China’s zero-covid approach, health system, reopening plans


Volunteers in protective suits look after on the 15th. More than 60 students in the University City of Zhuanghe were diagnosed with COVID-19 in Dalian on Sunday.

VCG | Visual China Group | Getty Images

China is pushing its zero-covid approach and there are signs that it won’t be giving up that stance anytime soon, according to U.S. investment bank Jefferies.

From the US to much of Europe and Asia, many countries are learning to live with the virus and have started lifting most of the restrictions.

Countries initially took an aggressive approach through mass bans and strict social restrictions, but gradually abandoned this strategy as the highly contagious Delta variant spread quickly and the bans became less effective.

But China hasn’t relaxed its ultra-strict zero-covid strategy, which includes mass bans – even if only one or a handful of cases are discovered. This also includes extensive tests, tightly controlled or closed borders, as well as robust systems for contact tracing and quarantine mandates.

Most recently, visitors to Shanghai Disneyland had to take Covid tests in order to leave the country. This request came after authorities learned that close contacts of an infected person had visited the park the week before.

‘Closed until further notice’

According to Reuters, the Asian giant is now fighting the spread of its largest Covid outbreak, which is caused by the Delta variant.

“China… seems to have done its COVID management very well, but the Delta variant poses new challenges. In addition to suppressing domestic cases, ‘preventing imported cases’ is an important part of the strategy, ”Jefferies analysts said in a November 18 release.

“The result appears to be a country that has no immediate plans to open up and live with the virus. The news of snap-downs continues and it looks like China will be closed until further notice. “

Jefferies highlighted three things that indicate China’s lack of immediate plans to move away from its zero tolerance approach.

1. Renewal of the passport

Passport renewal data suggests authorities are not planning any overseas travel or tourism for some time, Jefferies said. Chinese passport reissues and renewals decreased by more than 95% in the first half of this year compared to the same period in 2019.

“This could suggest that the central government is trying to restrict people’s ability to leave China,” Jefferies said.

The note also cited recent comments from China’s National Immigration Service that said those who do not have an urgent need to travel internationally should postpone their plans. Passport issuance or renewal would only be a priority for Chinese nationals studying or working abroad, the authorities said.

By comparison, U.S. passport issuance decreased 43% from 2019 to 2020, and increased 32% year over year in the first half of this year.

2. Special quarantine facilities

According to Jefferies, governments in Chinese cities should build 20 rooms for every 10,000 citizens in special or remodeled facilities – to accommodate overseas arrivals.

Guangzhou is already shifting away from hotel use and a new facility with more than 5,000 rooms is expected to open while other provinces are “moving quickly” according to Jefferies.

“The construction of special quarantine facilities suggests that the quarantine for incoming calls may last longer,” said Jefferies.

3. China’s health system

According to Jefferies, the medical infrastructure in China may not be prepared for higher cases if borders are opened or Covid is treated as endemic.

“China has significantly fewer hospital beds and doctors than many other countries. Its three tier healthcare system barely survived the first wave of the COVID outbreak in early 2020, ”the analysts said.

The three-tier health system includes city-level hospitals, district-level clinics, and rural health services provided by rural doctors, according to Jefferies. The number of hospital beds and doctors in rural areas per 1,000 people is less than half that of urban areas, the report said.

“Poor medical infrastructure in rural areas makes the early detection of COVID cases difficult and consequently leads to widespread outbreaks back into cities,” the bank said. With 36% of China’s population living in rural areas, “a closed border is the easiest solution to preventing the health system from collapsing,” Jefferies said.

In addition, China’s health expenditure is “significantly” lower than that of many other countries. “This could mean that Chinese authorities are concerned that a major national outbreak could overwhelm their healthcare system,” the bank concluded.