People standing in line outside of a pharmacy as the coronavirus continues to tighten its grip on the country.

People standing in line outside of a pharmacy as the coronavirus continues to tighten its grip on the country.

Foto: Thomas Peter / REUTERS

From One Extreme to the Other COVID Chaos Unfolds in China

Chinese leadership abandoned its zero-COVID strategy practically overnight. The consequences promise to be enormous. Rural areas in particular will struggle with the suddenly spiking caseload in the country.
By Christoph Giesen in Beijing

She is negative and no longer contagious. Finally, she is allowed to leave the quarantine center – and return to a country that has changed dramatically during the time she was forced to spend in this candy-colored container shelter in northeastern Beijing. The authorities kept her here for nine days, behind a fence festooned with warning signs: "COVID prevention and control. Please do not approach."

Now, Stacy, as she calls herself, is standing in front of the gates of the center, which only just opened a few weeks ago. Someone in the apparatus came up with the idea of calling it "Colorful Community.” While waiting for a taxi, Stacy tells her story.

DER SPIEGEL 51/2022

The article you are reading originally appeared in German in issue 51/2022 (December 17th, 2022) of DER SPIEGEL.

SPIEGEL International

It was Sunday, December 4, when her mobile phone rang. "The neighborhood committee called me and said I had had contact with a positive case," she says. She had just enough time to quickly pack her things – a toothbrush and some clothes – before boarding the bus. She was tested at the center. It came back positive.

From her room, she could hear the planes taking off and landing at the nearby airport. Every day, the "dabai," the "big whites," as the Chinese refer to the men and women from the health agency in their hazmat suits, would silently bring by three meals.

The fact that the Chinese government would end its zero-COVID policy just three days later was apparently of no interest to those running the center. The new rules now allowed those who had been infected to remain at home for the duration of the disease. But Stacy had to stay at the shelter. The apparatus had forgotten her – a bit like during a war, when the capitulation has been signed but it still takes a few days before all the units receive the message that the time has come to lay down their weapons.

For almost three years, the Chinese leadership stubbornly pursued its zero-COVID strategy, with the state-controlled media gushing with praise for the "dynamic zero." Almost every day, news outlets in the country made a point of saying that it was only thanks to the wise leadership of state and party leader Xi Jinping that China had been able to defeat the treacherous virus. In the United States and Europe, Chinese media has been fond of pointing out, cases are rampant, and people are dying – but in China, all is well.


China Has Gone from One Extreme to the Other

But the highly contagious Omicron variant of the virus is also began spreading in China. And instead of adjusting its strategy to meet the challenge, by launching a new vaccination offensive and preparing the country for a cautious opening as has been done in places like Taiwan, Japan, South Korea and New Zealand, Beijing opted for severity. In Shanghai, 26 million people were forced to spend several weeks isolated in their apartments in April and May. In almost all other Chinese metropolises, residents had to submit to a PCR test every two to three days in order to be permitted to take part in everyday life.

That, though, is a thing of the past. The country’s complete isolation is now being followed by an equally radical opening. The pressure from the street, which erupted in late November in the form protests against the government’s corona policies in more than 20 cities, apparently had an effect. And that in a country where the regime almost never bends in the face of protests. Nevertheless, Xi Jinping now finds himself in a dilemma: Winter has hardly even begun and the lockdowns and massive number of tests have already likely cost hundreds of millions of euros. But Xi didn’t slowly back away from that approach, he reversed course suddenly – with the result that the People's Republic is now staggering from one extreme to the next.

China is now facing a shortage of fever medication, pain killers, medical equipment and hospital beds.

China is now facing a shortage of fever medication, pain killers, medical equipment and hospital beds.

Foto: Tingshu Wang / REUTERS
A PCR test station in Shanghai

A PCR test station in Shanghai

Foto: ALEX PLAVEVSKI / EPA

The security booth in front of the quarantine center in northeastern Beijing has already been abandoned, with just a couple of traffic cones lying about. There are 13 buses parked in a side street, with a note in their windshields: "Hello, this vehicle is transporting passengers who have had contact with COVID, and I am thus not able to get out. Should you wish to speak with me, please call," they read. Beneath the note is a mobile phone number. But nobody answers if you dial.

The pandemic is about it enter its fourth year, but in China, it feels like it is only just beginning. The country is likely facing the uncontrolled spread of the disease, right in the middle of winter. Hundreds of thousands of people could die. And hardly anyone is really prepared. There is a lack of medicine, rapid antigen tests and protective clothing – in the country that essentially invented the concept of medical diplomacy. In the past couple of years of the pandemic, heads of state and government around the world eagerly awaited the next shipment of vaccine or medical supplies from the People’s Republic. Now, it’s China itself that is facing shortages.

Pain medication and drugs to reduce fever are sold out in many places. In the vast majority of pharmacies in the capital, only remedies from Chinese medicine are available, herbal mixtures that you must have faith in. It’s almost like in North Korea, where pretty much every illness is treated with ginseng because there isn’t anything else.

Instead, the black market is flourishing. You can obtain the drug Paxlovid, which can reduce the viral load if taken promptly after infection, but a single package currently costs 2,980 yuan, the equivalent of 400 euros. It isn’t even clear, though, whether the black-market version of the drug contains what it is supposed to or if the pills are just thrown together with whatever ingredients might be available.

There is also a lack of intensive care beds in the country. Hospitals have set up wings for patients suffering from fever, but at the Chaoyang Hospital in the embassy quarter of Beijing, for example, hundreds of people line up in the cold for several hours on end, before having to wait several more hours once they get into the hospital. If they weren’t infected before, they certainly will be once its their turn to receive treatment.


China's Unprepared Countryside

The biggest problem, though, is the country’s vaccination rate. Only around 60 percent of the population had received their booster by the middle of October, yet the Chinese vaccine can only reliably protect people from a visit to intensive care if they have received three doses. Might it be possible to quickly launch another vaccination campaign? The virus is spreading too quickly for that.

State-controlled media outlets are not reporting on such challenges. Instead, the erstwhile "dangerous virus" is now being described as a moderate "cold." Television viewers can watch interviews with the country’s top coronavirus authority, the 86-year-old pulmonologist Zhong Nanshan, talking about how an infection with the Omicron variant is unproblematic for 99 percent of the population. But what does that mean in a country with a population of 1.4 billion? It translates to 14 million people, far more than the population of the country of Belgium, who aren’t likely to suffer just minor symptoms.

A street scene in Shanghai. The country's "dynamic zero" policy has been abandoned.

A street scene in Shanghai. The country's "dynamic zero" policy has been abandoned.

Foto: Aly Song / REUTERS
The Communist Party is no longer responsible for the well-being of the Chinese people. Rather each person is responsible for themselves.

Thus far, the virus has primarily infected residents of the country’s largest cities. But what will happen if COVID begins spreading unchecked in the countryside? Almost 40 percent of the population still lives in villages, with many of them elderly. Their children have largely moved away to work in the factories of southern China or eastern China, where they sew sports shoes and solder circuit boards for smartphones and computers.

"The poorer the region, the weaker the healthcare system tends to be," says Armin Müller of Jacobs University in Bremen. For years, Müller has been conducting research into medical care in China’s rural regions. "The greatest weakness are the village doctors. Many of them are poorly trained and are relatively old." One-third of rural doctors are over the age of 55. "Many of them could become infected and won’t be available. Some will die and others will no longer be able to take care of all their duties because of long-COVID," Müller warns. "There is a risk that basic healthcare will disappear completely in some villages."

Much will depend on whether the government imposes travel restrictions during Chinese New Year celebrations on January 22. Several hundred million migrant workers are eager to return to their home villages for the celebration. It is the largest human migration in the world. This year, though, it could turn into a massive superspreader event.

Many Chinese are thus treating themselves, swallowing any pain medication they can get their hands on as a precaution – and they don’t always study the package insert. The first cases of acute liver failure have already begun appearing because some people, out of fear of the virus, have ingested the contents of an entire package at once. Chaos is becoming the order of the day.


A Propaganda Flip-Flop

Those who regularly read the People’s Daily, the Communist Party’s official newspaper, can’t help but be rather confused these days. In recent weeks, 17 commentaries have been published under the pseudonym Zhongyin – all of them politically correct odes to the state’s zero-COVID strategy.

On November 15, for example, an article proclaimed: "It is imperative that a country with a population of 1.4 billion people be able to maintain the bottom line of dynamic zero."

On November 25: China possesses "the foundation, conditions, confidence and ability to overcome the epidemic and spread caused by the new coronavirus and achieve dynamic zero."

Not even a week later, Zhongyin suddenly wrote: "In the face of an epidemic, we must all enhance our sense of responsibility and self-protection, consciously assume our responsibilities and obligations for prevention and control, and be the first to take responsibility for our own health." It was nothing less than a complete about-face, packaged in a dense thicket of hackneyed political verbiage. Translated, it means: The Communist Party is no longer responsible for the well-being of the Chinese people. Rather each person is responsible for themselves. It is a social experiment the ramifications of which are difficult to comprehend.

Heading to the pharmacy in Beijing. The coronavirus is spreading rapidly in the Chinese capital.

Heading to the pharmacy in Beijing. The coronavirus is spreading rapidly in the Chinese capital.

Foto: Andy Wong / AP

In late November, photographer Zhang Tongtong took to the streets, initially shooting pictures in her residential quarter in Beijing. More than 60 apartment high-rises are lined up here, one after the other, each of them 13 floors tall. Because a single resident had fallen ill with COVID, public officials decided to blockade the entire compound: tens of thousands of people, barricaded behind a blue metal fence. The frustration boiled over only a short time later at the eastern gate. "It must have been several hundred people," the photographer, who doesn’t want to see her real name in print, says in a video chat. She is carrying on the conversation from her bed, and she looks exhausted. Corona. Together, she says, the group tore down the fence and freed themselves. "I had a loudspeaker on hand and played the 'Communist International’ and the national anthem on repeat," she says.

She fell ill a couple of days later, and had never gotten vaccinated. On December 7, the day on which the government officially loosened quarantine rules, she made her infection public. "Everyone is positive," she wrote on WeChat, the popular Chinese messaging service.


The Symptoms Appeared One Week Later

She hardly had any symptoms at all during the first days. But the cough showed up after a week, and then the fever – more than 40 degrees (104 degrees Fahrenheit). Her mother and father have also come down with the illness, as have likely millions of others in China. Nobody knows the exact numbers.

"To be honest, I’m surprised at how quickly it has gone," Zhang Tongtong says. "There were a number of factors that forced the government to open up. The protests surely accelerated the process."

So now the country is on the route to contamination instead of quarantine. "It feels like a horror movie," says Zhang. "Overseas, it has already been shown in all the theaters, and we have seen the trailer numerous times and read the reviews. Now, it is finally playing in our country and the people are still surprised when the monster suddenly shows up."

From her ninth-floor window, she can see three old women who feed the cats every single day, the virus be damned. There are 11 of the animals at the moment, with names like Clown, Big Flower, or Little Black. Retirees have also spread out a bit of rice and millet onto the asphalt for the sparrows, who are lined up in the branches of a willow tree in the courtyard waiting for the cats to finally eat their fill.

A little over 65 years ago, there was a similarly radical political campaign that failed miserably because the ideology concealed everything else. It had to do with sparrows.

In the late 1950s, People’s Republic founder Mao Zedong proclaimed the "Great Leap Forward" and demanded that more steel be produced in China than in the United Kingdom. Primitive blast furnaces were quickly erected in the villages, and farmers suddenly became steelworkers. Hardly anybody tended to the fields.

At the same time, a campaign was launched to eradicate sparrows. The "rats of the air," according to the propaganda message, ate valuable seeds and must be exterminated. The "dynamic zero sparrow policy," as it might be called today, was a complete success. A short time later, the country was visited by a plague of insects, because their natural enemies, the sparrows, were gone. The consequence of Mao’s misguided industrialization policies: crop failures across the entire country. Up to 45 million Chinese starved to death and the birds had to be reimported from the Soviet Union.

Decades later, hundreds of thousands of people are again in danger. And again, many of them are likely to succumb.

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