The Hardest Days of This Year Are Behind Us
As outbreaks in Shanghai and Beijing come under control, the hardest days of this year are behind us. Universal routine nucleic-acid testing should, for a long time to come, effectively contain large-scale spread of COVID variants within China, although small local outbreaks will keep recurring. Many are dissatisfied with this approach, but personally I think that, comparatively speaking, our current policy remains a reasonable way forward.
Taiwan's outbreak has entered a plateau. On May 28, COVID deaths there passed 100 in a day; on May 29, deaths reached 145, ranging from people in their thirties to their nineties, including 70 unvaccinated and 75 vaccinated people who still died—a figure worth heeding. Moreover, this wave has already killed several children in Taiwan. The plateau may last about two weeks to a month, with more than 100 deaths a day. Before and after the plateau deaths will fall, but people will still die; the overall mortality may resemble Hong Kong's.
Taiwan has about 24 million people; the mainland's population is about 60 times larger. If the mainland lost control and entered a plateau, the mortality rate might be similar or even higher, because our medical resources lag behind Taiwan's. That would mean 6,000–10,000 deaths a day during a plateau lasting 20–50 days or more. Some cite North Korea to argue that Omicron is mild, but that is the wrong comparison because North Korea's data do not reflect reality. Nor can we compare with Shanghai or Jilin: mobilizing the whole country to support one or two cities is nothing like a nationwide outbreak overwhelming the medical system.
Had we abandoned dynamic zero-COVID, the shock to our economy and people's livelihood would be greater, not smaller. During a rampant outbreak our economy and daily life would be paralyzed, and daily deaths in the thousands would be a horrifying figure; social order would collapse and public anger would far exceed today's. So although many unsatisfactory things occur under dynamic zero-COVID, it is still far better than losing control.
A plague strikes society far harder than war. In turbulent times, preserving the current social order is already no small achievement. I have habitually criticized the government and praised it little, but this year my attitude has shifted; I praise more than I criticize. Worldwide, only China is willing to explore a path that uses public-health measures to contain COVID and protect its people's lives. As someone trained in medicine, I have deep respect for this: it is the greatest compassion and is fully consistent with the humanitarian spirit of medicine.
Beijing's new model, tested for over a month under pressure without a city-wide lockdown, has been no small achievement. But there were mistakes; some loopholes were foreseeable. The data-fraud problem among testing agencies, which I have written about before, was predictable: suddenly ordering a city-wide daily test for which Beijing lacked capacity was ill-considered. Checking health codes and test results to enter compounds and public places should have been done from the very beginning.
More importantly, after Shanghai's outbreak began, Beijing should have learned from Wuhan and required people out in public to test every 2–3 days, or at least weekly. Wuhan did exactly that and has had no major outbreak or city lockdown since 2020. Preventing an outbreak beats fighting one; had Beijing done its prevention better, this wave could have been avoided and the economic loss far smaller. Other cities should learn this lesson.
Qian Zhongshu quipped that studying abroad is like catching smallpox: once you've had it, you're immune. A city that goes through such an outbreak is like that too: after one, it gains immunity. This year, Shanghai, Shenzhen, Guangzhou, Beijing, Tianjin, Xi'an, Jilin, Zhengzhou, and Sichuan have all endured Omicron waves; having been through them, they will develop some partial "immunity" to such outbreaks. Epidemic shocks expose the weak links of a public-health system; after the shock, those links are strengthened, and our public-health system will be far more effective.
I do not think the current cost has been meaningless. In my articles The Long-Plague Era in Grand Historical Perspective and What If Plagues Last for a Hundred Years?, I noted that, with Earth overpopulated, humanity has entered a long-plague era (readers may consult my compiled Chronicle of Chinese Plagues for historical data). Over the coming century, we may face one infectious disease after another, and recurring waves every few years may become the new normal.
Now that we have entered such an age, and our science has reached its present level, it would be deeply embarrassing if we could not use technology to control infectious disease and minimize cruel loss of life. Against an infectious disease that causes mass death, we cannot simply surrender without even trying; that would betray the hard-won gift of life. To fight and lose is still honorable, but surrendering without a fight makes me doubt the value of preventive medicine.
So although many criticize our current policy, from an epidemiological standpoint China's COVID response may well become a textbook case worldwide, illustrating how public-health policy can contain infectious disease. This hard-won experience will matter greatly in the coming long-plague era: when the next, more lethal pandemic arrives, we will have a playbook. We need time to see the larger social and economic value of today's experiment; we must not judge by immediate gains and losses alone.
Once we cross this muddy stretch, cross-province travel may reopen this summer, many who have been unable to visit home for years may return, and our borders may open once more after more effective measures are found. The economy will recover to some extent in the second half; although, after the shocks of the pandemic and the Russia-Ukraine war (and perhaps climate disasters this year), we may miss our growth targets, the hardest days are over. From June onward the economy will improve step by step, and the second half will be far better than now.