Beijing Is Groping for a New Epidemic-Prevention Model
When I got up this morning, I saw my son's homeroom teacher post a notice in the class group: in Haidian District, except for the few subdistricts and towns where cases have appeared, which still need continued testing over the next two days, daily testing is no longer mandatory elsewhere. Apart from the control and lockdown zones, which remain under isolation policy, life in the other compounds has basically returned to normal. Beijing now requires residents, from May 5 onward, to show a negative nucleic acid test result within seven days when taking buses and the subway or entering public places; the Beijing Health Kit can also display a resident's health code, test result, and vaccination status on a single page.
The boy's mother smiled and told me that all this seems to be the very suggestions I had raised in my article Normalizing Universal Nucleic Acid Testing Could Achieve Dynamic Zero-COVID While Restoring Normal Life. I know I do not have that much influence; Beijing's current prevention policy does closely resemble what I suggested in that article, but it is probably just a coincidence.
To bring this Beijing outbreak under control may require more than twenty rounds of universal testing; in the days ahead these tests will be carried out region by region as the epidemic evolves, and the key areas are still being tested frequently. This differs from Shanghai's earlier precision control, because from May 5 Beijing is applying routine nucleic acid testing to everyone active in the community at large.
From the virological point of view, preventing viral spread requires monitoring sentinel populations. This is exactly the prevention strategy Beijing followed before this outbreak: Beijing had long conducted periodic testing among various key groups, with wet-market staff and cold-chain workers basically tested daily. This traditional sentinel-monitoring policy proved insufficient in the Omicron era—the monitoring range was too narrow. Moreover, prevention measures at wet markets and supermarkets were stricter than in residential communities, so these traditional sentinel sites were actually safer than the communities. Had we continued this sentinel-only strategy, a breakthrough would have been inevitable, and that is precisely the root cause of this year's outbreaks in Shanghai and Beijing. Going forward, China must expand monitoring to the whole community, treating everyone active in society as a sentinel.
Routine nucleic acid testing should also consider economic cost and minimize disruption to people's normal lives. Wuhan tested every 48 hours for a while; this strategy did effectively control the epidemic, but was perhaps too frequent. Shenzhen recently tests every 72 hours, and Shenzhen has its epidemic well under control too. Wuhan has now begun to adjust as well, moving from a two-day to a three-day interval.
I mentioned in an earlier article that we could also try testing once a week to see whether it controls the epidemic just as well. If it does, we should adopt weekly testing, which is less disruptive to the public. Key outbreak areas can be tested more frequently, and some low-mobility areas could try testing once every ten days. Our country is vast and resource-rich, so we can run trials in different places. Once we find the strategy with the smallest cost and reasonably good prevention effect, we can roll it out nationwide.
If this Beijing trial succeeds, the epidemic here is expected to be brought under control in May–June, with the number infected in this wave kept to around 1,000–3,000. Scattered cases may still appear in future, but an outbreak on the current scale is unlikely to recur—unless, of course, the virus mutates to the point where testing fails, in which case we will have no choice but to coexist with it.
If this routine universal-testing strategy can effectively achieve the goal of dynamic zero-COVID in the real world, then our society may reopen this summer. Years of being unable to travel freely or visit family will change, and economic growth in the third and fourth quarters can be protected—the ideal outcome. The key to this strategy lies in closely tracking viral mutation and evolution and developing more sensitive testing reagents.
The goal of zero cases across the whole country is no longer achievable, but perhaps we can keep the outbreak scale very small. Personally, I think the wording of our national prevention goal could be further improved; whether “dynamic zero-COVID” is the best expression is worth studying and discussing. We should study what social psychology these four characters have produced. Shaken by this year's outbreaks and by city lockdowns in some regions, many people now panic at the very words “dynamic zero-COVID.” A considerable portion of society no longer fears the virus; they fear being locked down at home instead.
We should as soon as possible settle on a new, stable prevention policy that gives the public a stable set of expectations. The reason people everywhere panic-buy basic supplies and dare not consume is, in the final analysis, that we now lack a sense of security and hold bad expectations. Local officials also lack security, so at the first scattered case they lockdown cities and over-epidemic-prevent. Their psychology is understandable—if they do not, they fear losing their jobs, and once a civil servant is out of work it is hard to find another. So future prevention policy should fully take people's psychological concerns into account; if we can give everyone stable expectations about what may happen, and let the public know their lives will not be disrupted the way Shanghai's were, then the impact of the epidemic and of prevention policy on the economy and livelihood will be far smaller.
Epidemic prevention is not very different from treating cancer: the earlier it is found, the better; the earlier it is found, the smaller the cost of treatment and control, the better the prognosis, and the smaller the impact. I sincerely hope our country can blaze a path of scientific prevention that contains the harm of infectious disease without damaging the economy and people's livelihood.
I expressed some of my own humble views in my article The Long Plague Era Seen Through a Grand Historical Lens. There I suggested that over the coming decades and even centuries, humanity will be continually affected by plagues, and that groping in this new era for the prevention strategy that best protects the welfare of all beings is an important task now facing us. Our current effort to grope for a new prevention model, whether it ultimately succeeds or fails, is a most worthy undertaking, because groping for a scientific prevention strategy is always better than lying flat and waiting to die.
I was previously disappointed with Beijing's prevention policy, but now I greatly admire Beijing for daring to try a new model. I had also predicted in advance that Beijing would face heavy prevention pressure in May–July (see my short piece Moving the Vegetable Garden from the Foot of West Hill to My Balcony). I am not an Indian prodigy child; I predict the epidemic not by superstitious means but by scientific analysis.
I live in Beijing, and the phenomena I hear and see every day tell me that Beijing previously had enormous loopholes in its prevention, so from common sense alone I could infer this outbreak would happen here. To prevent the epidemic by slogans rather than science is surely wrong. I hope our country can, as fast as possible, grope out a scientific path of prevention and reduce the harm to people's livelihood and economy, because many people truly cannot hold on for much longer.