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Reversing China’s Zero-COVID policy too quickly has the makings of a global disaster

China’s “Zero-COVID policy” was implemented at the beginning of the pandemic to limit the spread of COVID. It encompassed aggressive means of testing and isolation for individuals at-risk and exposed to COVID. Additionally, extensive lockdowns occurred when multiple cases in similar geographic areas or buildings were noted. The measures were ostensibly successful at preventing China from having comparable numbers of cases of COVID to other locales. However, after 3 years of these unpopular measures, the Chinese government is starting to reverse its practice.

The results could be shaping up to be a global disaster.

Initial feedback from communities where the policy is being reversed is revealing increased numbers of cases. Cities like Beijing are having over a thousand cases a day. Some hospitals are being overrun with cases even though people with mild cases are being told to stay home and isolated. These busy hospitals are having staffing issues and are shockingly reporting healthcare staff to work with less symptomatic COVID infections. Queues are forming at healthcare facilities. Phone lines for COVID questions are being swamped.

This could be just the tip of the iceberg.

A great part of the reason for the Zero-COVID policy was China’s major vulnerability to a catastrophic COVID outbreak. The country has a high proportion of an elderly population, the majority of which have not received booster shots. Additionally, China has not allowed the more superior mRNA vaccines to be given to its own people and only given domestically produced vaccines that have inferior technology.

Other reasons heightened these concerns and led to the Zero-COVID policy for these years. The population is also spread out across a vast landscape that does not have equal healthcare access and resources throughout. In the cities, the density of people is so intense that thousands of people or more in certain areas could be rapidly infected and potentially overwhelm the most capable centers. Finally, the Chinese government knew that a major outbreak could lead to civilian unrest and threaten their authoritarian power. If this happened before last month, the Chinese Communist Party could lose the leadership of President Xi who was seeking his record third term.

Eventually, a number of protests after the election and the sting of the policy’s economic damage did indeed lead to the abrupt reversal of this policy following the party’s convention.

The effects of these policy changes may just be beginning. As the testing and lockdowns wane, more COVID cases will develop. The ability of the healthcare system to manage these potential outbreaks will be tantamount. Public tolerance of these cases is unpredictable. The people have been told for so long the dangers of COVID that their response could be panic or flooding hospitals that could spread infections even more quickly. Since China is just a global travel hub, the lifting of travel restrictions could cause massive numbers of global cases, similar to the beginning of the pandemic. Large numbers of cases with inadequate health care resources could foster the beginning of new more divergent variants that may escape current vaccination and boosters. More economic disruption of supply chains could ensue.

Certainly, western countries can do nothing to prevent changes in Chinese policy. However, they do need to prepare for these potential events. Companies and schools with personnel in China or traveling there should be concerned with vaccination status and active COVID infections. Surveillance for at-risk personnel should be strongly considered domestically and abroad. People who even vacation in areas at risk for global exposure should be considered for testing. Most importantly, monitoring for the next phase of the pandemic and more infections should be at the forefront.

A chapter in the pandemic story is closing with the reversal of the Zero-COVID policy. The tone of the next chapter will be dictated by the thoughtful response of non-Chinese organizations.



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