Normalizing Universal Nucleic Acid Testing Could Achieve Dynamic Zero-COVID While Restoring Normal Life

Today I took the second round of citywide nucleic acid testing in Beijing's Haidian District since this outbreak. Before I took the first test the day before yesterday, my Beijing Health Kit showed that my last nucleic acid test had been more than 660 days earlier. Many Beijing residents are probably in the same boat as me—having had one nucleic acid test since the Wuhan outbreak, or none at all; residents of other low-risk cities are likely much the same.

Among the first-round results in Haidian District, only one ten-in-one pooled sample was positive; all the rest were negative. When I got up this morning, I could still move freely in and out of the compound and everyone was still living normally. I truly feel fortunate, though I do not know whether tomorrow will be the same. Some of my friends' compounds have already been locked down, and their lives are now affected.

So far this year, the outbreaks in Jilin and Shanghai have had an enormous impact on the economy and people's livelihood. Beijing is China's capital; judging from current data, the scale of this Beijing outbreak may not be large, but because the outbreaks in Jilin and Shanghai have left a shadow in everyone's mind, as soon as an outbreak appears in Beijing, not only do residents panic-buy grain and vegetables, the stock market is also greatly affected. The impact of an epidemic on the economy and people's livelihood is truly enormous.

After these months of recurring outbreaks, we must recognize that the prevention methods we previously adhered to are no longer suited to the new situation. Shenzhen and Wuhan have been carrying out universal nucleic acid testing continuously, and both cities have their epidemics well under control. Although a small number of infected people appear from time to time, they are quickly cleared. The experience of Shenzhen and Wuhan fully demonstrates that normalizing universal nucleic acid testing is both a scientific and an economical means of epidemic prevention. The two metropolises of Shanghai and Beijing were overconfident for a while and failed to carry out frequent universal testing like Shenzhen and Wuhan, so once the outbreaks expanded, the damage to the economy and people's livelihood was far too great.

Because Wuhan was the city where the epidemic was first discovered, its residents paid a heavy price for it, which is why Wuhan now does its epidemic work so thoroughly. I have many relatives and friends living in Wuhan, some of them medical workers, and from them I know that nucleic acid testing is now routine there. Testing is done every 48 hours, using 20-in-one pooled samples; residents who do not get tested on time have a gray health code and are not allowed to move about in public. Compared with the economic losses caused by Shanghai's citywide lockdown, the cost of this routine 20-in-one pooled testing is very low.

Shenzhen is close to Hong Kong; Hong Kong's epidemic is out of control, yet Shenzhen keeps its own well in check. Shenzhen residents now must have a nucleic acid test result within 72 hours to go out and handle business; otherwise, they are not allowed into many venues. These measures allowed Shenzhen's outbreak to be swiftly stamped out, with no resurgence since.

So, judging from the experience of Wuhan and Shenzhen, there is a way to achieve the goal of dynamic zero-COVID without harming the economy and people's livelihood, and that is to conduct routine universal nucleic acid testing. My older brother lives in Shenzhen, and Wuhan is the capital of my home province; I understand that life in both cities is now quite normal. Frequent testing does impose a certain disruption on residents, but in these extraordinary times, the annoyance of routine testing is far smaller than that of citywide lockdowns at the drop of a hat.

Many people now hope the country abandons the dynamic zero-COVID policy to restore normal order. Having lived in an abnormal state for so long, such a wish is understandable, but judging from overseas data, it would exact a terrible price: millions of our compatriots would die from disasters directly or indirectly caused by the plague. The dynamic zero-COVID policy our government upholds is a policy of high responsibility for the people's lives and safety, and it is worthy of affirmation. It is just that the current piecemeal, local lockdowns—rather than the scientific approach of routine nucleic acid testing—inflict too much damage on the economy and people's livelihood and disrupt everyone's daily life too greatly.

So if our government can sum up the successes and failures of epidemic prevention across the country over the past few months, and launch a nationwide policy of routine universal nucleic acid testing at the national level—letting everyone return to normal life and letting those who have not gone home to visit family for years finally go home—then our dynamic zero-COVID policy will be further perfected and will win still broader support.

Normalizing universal nucleic acid testing can be carried out in a differentiated way across population groups. For example, rural areas and county-level cities have low mobility, so universal testing once a week or once every two weeks may suffice. First-tier cities can follow Shenzhen's approach, requiring a test result within 72 hours before residents enter public places; some cities could even pilot testing once a week to see whether the results are just as good. For people who need to move between cities for work or other reasons, they could be required to take a test every 24 hours for three consecutive days or a week, without restricting normal travel.

Large-scale testing can use 20-in-one pooled samples to lower costs. A biology postdoc on the front lines of testing in Wuhan told me that Omicron has a very high viral load, so the accuracy of 20-in-one pooled testing is high, and even pooling above 20 may pose no problem. Because Wuhan and Shenzhen test every 2–3 days, the medical staff can keep up. Sample collection and testing are not complicated either; if there is a shortage of hands, a batch of personnel can be trained and certified to perform testing, which would also help resolve part of the employment problem.

The COVID virus will inevitably long coexist with humanity; how we coexist is a question we can decide for ourselves. Our country achieved outstanding results in the early fight against the epidemic; suddenly abandoning dynamic zero-COVID would cost millions of our compatriots their lives, which is certainly not desirable. But now that we have been feeling our way through the epidemic and have gleaned some successful experience, we can absolutely scale up these experiences, formulate a new national anti-epidemic strategy, and achieve both the goal of dynamic zero-COVID and the restoration of normal life—the best of both worlds.

I believe that if we can advance a national strategy of routine universal nucleic acid testing, we can fully restore people's lives to their pre-pandemic state, allow free cross-city movement, and still not trigger a major outbreak; we can certainly win this war by relying on the various advantages we have accumulated. My voice carries little weight, and I dare not pose as an authority; I only offer this as a brick to attract jade, hoping that wiser experts and scholars will explore the feasibility of this proposal.