or [outbreaks] happen repeatedly, I think it will be more evidence that China needs to consider other methods," says Dr. Jennifer Bouey, an epidemiologist at the RAND Corporation.

She questions "whether the completion of testing and quarantines is feasible when the delta transmission is so fast," because there is no guarantee China can contact trace and quarantine people in time before they infect others.

The lockdowns continue despite a high rate of vaccination. China has given out 2 billion doses, mostly of domestically-produced vaccines, enough to cover nearly 80% of the population. But it remains hesitant to relax its strict policies because there is no public data on how effective Chinese vaccines remain over time or how good they are against variants.

And so China has indicated it will likely stick with their zero infection approach, even though experts predict that seasonal outbreaks of the novel coronavirus are almost certainly here to stay.

"Is it feasible to 'coexist with the virus'? The author believes that it is definitely not feasible," wrote Gao Qiang, a former Chinese health minister, in early August. "The 'coexistence with the virus' as adopted by Britain, the United States and other countries has already brought serious consequences to global efforts to contain the epidemic. We must not repeat the same mistakes."

The lockdowns have a commercial and intellectual cost

By keeping new infections low, China has been able to restart its economy and resume most domestic travel.

But the prioritization of total virus containment has come at the expense of cultural, commercial and intellectual ties to the world.

"The steady flow of people back and forth has completely eroded," says Rory Truex, an assistant professor of international relations at Princeton University. "The simplest thing that's missing is the trust building exercise that comes with human-to-human exchange."

Chinese public health officials say they intend to keep China isolated for at least the next year. Truex argues that international border closures could worsen China's diplomatic relations with the U.S.

"Now you have people both in the U.S. and China that are sort of able to speculate or pontificate about what's going on the other side without much first-hand knowledge," says Truex. "That leads us down a path where both parties are assuming the worst about the other."

There's also been a disruption in programs that bring in international students. Before the pandemic, China was trying to become a global research hub to rival the U.S. It gave government scholarships to promising Ph.D. researchers to study and work in China.

"We are vaccinated. We are ready for quarantine and for all the testing, whatever they want. But please, do not destroy our future," says Waqas, a Pakistani student pursuing his Ph.D. in China.

But now he cannot get back to China from Pakistan, nor can he finish his doctoral research: "Unfortunately, my lab mates have packed my experiment table and the thing on which I spent ten months is now in the dustbin." He asked that his last name not be used lest he jeopardize his chances of returning to his studies.

Luckier international students can finish their degrees virtually but say an online education is far less robust. "I ask China, would you trust a doctor who learnt about appendix surgery by reading a 42-slide PowerPoint at home while eating Oreos?" says Puneet Sharma, a medical student in India who hopes to resume her studies in person at a Chinese university.

Police officers (left and second from right) wear protective gear as they explain how to fight the spread of Covid-19 to workers at Nanjing port in China's eastern Jiangsu province on August 4.
Stringer / AFP via Getty Images
Police officers (left and second from right) wear protective gear as they explain how to fight the spread of Covid-19 to workers at Nanjing port in China's eastern Jiangsu province on August 4.

China's global commercial ties are also taking a hit. International shipping has been seriously snarled up by quarantines at major Chinese ports. Entire factories have to go offline if a region is shut down. Three-week quarantines and travel restrictions have diminished China's ability to attract foreign workers.

"In many cases they were unable to or didn't want to travel to China because of travel restrictions," says Max Lee, a manager at JobRight Human Resources, a recruiting firm that works with Chinese firms.

"Our number one issue right now is mobility and its impact on business continuity. It's getting the executives in and out of China and with their families," says Ker Gibbs, president of the American Chamber of Commerce in Shanghai.

Slowing domestic consumption, coupled with the delta variant, caused Nick Marro, a macro economist with the Economist's Intelligence Unit, to shave 0.4% off his China economic growth forecast: "The COVID restrictions kind of pushed us to make that call just because we are seeing quite a strict, quite a severe approach to ensuring that the outbreak remains controllable."

The Beijing Olympics has its own set of pandemic rules

Yet Beijing has committed to host the Winter Olympics in less than half a year. Thousands of athletes and reporters from all over the world are expected to attend. Beijing Olympics organizers have already said they will ask staff to quarantine in government facilities before and after entering game venues and has barred international spectators.

Beijing is also planning three "bubbles" with limited access around major athletic facilities in and around the city, according to two diplomats working on Olympics access issues. They requested anonymity because they were not authorized to speak publicly. Visiting reporters will need to leave right after the games and will not be allowed to travel to other parts of China, as was possible during Beijing's previous 2008 summer Olympics.

These measures – and a lackluster Tokyo Olympics — have bolstered fears that China's coronavirus prevention measures could stymie independent coverage of China during the games, turning an athletic spectacle meant to highlight global engagement into a highly-managed stage-show.

"Will [journalists] have any freedom of movement? Will they be able to move beyond just where the games are being held so they can understand some of the broader fabric of the nation that is hosting the games?" asks Bill Holstein, a board member of the Overseas Press Club, a professional association.

Copyright 2021 NPR. To see more, visit https://www.npr.org.