Beijing is fine-tuning its virus response playbook to try to limit the cost of restrictions. But its goal of eliminating all infections could make that difficult.

Quarantine workers in Shanghai on Monday, near a neighborhood that had just been locked down.

By Amy Qin and Amy Chang Chien

When the coronavirus first swept across China in early 2020, the country’s leader, Xi Jinping, declared a “people’s war” against the epidemic, launching what would become a no-holds-barred strategy to eliminate infections.

Now, in year three of the pandemic, and faced with the rise of a stealthy and rapidly spreading variant, Mr. Xi is trying to fine-tune the playbook, ordering officials to quash outbreaks — but also to limit the economic pain involved.

As China grapples with the country’s largest outbreak since the pandemic began in Wuhan more than two years ago, Beijing says its measures should be more precise in scope. Officials are now promoting policies that to much of the world might either seem obvious, such as allowing the use of at-home test kits, or still extreme, such as sending people to centralized isolated facilities instead of hospitals.

But in China, where no effort has been spared to stamp out the virus, these point to a notable shift. Last week, for the first time, Mr. Xi urged officials to reduce the impact of the country’s Covid response on people’s livelihoods.

The adjustments are largely out of necessity. So far, the number of cases remains relatively low, and only two deaths have been reported in the latest wave. But many of the more than 32,000 cases reported across two dozen provinces in recent weeks have been of the highly transmissible BA.2 subvariant of Omicron.

The mushrooming of outbreaks around the country could quickly overwhelm the medical system if every person who tested positive were sent to a hospital, as was required until recently. It could wear down the armies of community workers and neighborhood volunteers tasked with organizing mass PCR tests for millions of people every day and checking on residents under quarantine. Lengthy, unpredictable lockdowns could wipe out the already razor-thin profits of many factories or lead to layoffs of service workers.

A locked-down neighborhood  in Shanghai on Tuesday.
A locked-down neighborhood in Shanghai on Tuesday.Credit…Qilai Shen for The New York Times

In his remarks to top officials last week, Mr. Xi said officials should strive for “maximum effect” with “minimum cost” in controlling the virus, reflecting concerns about the economy’s slowing growth. Yet his order to swiftly contain the outbreaks underscored a broader question about how far his rhetoric on controlling costs would go. On Friday, Chinese health officials emphasized to reporters that the effort to be more targeted did not amount to a relaxing of the policy.

Dali Yang, a professor of political science at the University of Chicago, said Mr. Xi was signaling a “willingness to adapt and to reduce the disruptions to the economy,” but not that the government was giving up control.

The ruling Communist Party’s zero-tolerance approach creates high costs for officials should outbreaks occur under their watch, Mr. Yang said, pointing to the recent firings of top officials in Jilin City and a district in the city of Changchun as examples. State media reported that more than two dozen officials had been dismissed in recent weeks, accused of negligence in responding to the outbreaks.

For many in China, everyday life has been upended since the latest wave began. Tens of millions of people are now under some form of lockdown. Factories have suspended work and truck traffic has been delayed, snarling already frayed supply chains. In some areas of the major metropolises of Shenzhen and Shanghai, life has ground to a halt as offices and schools have been shuttered and residents have been ordered to stay in their homes.

From the street, a woman  talked to a couple in a locked-down Shanghai building.
From the street, a woman talked to a couple in a locked-down Shanghai building.Credit…Qilai Shen for The New York Times

In Shanghai, the authorities have avoided imposing a citywide lockdown, using contact tracing instead to contain neighborhoods deemed high-risk. Still, the restrictions have hit the bottom line for businesses, such as a spicy hot pot restaurant in the upscale Xuhui district of Shanghai.

Zhang Liang, the owner of the restaurant, said his profits had plunged by more than 80 percent since the lockdowns began. He was worried about his bills.

“We’re still open, but no one is coming,” Mr. Zhang said.

The lockdown is taking a toll on residents in other ways. Tang Min, a 37-year-old gas station worker in a town in Jilin Province, was among residents ordered to stay at home. Days later, she was running out of the prescription medicine she takes to treat her depression.

She called the local government hotline, and neighborhood volunteers eventually brought her more medicine, just before she would have run out.

“When I don’t take medicine, I don’t feel like I have much to live for,” Ms. Tang said in a telephone interview.

China’s stringent virus controls still appear to enjoy widespread support, with people hoping to avoid the devastation Covid has wrought on hospitals and communities around the world. But in recent weeks, there have been signs that the public’s patience is wearing thin.

Testing for Covid at a Shanghai community center.
Testing for Covid at a Shanghai community center.Credit…Qilai Shen for The New York Times

When Zhang Wenhong, a prominent infectious disease expert from Shanghai, suggested last summer that China should learn to live with the virus, he was attacked online as a puppet of foreigners. Now, people online have started debating the question of how long the measures will last. Some have even joked that the government should “lie flat,” a reference to a popular term among Chinese millennials for pushing back against societal pressures by doing less.

“People seem to be increasingly fed up with these excessive anti-Covid measures,” said Yanzhong Huang, director of the Center for Global Health Studies at Seton Hall University.

But the outbreak in Hong Kong — where patients on gurneys have been parked outside hospitals and body bags have piled up in wards — has shocked many in the mainland. Charts showing high Covid death rates in Hong Kong, where many older residents are unvaccinated, have been ricocheting around Chinese social media.

The toll on older people in Hong Kong has spurred officials in China to redouble efforts to boost vaccinations among the country’s vulnerable groups. More than 87 percent of China’s population has been fully vaccinated. But among people 80 and older, just over half have had two shots, and less than 20 percent have received a booster, Zeng Yixin, a vice minister of the National Health Commission, said on Friday.

Workers at a quarantine checkpoint took delivery of goods ordered by residents of a locked-down Shanghai neighborhood.
Workers at a quarantine checkpoint took delivery of goods ordered by residents of a locked-down Shanghai neighborhood.Credit…Qilai Shen for The New York Times

Officials have announced plans to send vaccination trucks to inoculate the many older Chinese who live in less accessible rural areas. Misinformation about the vaccines and a lack of urgency stemming from the relatively low number of cases have exacerbated the problem.

For months, Li Man, a 69-year-old housewife in Beijing, put off getting vaccinated, believing that she was at low risk for contracting the virus because she did not often go out. Eventually, at the urging of her daughter, she got the jab a few months ago. But in a telephone interview, she said she still felt it had been unnecessary.

“China’s situation is way better than in the United States or other Western countries,” Ms. Li said.

Ms. Li’s confidence points to the high stakes the government faces as it tries to calibrate its response. Beijing has touted China’s low number of deaths from the virus as a sign of the superiority of the country’s top-down, centralized system. A failure to contain the latest surge could erode the party’s legitimacy.

With each new variant, tracing the chain of transmission has become more difficult. Last month, a village near Shenzhen was locked down for nearly three weeks. The community was later cleared and the lockdown was lifted. But within a few days, cases began to emerge, and the village was placed under lockdown again.

In allowing the use of at-home test kits, officials have said that the onus was on residents to report any positive results to their local authorities. Jiao Yahui, an official with China’s National Health Commission, said on Friday that people would be punished if they failed to do so, but she did not specify what the consequences might be.

Even if the authorities succeed in quashing all infections in the current wave, it will only be a matter of time before the next outbreak, said Jin Dongyan, a virologist at the University of Hong Kong. That is why, he said, China urgently needs to come up with a road map to learn how to live with the virus.

“It’s the only option,” Mr. Jin said. “It’s almost impossible now to come back to zero.”

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