From one extreme to the other?

[Moshen]

Can someone explain to me China's current Covid strategy (if they have one)?  I'm reading about Covid spreading like wildfire within China, pharmacies being closed because the pharmacists all got sick, epidemics among hospital staff, etc., and even people who didn't like the constant testing and controls are freaking out about all the disease-fighting infrastructure having been suddenly canceled.

 

First, was this really a response to the protests?

 

Second, is there a coherent loosening up strategy underway, and are Chinese people generally behind that?

 

Third, couldn't there have been a more gradual, well-planned reduction in Covid controls?

 

If my questions are wrong-headed, please explain.  Thanks!

[Demonic_Duck]

Personal opinion on all counts, because government communication around it all is pretty opaque.

 

On 12/13/2022 at 3:13 AM, Moshen said:

First, was this really a response to the protests?

 

Officially: no. Unofficially: absolutely, 100%. Taking Shanghai as an example, a few days before the protests they tightened restrictions around PCR testing (72 down to 48 hours for anywhere selling food items); a few days after, they quietly abandoned almost all requirements for PCR testing. You can now go to the supermarket or get on the subway without anyone even checking your health code.

 

On 12/13/2022 at 3:13 AM, Moshen said:

Second, is there a coherent loosening up strategy underway

 

From the outside, it doesn't seem very coherent, but central government policy gives a range of options within which local governments can act, and there's clearly been a change there. I think they'd hoped to have a more managed rollout of loosening restrictions, but TBH I was always skeptical that that could ever work with the rapid transmissibility of Omicron.

 

On 12/13/2022 at 3:13 AM, Moshen said:

are Chinese people generally behind that?

 

It's really tough to say if Chinese people "as a whole" are behind it. What might be generally true among students in Beijing or tech sector workers in Shenzhen won't always hold for truck drivers in Gansu or rice farmers in Yunnan. But at least among my social circle in Shanghai, people have all directly suffered hardships due to covid restrictions, ranging from relatively trivial quality-of-life things to genuinely distressing situations like going without proper food for a few days. Meanwhile, until recently, the majority didn't know anyone who had even caught covid, much less someone who had died or got seriously ill from it. So most people are in favor of abandoning zero covid, while also being somewhat worried about the prospect of covid running wild, or about them or their families catching it.

 

On 12/13/2022 at 3:13 AM, Moshen said:

Third, couldn't there have been a more gradual, well-planned reduction in Covid controls?

 

Honestly, I don't really see how. It could certainly have been communicated better and rolled out more consistently across the country; but with Omicron, you can't really contain it in a localized way without the type of harsh restrictions that "dynamic zero covid" entailed.

 

I do wonder if the ubiquity of PCR testing in the past might now work against China's anti-covid efforts, as it's perceived as something you do every couple of days in order to be allowed to participate in society, rather than something you do if you suspect you might have covid to help constrain the spread of the virus. So even if PCR tests remain widely and freely available, people might simply not take them when they'd be most useful (i.e. when they most likely have covid).

[realmayo]

Because zero-covid has been such a big deal for Mr Xi, I wonder whether anyone in government over the last 12 months has felt comfortable planning hypothetically for the end of 'zero covid'. Of course we've no idea how that government really works but it's surely possible that making such plans could have been career-limiting, until now. I remember in the UK before the Brexit referendum, the government didn't allow anyone to plan for what might happen if they lost the referendum, out of fear, I guess, that people might think they were expecting to lose.

 

I would have guessed that, with winter getting underway, and then Spring Festival (elderly relatives etc etc) a few weeks away, this was probably the riskiest time to make the change?

 

Maybe no one knows how bad or how mild Omicron will be on a population with much less immunity than everywhere else in the world. Maybe it's worth letting Omicron infect the population now, out of fear that future variants could be more deadly (to a population that has never previously experienced a Covid wave)?

 

Or if things do start getting out of control and hospitals overwhelmed, people might demand lockdowns and the government will oblige, on a city-by-city basis, until the hospitals are working properly again, and then open up for a while, before closing, and that way they can carry out a 'managed infection' of the population?

 

I remember reading something asking what would have happened if Covid had started not in China but in a more normal country. Presumably there would have been no lockdowns in that country. And as a result, probably no lockdowns in most other countries either.

[Demonic_Duck]

On 12/13/2022 at 4:48 PM, realmayo said:

I remember reading something asking what would have happened if Covid had started not in China but in a more normal country. Presumably there would have been no lockdowns in that country. And as a result, probably no lockdowns in most other countries either.

 

I don't buy that at all. Lockdowns early during the pandemic and during Delta were largely implemented on the advice of epedemiologists and other health professionals. They were unpopular politically in many circles, partly due to their association with China, but if covid had started somewhere else, the objection that they were "authoritarian" would have carried less force. Also, since when do governments of western liberal democracies (assuming they're included in "most other countries") look to China for policy leadership?

[realmayo]

On 12/13/2022 at 9:31 AM, Demonic_Duck said:

Lockdowns early during the pandemic and during Delta were largely implemented on the advice of epedemiologists and other health professionals

This is not correct. Those people had spent their careers planning for something like Covid, yet their initial advice did not include lockdowns. It was not thought politically viable, until China showed it could be done. It was not previously in the planners' vocabulary. To lock down a whole country!! No one considered that before Covid. I wouldn't be surprised if after a few years' reflection they may not consider it wise in the future either.

 

To clarify: people didn't previously think locking down a country internally would be a viable policy option. Seeing China do it put that option on the table. Imagine if Covid had started in Sweden. They wouldn't have had lockdowns. Then it spreads to Denmark. Would Denmark have been the first to invent lockdowns? Probably not. Germany? France? The UK?

[Moshen]

But according to this article, there were localized lockdowns that helped to end the 1918 "Spanish flu" epidemic:

https://www.nationalgeographic.com/history/article/how-cities-flattened-curve-1918-spanish-flu-pandemic-coronavirus

[realmayo]

That article says localised actions helped flatten the curve in some places, not that they helped end that particular pandemic.

 

Also, clicking through the links suggests that they weren't even proper lockdowns. Schools closed, theatres closed, sure, but not much more than that. Nothing like the Covid lockdowns. Seems like the 'St Louis' example has been distorted into a bit of a myth the last couple of years.

 

Lockdowns bought time (for vaccinations, to build hospital capacity, for the virus to hopefully evolve into something weaker) but they come at price no nation would have considered calculating until Wuhan. And in fact it will take a lot longer to get a true guesstimate of the ultimate cost.

 

In the UK at least, in Jan/Feb 2020, the epidemiologists were all going on TV saying there was no point locking down, everyone was going to be exposed to the virus sooner or later. Some people even reckon the higher mortality rate of the first few big variants was a consequence of lockdowns.

[alantin]

On 12/12/2022 at 9:13 PM, Moshen said:

First, was this really a response to the protests?

 

Second, is there a coherent loosening up strategy underway, and are Chinese people generally behind that?

 

Third, couldn't there have been a more gradual, well-planned reduction in Covid controls?

 

Apparently they were already planning gradually loosening the restrictions before the protests. They announced some cosmetic relaxations, but the rhetoric stayed zero-covid, and the local governments didn't seem to start following the relaxations. Then the protests happened and the rhetoric went completely from one end to the other. I personally believe they had plans to open up gradually, maybe after the Chinese New Year, but the protests scared the h*ck out or them and basically the threat of more people pouring into the streets to protest against the government 1989 style forced them to do something drastic to appease them before that happened. The foreign ministry spokesperson's awkward silence, when asked if China was reconsidering zero-covid due to the protests, was very telling. He clearly didn't have any idea what to say and finally stuttered something about  there having not been any protests.

 

Without the protests, I don't think they wouldn't have opened up as suddenly as they did and especially not now. Winter is the best time for the bug to spread, they don't have good vaccination coverage for the most vulnerable people, and the people who do have it, took the booster a year ago without having encountered the virus in the wild so their immunity to it has waned away. And to top it off the Chinese New Year is coming so if you think it is spreading now, it is going to explode then! They are talking about vaccinating the old people before then, but who believes they can give those shots to most of them in a month after having told them for three years that the vaccines are dangerous to them, and they need to take boosters too 12 or so weeks after the first shot anyway to get good protection. They ended up doing it at the worst possible time and now the whole thing is headed for a complete nightmare scenario! Fudan university earlier this year predicted 1,5 million dead with over 70% being unvaccinated if China suddenly opened up.

 

The Chinese people I've talked to seem to generally be resigned about it. Not wanting to leave home for fear of catching it, though they don't seem to fear getting sick too much. More like just wanting to avoid it for as long as possible. Also worry about getting it and then transmitting it to their parents on Chinese New Year and weighing that against not having gone home for two years and that everyone is going to get it soon anyway. And maybe even looking forward to finally moving on from the endless zero-covid to living with the virus, though their is going to be a few tough months ahead. Someone told me that China was a year late in opening up, and another person (incidentally from Shanghai) has been quite vocal about how the government has screwed the whole thing up. But generally they aren't opposed to the opening. More like resigned to having to muddle through it. Also, I asked if they think there are going to be more lock-downs when death rates start rising. They don't seem to believe there will be more lock-downs even if the health-care system collapses..

 

I think there has been a marked change in "tone" of my Chinese friends (all young middle class in big cities. I have no idea what rice farmes in yunnan think...) over the last year and it was interesting to hear one of them say the same thing last week. That there is a lot of hopelessness and cynicism now due to people not finding jobs and there being a sense that things were just going to get worse, that wasn't there even a year ago. I've lately heard them say things like "maybe the plan is to infect everyone as soon as possible", "the people don't matter here", and "maybe they are trying to reduce old people with this", that I didn't hear before... But behind that cynicism maybe this opening up is giving them hope of finally being headed back to some kind of normalness.

 

I wonder if the sentiment is still going to be the same a month or two down the road. Or if there are going to be more protests, this time due to poor handling of the opening up. But then again, the protests grew from profound tiring under the Zero-Covid policy with no end, so maybe not, because now there is some kind of an end in sight.

[markhavemann]

On 12/13/2022 at 3:13 AM, Moshen said:

First, was this really a response to the protests?

I do agree that the timing of this was in response to all that, but there were loooots of policy changes recently, relaxing all kinds of restrictions, quarantines, flights allowed in etc. as well as a shift in the way that covid was talked about.

 

On a weekly basis there were posts on wechat about some new change allowing shorter quarantines etc, and just a few weeks before all the protests I saw an official video where they were saying covid is much weaker now and closer to the common cold.

 

After seeing all these changes I fully expected that after spring festival all covid restrictions would more or less disappear and was saying to everyone not long ago that within the next 6 months China would where the rest of the world is, I just didn't expect it to happen so soon and so quickly.

 

It's kind of a pity really. I think if the originally planned timeline was pushed up by like even two or three months then the whole covid thing would have been a nice little victory for China.

 

 

[Flickserve]

Will President Xi step up and say something on covid policy? This is a matter of national importance. 

[Jim]

I popped out with the boy to buy tofu off the grandad who comes round on his trike selling tofu in the village and he grumpily reminded me I should have a mask on out of doors at all times, so not everyone that keen on the new freedoms it seems.

[Demonic_Duck]

On 12/13/2022 at 7:57 PM, realmayo said:

In the UK at least, in Jan/Feb 2020, the epidemiologists were all going on TV saying there was no point locking down, everyone was going to be exposed to the virus sooner or later.

 

Maybe this is a consequence of the filter bubble effect combined with the "choose your own expert" effect (you can find an expert in any field who'll back up your viewpoint if you look hard enough), but my impression was that the general consensus among epidemiologists was that lockdowns in general were both necessary and effective, and that the UK's implementation of them came too late each time, which worsened both public health and economic outcomes. SAGE members like Patrick Vallance and Chris Witty may have given off a different impression early on during the pandemic, but SAGE was also frequently criticized for lacking independence and being subject to political pressure (e.g. Dominic Cummings participating in meetings).

 

On 12/13/2022 at 7:57 PM, realmayo said:

Some people even reckon the higher mortality rate of the first few big variants was a consequence of lockdowns.

 

Sounds unlikely, what would even be the mechanism for them driving up the mortality rate? And who in the medical profession is promoting this theory?

[Insectosaurus]

 

On 12/13/2022 at 11:30 AM, realmayo said:

Imagine if Covid had started in Sweden. They wouldn't have had lockdowns.

 

True. It's illegal here. As it is in Japan. I wouldn't be so sure of the Danes though, they do whatever the f*ck they want lately.

 

On 12/14/2022 at 10:01 AM, Demonic_Duck said:

that lockdowns in general were both necessary and effective

 

I think this depends on where we are on the timeline. realmayo is completely right that it was not part of the contingency plan in most democracies, including the EU:s. I, like realmayo, think that we would have had a different pandemic policy wise if China's policy would not have seemed effective. I remember being baffled by invited Chinese experts shouting at Italian journalists early on in the pandemic. That said, lockdowns were legal in most countries, so you can argue that lawmakers had had it in mind in at least some shape or form. However, probably not like they turned out.

 

Weather or not they really *were* necessary is of course not up to the epidemiologists.

 

On 12/14/2022 at 10:01 AM, Demonic_Duck said:

Sounds unlikely, what would even be the mechanism for them driving up the mortality rate?

 

More people up and about at the same time. More people sick at the same time. More to do in the hospitals. I've never heard this theory myself and doubt it too, but that would be one explanation I guess.

[realmayo]

On 12/14/2022 at 9:01 AM, Demonic_Duck said:

my impression was that the general consensus among epidemiologists was that lockdowns in general were both necessary and effective, and that the UK's implementation of them came too late each time

 

Yes and no: this became the consensus, but after Wuhan! Before the Wuhan lockdown was underway, Western experts pooh-poohed the idea of nationwide internal lockdowns (and said shutting borders was racist).

In mid-January 2020 in the UK I couldn't believe that we weren't taking Covid seriously, I was sure we'd lockdown (although my friends & colleagues all thought I was mad). So I paid attention to what the experts said. They didn't talk about lockdowns until several weeks later: initially they said they would do more harm than good. It was only when they thought hospitals might be overwhelmed that they started talking about lockdowns, and at that point it was solely in order to flatten the curve - which is not the same thing as reducing (over a longer period) Covid infections. It was to stop hospitals being overwhelmed by a large number of cases in a short time, a danger highlighted by Cummings who pushed hard for lockdowns at that point.

 

[realmayo]

On 12/14/2022 at 9:01 AM, Demonic_Duck said:

Sounds unlikely, what would even be the mechanism for them driving up the mortality rate? And who in the medical profession is promoting this theory?

 

The theory was: a flu/corona virus spreads by social contact. As variants emerge, the variants that spread the most effectively will predominate, the others will fade away. Consider two competing variants, one mild, one severe. If you get the mild one, you won't feel very sick, so you will continue to socialise. If you get the severe one, you will stay at home or go to hospital. That means that the mild one spreads much more than the severe one.

In lockdowns, though, if you have a mild variant, you stay at home (because everyone stays at home). But if you have the severe one, you stay at home or go to hospital. In this scenario, the best way for the virus to spread is in hospitals. So, the severe virus spreads more than the mild one.

This was used to explain the Spanish flu which kind of started in WWI: people with mild illness stayed in the trenches, those with severe illness were transported back from the front lines, travelling widely, through lots of people's hands, until arriving in hospitals in towns and cities. So: the severe variants spread more than the mild variants.

 

I'm not saying any of this is true: just that it was an idea circulated at the time by experts who were putting an alternative case against lockdowns, and I think it illustrative of the fact that, before lockdowns, there wasn't an established consensus in favour of lockdowns. Which most people have forgotten by now. (But not @Insectosaurus with whom my previous post cross-posted.)

 

 

On 12/14/2022 at 10:09 AM, Insectosaurus said:

lockdowns were legal in most countries

In the UK they needed new, specific legislation.

[realmayo]

On 12/13/2022 at 9:31 AM, Demonic_Duck said:

Also, since when do governments of western liberal democracies (assuming they're included in "most other countries") look to China for policy leadership?

 

Read this article from March 2020. https://www.nature.com/articles/d41586-020-00741-x  People have short memories. It's pretty clear that experts regarded the Chinese lockdowns as something new that needed to be studied to see if they were effective or not, rather than the deployment of an obvious tool in the pandemic toolkit.

Quote

Dozens of countries across Europe, the Americas and Africa and Asia have now introduced travel restrictions.

Although the WHO warns against them, saying they aren’t usually effective in preventing an infection’s spread, and they could divert resources from other more helpful measures and block aid and technical support, in addition to harming many industries.

 

Quote

New cases of COVID-19 have slowed dramatically in China, but some fear that once the country fully eases its control measures, the virus could start circulating again. It could even be reintroduced into China from the countries now experiencing outbreaks. Because China’s measures protected so many people from infection, a large pool of people have no immunity against the virus, says Leung.

China is suppressing the virus, not eradicating it, says Osterholm. The world will need to wait until about eight weeks after China resumes to some form of normality to know what it did or didn’t accomplish with its population-movement limitations, he says .

There is probably a fierce debate going on in China about when to relax the lockdown measures, says Roy Anderson, an epidemiologist at Imperial College London. He suggests there could be a second wave of new infections when they are lifted.

Lockdowns have to end at some point, and governments should remind people to maintain social distancing and good hygiene, says Anderson. “It’s our actions more than government measures that will matter,” he says.

 

[alantin]

As I remember, the main point in the lockdowns in EU was to slow down the spread of the virus to ”flatten the curve” to protect the health care systems and maybe secondarily to to protect vulnerable people until we had vaccines. In Finland the government declared State of Emergency to get the legal rights to isolate the capital for a few weeks and to restrict travel to and from the country if I remember correctly, but other than that there were never any lockdowns. Just ecommendations were enough.

 

My impression was that the main problem with the lockdowns or restrictions in many countries were in implementation or observing them. People tried to evade them and the governments didn’t have the will or ability to enforce them enough to stop the spread all together. And I don’t remember stopping it ever having been in the options anyway.

[Insectosaurus]

On 12/14/2022 at 11:22 AM, realmayo said:

In the UK they needed new, specific legislation.

 

I should have specified that in the case of Sweden it would have needed a change of the constitution, which would have taken years.

[Insectosaurus]

On 12/14/2022 at 1:10 PM, alantin said:

Just recommendations were enough.

 

If you know Swedish, this interview with Mika Salminen of the Finnish Health Agency shows quite clearly how (unexpectedly to some) similar Swedish and Finnish discourse was at the time. It's a fascinating interview considering the discussions in most of Europe at the time. For the non-Swedes and non-Finns on here (there might be some after all), he's basically saying that going to the gym is fine; house parties are not all bad, but people should at least think about possible risks; working from home is both good and bad for people's health and well-being; traveling by bus or train is doable but you should wear a mask (he also points out that it's better to go by public transport than by car).

 

This was aired in september 2020.

 

https://areena.yle.fi/1-50641151

 

Note, once again, that this is not an argument about what is right. It's plainly adding to the comment above about how discussions sounded differently in different places, and probably would have sounded different on a global scale depending on where the virus would have had it's breakout.

 

Rereading the topic I realize now this is a bit off topic. I will not make further posts not connected to the policies in China.

[Moshen]

Quote

Rereading the topic I realize now this is a bit off topic. I will not make further posts not connected to the policies in China.

 

Yes.

 

From here on, let's please keep the discussion on China and what's happening there.