China’s dilemma: Face 1.6 million deaths by dropping zero-COVID strategy, or continue with ‘unsustainable’ policy?

China has taken one of the world’s strictest approaches to handling the coronavirus, with many of its original COVID policies still in place. Recent outbreaks of the virus in Shanghai and Beijing have prompted fresh lockdowns for residents of two of the country’s biggest cities.  

Chinese and American scientists said in a peer-reviewed paper published in the journal Nature Medicine on Tuesday that without the zero-COVID policy in place, the Omicron variant would have had a catastrophic impact in China.

Using data from Shanghai’s 2022 Omicron outbreak, researchers applied a mathematical model to simulate what a hypothetical Omicron wave would look like in the country.

In the absence of China’s “non-pharmaceutical intervention protocols”—policies the government has implemented as a part of its zero-COVID strategy—an Omicron outbreak in March 2022 “could have the potential to generate a tsunami of COVID-19 cases,” scientists said.

“Over a six-month simulation period, such an epidemic is projected to cause 112.2 million symptomatic cases (79.58 per 1,000 individuals), 5.1 million hospital admissions (3.60 per 1,000 individuals), 2.7 million ICU admissions (1.89 per 1,000 individuals), and 1.6 million deaths (1.10 per 1,000 individuals), with a major wave occurring between May and July 2022,” they said in their paper.

 “We find that the level of immunity induced by the March 2022 vaccination campaign would be insufficient to prevent an Omicron wave that would result in exceeding critical care capacity, with a projected intensive care unit peak demand of 15.6-times the existing capacity,” they added.

Zero-COVID policy ‘unsustainable’

But the WHO said this week that it disagreed with Beijing’s approach to tackling the pandemic.

“When we talk about the zero-COVID strategy, we don’t think it’s sustainable considering the behavior of the virus now and what we anticipate in the future,” WHO Director-General Tedros Adhanom Ghebreyesus said at a press briefing on Tuesday.

Tedros explained that the virus was evolving and continuing to become more transmissible, meaning that China’s attempt to eliminate the virus could not be sustained in the long term.

Tedros’s comments were reportedly censored on Chinese internet platforms, with articles and hashtags referring to the WHO chief’s opinion on the policy blocked on social media sites Weibo and WeChat.

The WHO had discussed its concerns with the Chinese government, Tedros said at Tuesday’s briefing.

“Considering the behavior of the virus, I think a shift [in policy] would be very important,” he said.

Maria Van Kerkhove, the WHO’s COVID-19 technical lead, added at the press conference that the organization’s goal at a global level was not to find all cases of the virus and stop transmission.

“It’s really not possible at this present time,” she said. “What we need to do is drive transmission down, because the virus is circulating at such an intense level.”

Lockdowns continue

As China continues to pursue its zero-COVID policy, recent outbreaks of the virus have led to fresh crackdowns, prompting concerns about the world economy and global supply chains.  

Shanghai—China’s wealthiest city and a major economic hub—has been in lockdown for more than six weeks, a move that has sparked public outcry, with residents struggling to access basic groceries, problems with rotten items in government food packages, and some people in the city being expected to live at their workplaces to keep the economy going.  

Authorities have also ramped up restrictions in Beijing in recent weeks in an attempt to curb a COVID outbreak in the Chinese capital.

Many countries that initially took a zero-tolerance approach to COVID-19 have abandoned such policies as vaccination coverage improved, the toll of the approach weighed on their economies, and the virus became increasingly transmissible and difficult to keep up with.

Singapore, Vietnam, and Australia are among the countries to have turned away from trying to eliminate the virus from their communities. New Zealand, which managed to maintain a relative sense of normality at the height of the pandemic after swiftly closing its borders and implementing a COVID elimination strategy, has also turned away from many of its harshest restrictions, announcing Wednesday that it would fully reopen its borders in August.