How China’s zero-Covid policy is failing Shanghai

“Shanghai, China’s bustling cosmopolis of 26 million has been under lockdown since late March under the nation’s strict “dynamic zero-Covid” protocols, a system so poorly managed that residents are frequently unable to access basic necessities like food, medications, and medical care, prompting fairly widespread, spontaneous protests both online and in real life.

The government has touted the zero-Covid strategy, the government’s system of containment using intensive testing and tracing, combined with partial or complete lockdowns when a case is detected, has kept case counts and deaths low over the past two years. But the reports coming out of Shanghai suggest that the local government was unprepared for an outbreak in the country’s economic center and cast doubt on the feasibility of zero Covid at this point in the pandemic. That’s translated into serious struggles for residents, including hours-long ambulance wait times, dwindling savings, and inadequate or rotten food supplies, among others. Although the central government is reportedly stepping up efforts to get supplies to the city, the overall policy is driving many residents to criticize the government’s policy — and Shanghai’s implementation of it — despite serious potential risks to their safety and freedom by doing so.”

“The Shanghai outbreak is thus far China’s most serious since the beginning of the pandemic; a staggering 200,000 cases have been reported since the outbreak started in March, though that’s likely under-reported, according to the New York Times. What started as a patchwork of temporary lockdowns to limit the spread of disease quickly turned into an interminable, city-wide shutdown with people only allowed out to take PCR tests, as a New York magazine piece explained earlier this week. Shanghai’s lockdown, two years into the pandemic, is rivaled only by those in Wuhan in 2020 and Xi’an at the end of last year in terms of strictness.

Shanghai residents’ outrage — which they’ve expressed by singing and chanting from their balconies and co-opting anti-American hashtags used by government officials to criticize the US — is borne from the fact that the government isn’t providing the stability it promises in exchange for personal freedoms, according to Rui Zhong, program associate at the Wilson Center’s Kissinger Institute on China and the United States. “I think what makes people angry in Shanghai, and what made people angry in Xi’an is, Covid has been a problem for years,” she told Vox. “I think they’ve been really stunned at the degree to which their local officials haven’t necessarily prepared, including non-supply-chain issues,” like hospital admissions.”

“Shanghai’s local government enjoys a degree of relative autonomy in the context of President Xi Jinping’s China; it’s technically directly under the control of the central government, as a province-level city, but enjoys special status as the country’s financial hub and a showpiece for the rest of the world. Until March, the local government had handled the pandemic well, with no major outbreaks. But the rapid onset of the omicron variant and the corresponding draconian government measures are pushing some citizens to the brink.

“I have no more money … What am I to do? I don’t care anymore,” one man shouts to his whole building in a viral video on Weibo, China’s answer to Twitter. “Just let the Communist Party take me.””

Lockdowns’ High Costs and Murky Benefits

“If legislators were determined to “save lives, period, whatever it costs,” they would set the speed limit at 5 miles per hour, or perhaps ban automobiles altogether, which would prevent nearly 40,000 traffic-related deaths every year. Those policies seem reasonable only if you ignore the countervailing costs. In public policy, economist Thomas Sowell famously observed, there are no solutions; there are only tradeoffs.

“Logically,” Bourne writes, “there must be some negative consequences of government lockdowns, and some point at which they might become self-defeating.” To figure out when that might be, policy makers needed to estimate the public health payoff from lockdowns and compare it to the harm they caused.

Contrary to Cuomo’s framing of the issue, this is not a matter of weighing “the economic cost” of maintaining lockdowns against “the human cost” of lifting them, as if those categories were mutually exclusive. Even in life-and-death terms, lockdowns had a downside, since they plausibly contributed to a spike in drug-related deaths, discouraged potentially lifesaving medical care, and inflicted financial and psychological distress, neither of which is good for your health. And as Bourne emphasizes, “economic welfare” goes beyond household finances or GDP, encompassing everything people value.”

Southern California sheriffs are refusing to enforce stay-at-home orders

“These sheriffs’ refusal to enforce the stay-at-home orders is part of a long tradition of sheriffs picking and choosing when and how to require their constituents to follow the law. From defying gun control orders to selective enforcement of traffic violations, our system has granted wide latitude to law enforcement.”

“The nature of policing requires some level of discretion when it comes to enforcement. Traffic violations are so common that police have to decide which ones are worth ticketing and stopping (these decisions are rife with racial bias). However, outright refusal to uphold a law goes beyond that day-to-day discretion as sheriffs appoint themselves lawmakers and law enforcers in the same breath.”

How Melbourne eradicated Covid-19

“Australia enjoyed plenty of advantages over the United States in containing Covid-19. It has no land borders to speak of. Its population density is very low (though the population is concentrated on the coasts). Its outbreak never got nearly as bad as the US’s did. On its worst days, Victoria saw about 700 new cases; Missouri, with (very roughly) a similar population and landmass, is currently averaging more than 3,000. Some of the Australian states also closed their borders to the others, which lowered the risk somebody might bring Covid-19 from one part of the country to another.

But the Australian epidemic has also mirrored America’s in important ways. Once the coronavirus arrived in the spring, the country went into lockdown. When cases abated, some of those restrictions were eased — and, before too long, Covid-19 cases were spiking again. Each state was responsible for its own response, with the federal government playing an advisory role outside of obviously national issues like foreign travel.

In the second wave, Victoria was by far the hardest-hit state. Its case numbers were dwarfing those in every other state including New South Wales, home to the country’s other great metropolis, Sydney.”

“The state had gone into a stage 4 lockdown — most businesses closed, there was a nightly curfew, and residents were ordered to stay within five kilometers of their home — in August, and it was then extended in September, with the explicit goal of eventually reaching zero new cases.”

“They treated the threats to public health and the economy as intertwined, which most experts agree they are. The Australian states that contained Covid-19 best also saw the strongest economic recoveries. Victoria, with the worst outbreak among the states, was lagging behind in consumer spending and business revenue.”

““Without elimination, the third, fourth, or fifth wave is an inevitability. This will either involve more lockdowns or the government will lose the social license to do lockdowns and the virus will spread indiscriminately,” Duckett told me over email, perhaps unwittingly describing the very challenge before the United States during this winter surge. “A hard lockdown in the early stages of the virus gives a chance for elimination, and that gives the chance for business certainty and a full recovery.”

Melburnians are now enjoying the benefits of their sacrifices. Duckett said he had just gone to lunch with a few friends before responding to my email.

The US probably cannot achieve zero Covid-19 cases anytime soon. But it could embrace the spirit of the Victorian model: a clear goal, support for the proven mitigation strategies, and a commitment from the public.”

“They expanded testing, including random pooled testing and testing for workers in essential industries and of people attending schools or other indoor events. They achieved 24-hour turnarounds for test results, so if a person tested positive, they could quickly isolate. Once cases reached zero, the state was planning to start testing sewage for Covid-19 to get a head start on any resurgence.”

““A system that relies on self-isolation in which people are unable or refuse to self-isolate cannot succeed,” Duckett and Mackey wrote.

That probably sounds draconian to Americans. Certainly, the harshest lockdown measures taken in Victoria — requiring people to stay within a few miles of their house and stay inside completely at night — would be politically challenging in the US.

But Australians took it in stride because they knew the goal they were working toward.”

“The government there made it easier for businesses and workers by providing subsidies to businesses to keep people employed and by increasing their unemployment benefits — the same policies that the US has let lapse and is now struggling to reinstitute even during this devastating winter wave.

As cases dwindled, the lockdown measures were relaxed in a clear, tiered fashion. The extreme travel restrictions were the first to go. Schools and businesses could reopen with spacing. Masks continued to be required indoors and on public transportation. Eventually, all restrictions except for international quarantine could be lifted.

Things could still go wrong for Victoria and the rest of Australia. The state has started prioritizing having “normal” conditions for the Christmas shopping season over maintaining zero new cases. But it is easier to focus on reopening when community spread is eliminated — rather than pushing forward with reopening in spite of sustained spread, as the US has done.”

“I don’t believe it was impossible for America to execute a similar strategy to the one that has succeeded in Victoria. Polls showed most Americans did support wearing masks and other mitigation measures, even if there was some divide among partisans. They worried that social distancing would be relaxed too quickly, not too slowly, much like the Australians did.

The problem, or one of them, is that the US just never set a clear goal for Covid-19 suppression. It was understandably hard to ask people in Wisconsin to abide by social distancing restrictions back when they thought the coronavirus was just a New York City problem — and when they didn’t know what the plan was.

Today, of course, the pandemic is a very real problem for every American. So as we try to bring the winter wave under control, we might benefit from taking a lesson from the Aussies and coming up with a specific objective that all of us, together, can work toward.”

European countries with spiraling Covid-19 outbreaks are shutting back down

““Lockdowns only make sense if they’re followed by testing and tracing,” Steven Hoffman, director of York University’s Global Strategy Lab, summed up. “Otherwise you’ve endured a painful experience without any longevity in its benefit.”

Indeed, countries that didn’t use the lockdown, and post-lockdown, period as effectively are now faring worse in the second wave.”

Experts Think The Economy Would Be Stronger If COVID-19 Lockdowns Had Been More Aggressive

“our economic survey, conducted in partnership with the Initiative on Global Markets at the University of Chicago Booth School of Business, FiveThirtyEight polled 32 quantitative macroeconomists about the present and future of the economy. And because we couldn’t resist some Monday-morning quarterbacking, we also asked whether the lockdowns earlier in the year were too aggressive or not aggressive enough.

Out of those surveyed, 74 percent of economists said the U.S. would be in a better economic position now if lockdowns had been more aggressive at the beginning of the crisis. Among that camp, the most commonly cited reason was that early control over the virus would have allowed a smoother and more comprehensive return to economic activity later on.”

“Proponents of tighter lockdowns pointed to Japan and various European countries (such as Germany, Norway and Denmark) as examples of how reducing the virus to extremely low levels early on allowed for a quicker recovery. Others noted that children could have returned to school for in-person learning faster with earlier control over the virus — a major consideration in maximizing the country’s economic power as it bounces back from the pandemic.

Among the 26 percent who thought lockdowns should have been less aggressive, the main theme was that more good could have been done with a targeted approach that protected at-risk populations and stopped potential superspreading events, while allowing more activity overall. Others thought the lockdowns didn’t even matter much, or that most of the reduced activity was due to individual self-regulation rather than government intervention.”

“In the same vein — but this time, looking forward — we asked the economists to imagine a new shutdown had to occur as the result of a spike in COVID-19 cases. Which activities would they shut down first if they also wanted to minimize economic damage? With the caveat that our panel consists of economic experts — not epidemiologists — they clearly prioritized indoor dining (and to a lesser extent, gyms) to be the first shut down, while outdoor dining and recreation were at the bottom of the list “

Lockdowns worked. Now what?

“Flattening the curve through social distancing has worked in restraining Covid-19’s growth, according to new research published in Health Affairs.”

“The goal of flattening the curve was to prevent local health systems from becoming overwhelmed, which could have led to even higher fatalities than the US has already seen (about 90,000, as of Monday morning). Even New York City, the hardest-hit place in the country, has not seen its hospitals overrun in any kind of systemic way.
Take together the reduced spread through social distancing and the medical system being able to meet the Covid-19 need, and there is solid evidence that flattening the curve has worked.”

““In principle, the measures also bought time to develop a more effective testing and contact tracing infrastructure, although we will see whether that actually has been achieved as states start to reopen.””