It constitutes a real success – leaving aside the harsh management methods to ensure restrictions and the ensuing propaganda that has, perhaps imprudently, attributed the whole policy to Xi Jinping.
We may criticize the balance sheet regarding human suffering and restrictions on freedom of movement. These criticisms are amplified by the fact that expatriates in China’s key cities have also been affected. But, until Omicron arrived, these criticisms did not extend to the balance with the economy. Our societies have traded off their freedom of movement against a casualty rate that, to this day, is higher than that of a permanent flu epidemic. They had also sustained, before Omicron, more economic losses than China. This is nothing new – societies make choices that are partly public health policies and partly behavioral. Sometimes, these are life and death choices, and they should not be over-simplified.
A second viewpoint has now taken hold: Omicron has turned the table by defying all but the most radical confinement methods with its high infectiousness. Although we now tend to think of the variant as a persistent flu, it is actually as dangerous as the Alpha variant for the unvaccinated or partially vaccinated, the elderly, or the vulnerable. China is now a victim of the gaps in some of its previous policies – and even of its own past success. The most obvious gap is that, since the population has had almost no exposure to Covid, it has no natural immunity – even if there is a debate about the true extent of natural immunity. Its authoritarian administration of tests and vaccines has largely been based on rules regarding access to shops and restaurants, transport, and travel: elderly people, especially people over 80, move very little and were therefore not caught by this net. In spite of the impressive quantity of vaccines made in China, the vaccination scheme is considered complete after receiving two injections, not three. It so happens that the efficiency of China’s inactivated vaccines climbs to a level comparable to mRNA vaccines with three shots, not two. The failure to produce or import Pfizer-BioNTech vaccines is a result of China’s search for indigenous innovation, nationalist pride, and propaganda. This is a politically motivated gap. But is it realistic to believe that China would independently produce more Pfizer doses than the 3 billion delivered across the world in 2021? Did India, for example, make that choice?
The reliance on tests and isolation has created a path dependency that has been aggravated by the vaccination gap, especially for the elderly. China shares another trait with other developing or emerging economies: it has fewer hospital beds, especially in ICUs, than among the most developed nations. As we know too well, this shortage cannot be remedied instantly, given the required human training for operating these units. All in all, particularly in China’s countryside, where many elderly remain, an Omicron wave similar to what has happened over Europe and the US would be more deadly in China.
Politics, of course, intervene. As is the case in democracies: elected leaders weigh the economic disadvantages and the unpopularity of confinement against the "acceptable" level of casualties. This is even more so the case in China, because it has trumpeted the unique success of its containment policies and directly attributed them to Xi Jinping.
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