The strict lockdowns imposed on China's largest city, Shanghai, have brought into sharp focus the sustainability of China's until now successful strategy of total suppression. That success is reflected in the reality that while America lost just under 1,000,000 lives due to its Covid approach, China to date has recorded under 5,000 deaths.
But the highly infectious Omicron variant, emerging weaknesses in China’s vaccine programme and the precariousness of China’s underfunded hospital system all make for a potential perfect storm for the country.
Strict containment is also hugely costly economically. Beijing now needs to begin to develop a strategy to exit zero-Covid and live with the virus. Such a course correction is not easy for an autocratic regime, particularly one that has staked so much internationally on the superiority and infallibility of its approach.
The Shanghai outbreak comes in the wake of a disastrous couple of months for Hong Kong, where draconian border restrictions seemed to have succeeded in keeping the virus out. But it then swept through the city, causing some of the highest short-term death rates anywhere in the world, particularly among the old. Analysis by the Financial Times suggests China itself has similar vulnerability with more than 130 million Chinese aged 60 and above not fully vaccinated.
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China has also been reluctant to sanction foreign vaccines despite evidence that its own have produced weaker immune responses to the virus, especially against the Omicron variant. Signs that the regime is reconsidering its position come with the news that in the past week its pandemic guidelines have been revised to include use of antiviral pills made by Pfizer.
The real possibility of major outbreaks breaking through the zero-Covid firewall will also necessitate a rapid upgrade of health investment. The country has about 20 doctors per 10,000 people, well below the OECD average of 34, while its number of intensive care beds per capita is a quarter of the OECD average.