美国国家公共电台 NPR--Why China's 'zero COVID' policy is finally faltering

Why China's 'zero COVID' policy is finally faltering¹

Transcript²

For nearly three years now, China has had incredible success at keeping its number of COVID deaths relatively³ low. So far, the country has recorded only about 6,000 deaths among 1.4 billion people. By comparison, the U.S. has recorded more than a million deaths in a population of only 330 million.

China has accomplished⁴ this feat⁵ with what's known as a "zero COVID" policy – using strict lockdowns and community-wide testing and other measures to keep case counts close to nil⁶.

But in the past few weeks, this strategy has begun to show signs of faltering – and some scientists think it could be crumbling⁷.

Cases are surging to record numbers in parts of the country. On Nov. 29, China recorded an all-time daily high of more than 71,000 new cases. COVID restrictions⁸ have sparked protests and dissent⁹ in major cities at levels not seen in a decade.

Is "zero COVID" even possible with omicron? What will happen if China reopens and SARS-CoV-2 begins to transmit freely across the country? Is China prepared for a surge? Those are questions that epidemiologists and public health experts are considering. Here's a look at the key queries¹⁰ – and what we know so far about the possible answers.

Let's start with the basics: What does a zero-COVID policy involve? Does it really mean aiming for no cases at all?

The idea is to stop transmission of the virus inside a country. That's a tremendous challenge with a highly contagious¹¹ virus like the omicron variant¹². Even in a country with a zero or remarkably¹³ low case count, foreign travelers may import cases and spark outbreaks from time to time. The government tries to limit both of these occurrences by severely¹⁴ limiting the number of people who can enter the country. And when outbreaks do occur, the government uses a combination of quarantining, contact tracing and mass testing to stamp the virus out as quickly as possible.

Since the pandemic began, about 16 countries or regions have attempted this zero-COVID approach, including Australia, New Zealand, Singapore and Taiwan.

But as SARS-CoV-2 evolved to become more transmissible, this approach has become harder and harder to carry out, says epidemiologist Jennifer Nuzzo at Brown University.

"Omicron moves through a population really quickly," she says. "It runs around the traditional public health measures that the world has used over the last two years, such as masking and quarantining."

So to maintain a zero-COVID policy, China has needed to implement¹⁵ extremely harsh and severe restrictions on people's movements. And they launched enormous amounts of testing on a massive scale.

For example, earlier this week, the government once again began testing millions of people in Shanghai on a daily basis. And back in the spring, the government locked down essentially¹⁶ all 26 million residents of the city – for a stunning¹⁷ two-month period. Sometimes during the lockdown, people couldn't even leave their homes to go on a walk. (Imagine New York City completely locked down for that long during the third year of the pandemic.)

So is "zero COVID" even possible with omicron? Is this approach going to work for China?

For most of the pandemic, the zero-COVID policy has worked for China, says computational biologist David Welch, at the University of Auckland. "Many countries showed that zero-COVID policy does actually work," he says. "New Zealand ran a successful zero-COVID policy for a good couple of years."

China has held case counts to remarkably low levels throughout the pandemic. The country has recorded only about 1.6 million cases since 2020, or only 0.1% of the population. And what many people don't realize is that the vast majority of those cases are asymptomatic cases detected through mass testing, says global health researcher Yanzhong Huang, at the Council on Foreign Relations. "In November, more than 90% of the 300,000 cases [in China] were asymptomatic," he says. "There are very few severe cases."

(If you're wondering why so many asymptomatic cases – it's partly because the mass testing uncovers cases that would otherwise have gone unrecorded, but otherwise ... it's a mystery.)

The problem with the zero-COVID policy, however, is that it's not sustainable year after year, both Huang and Welch say, because COVID can be found now in virtually every corner of the world. "The point of a zero-COVID policy is to use the time when you have few cases to prepare for when COVID does arrive," Welch says. The key preparation is vaccinating¹⁸ people to protect them against severe disease but also ensuring hospitals can handle large surges.

Over the past year and half, every other country that attempted the zero-COVID approach has abandoned it, says Jennifer Nuzzo of Brown.

Right now, it looks like the zero-COVID strategy might be starting to fail in China as well.

"Despite very aggressive measures such as high levels of mask usage, massive testing efforts and quarantining, China is still dealing¹⁹ with what's probably more community transmission of SARS-CoV-2 than the country is recognizing," Nuzzo says.

So is it inevitable²⁰ that China will have to abandon the zero-COVID policy and stop these massive quarantines and restrictions?

"There's no sign the government is abandoning the approach," says the CFR's Yanzhong Huang. In fact, in some cities, officials have doubled down on restrictions and quarantines in the past few weeks.

"But the government may be forced to give up the approach in the coming year, I believe, if not in the coming weeks or months," he says.

Why?

"People are simply tired of the restrictions," Huang says. "Once people began to understand the nature of the virus – that it's typically mild [when you're fully²¹ vaccinated] – they started to question the zero-COVID policy" – a policy that's had huge consequences on people's lives. There have been food shortages. People have lost jobs. The country, as a whole, is cut off from the world.

If China ends these restrictions, does that mean it will likely see a massive omicron surge as other countries have?

Analysts²² at Bloomberg have speculated that if omicron hits in China as hard as it did in the U.S., a full reopening may lead to nearly 6 million people admitted to ICUs and more than 600,000 deaths.

One reason for this severe toll²³ is that less than 60% of the population has had three doses of the vaccine²⁴ – which is needed to give excellent protection against severe disease. Vaccination²⁵ rates for elderly people in China are quite low, Huang says. On Tuesday, Chinese officials announced that 68% percent of people over age 80 have received three shots. That percentage still leaves at least 10 million at high risk for severe COVID and death.

"It's precisely²⁶ this concern about the worst case scenario²⁷ – with rapid increase of cases nationwide and potentially a mass die-off – that the government uses to justify²⁸ zero-COVID policy," Huang says.

No country has been in this particular situation before, where they've held off the virus for so long. If China can reopen extremely slowly to limit transmission, it could possibly avoid a massive crisis.

Nonetheless, China is preparing for a big surge in severe COVID cases. The government is building more hospitals and ICU beds across the country. And it's ramping²⁹ up vaccinations³⁰ among the most vulnerable.

"I can't predict what will happen when the government relaxes the restrictions," Huang says. No country has been in this particular situation before, where they've held off the virus for so long – and have the tools to slow down transmission so quickly.

If China can reopen extremely slowly, to limit transmission, the country could possibly avoid a massive health crisis.

1 faltering   

犹豫的，支吾的，蹒跚的

参考例句：

• The economy shows no signs of faltering. 经济没有衰退的迹象。
• I canfeel my legs faltering. 我感到我的腿在颤抖。

2 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

3 relatively   

adv.比较...地，相对地

参考例句：

• The rabbit is a relatively recent introduction in Australia.兔子是相对较新引入澳大利亚的物种。
• The operation was relatively painless.手术相对来说不痛。

4 accomplished   

adj.有才艺的；有造诣的；达到了的

参考例句：

• Thanks to your help,we accomplished the task ahead of schedule.亏得你们帮忙,我们才提前完成了任务。
• Removal of excess heat is accomplished by means of a radiator.通过散热器完成多余热量的排出。

5 feat   

n.功绩；武艺，技艺；adj.灵巧的，漂亮的，合适的

参考例句：

• Man's first landing on the moon was a feat of great daring.人类首次登月是一个勇敢的壮举。
• He received a medal for his heroic feat.他因其英雄业绩而获得一枚勋章。

6 nil   

n.无，全无，零

参考例句：

• My knowledge of the subject is practically nil.我在这方面的知识几乎等于零。
• Their legal rights are virtually nil.他们实际上毫无法律权利。

7 crumbling   

adj.摇摇欲坠的

参考例句：

• an old house with crumbling plaster and a leaking roof 一所灰泥剥落、屋顶漏水的老房子
• The boat was tied up alongside a crumbling limestone jetty. 这条船停泊在一个摇摇欲坠的石灰岩码头边。

8 restrictions   

约束( restriction的名词复数 )； 管制； 制约因素； 带限制性的条件（或规则）

参考例句：

• I found the restrictions irksome. 我对那些限制感到很烦。
• a snaggle of restrictions 杂乱无章的种种限制

9 dissent   

n./v.不同意，持异议

参考例句：

• It is too late now to make any dissent.现在提出异议太晚了。
• He felt her shoulders gave a wriggle of dissent.他感到她的肩膀因为不同意而动了一下。

10 queries   

n.问题( query的名词复数 )；疑问；询问；问号v.质疑，对…表示疑问( query的第三人称单数 )；询问

参考例句：

• Our assistants will be happy to answer your queries. 我们的助理很乐意回答诸位的问题。
• Her queries were rhetorical,and best ignored. 她的质问只不过是说说而已，最好不予理睬。 来自《简明英汉词典》

11 contagious   

adj.传染性的，有感染力的

参考例句：

• It's a highly contagious infection.这种病极易传染。
• He's got a contagious laugh.他的笑富有感染力。

12 variant   

adj.不同的，变异的；n.变体，异体

参考例句：

• We give professional suggestions according to variant tanning stages for each customer.我们针对每位顾客不同的日晒阶段，提供强度适合的晒黑建议。
• In a variant of this approach,the tests are data- driven.这个方法的一个变种，是数据驱动的测试。

13 remarkably   

ad.不同寻常地，相当地

参考例句：

• I thought she was remarkably restrained in the circumstances. 我认为她在那种情况下非常克制。
• He made a remarkably swift recovery. 他康复得相当快。

14 severely   

adv.严格地；严厉地；非常恶劣地

参考例句：

• He was severely criticized and removed from his post.他受到了严厉的批评并且被撤了职。
• He is severely put down for his careless work.他因工作上的粗心大意而受到了严厉的批评。

15 implement   

n.(pl.)工具，器具；vt.实行，实施，执行

参考例句：

• Don't undertake a project unless you can implement it.不要承担一项计划，除非你能完成这项计划。
• The best implement for digging a garden is a spade.在花园里挖土的最好工具是铁锹。

16 essentially   

adv.本质上，实质上，基本上

参考例句：

• Really great men are essentially modest.真正的伟人大都很谦虚。
• She is an essentially selfish person.她本质上是个自私自利的人。

17 stunning   

adj.极好的；使人晕倒的

参考例句：

• His plays are distinguished only by their stunning mediocrity.他的戏剧与众不同之处就是平凡得出奇。
• The finished effect was absolutely stunning.完工后的效果非常美。

18 vaccinating   

给…接种疫苗( vaccinate的现在分词 )； 注射疫苗，接种疫苗

参考例句：

• At first blush, vaccinating the wolves against rabies seems a simple solution. 乍一看来，为狼群注射防狂犬病疫苗是一种简单的办法。
• Also vaccinating children against misers (measles) has saved many lives. 还有，给儿童进行疫苗接种防止麻疹也挽救了许多生命。

19 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。

20 inevitable   

adj.不可避免的，必然发生的

参考例句：

• Mary was wearing her inevitable large hat.玛丽戴着她总是戴的那顶大帽子。
• The defeat had inevitable consequences for British policy.战败对英国政策不可避免地产生了影响。

21 fully   

adv.完全地，全部地，彻底地；充分地

参考例句：

• The doctor asked me to breathe in,then to breathe out fully.医生让我先吸气，然后全部呼出。
• They soon became fully integrated into the local community.他们很快就完全融入了当地人的圈子。

22 analysts   

分析家，化验员( analyst的名词复数 )

参考例句：

• City analysts forecast huge profits this year. 伦敦金融分析家预测今年的利润非常丰厚。
• I was impressed by the high calibre of the researchers and analysts. 研究人员和分析人员的高素质给我留下了深刻印象。

23 toll   

n.过路(桥)费；损失，伤亡人数；v.敲(钟)

参考例句：

• The hailstone took a heavy toll of the crops in our village last night.昨晚那场冰雹损坏了我们村的庄稼。
• The war took a heavy toll of human life.这次战争夺去了许多人的生命。

24 vaccine   

n.牛痘苗，疫苗；adj.牛痘的，疫苗的

参考例句：

• The polio vaccine has saved millions of lives.脊髓灰质炎疫苗挽救了数以百万计的生命。
• She takes a vaccine against influenza every fall.她每年秋季接种流感疫苗。

25 vaccination   

n.接种疫苗，种痘

参考例句：

• Vaccination is a preventive against smallpox.种痘是预防天花的方法。
• Doctors suggest getting a tetanus vaccination every ten years.医生建议每十年注射一次破伤风疫苗。

26 precisely   

adv.恰好，正好，精确地，细致地

参考例句：

• It's precisely that sort of slick sales-talk that I mistrust.我不相信的正是那种油腔滑调的推销宣传。
• The man adjusted very precisely.那个人调得很准。

27 scenario   

n.剧本，脚本；概要

参考例句：

• But the birth scenario is not completely accurate.然而分娩脚本并非完全准确的。
• This is a totally different scenario.这是完全不同的剧本。

28 justify   

vt.证明…正当(或有理)，为…辩护

参考例句：

• He tried to justify his absence with lame excuses.他想用站不住脚的借口为自己的缺席辩解。
• Can you justify your rude behavior to me?你能向我证明你的粗野行为是有道理的吗？

29 ramping   

土堤斜坡( ramp的现在分词 )； 斜道； 斜路； （装车或上下飞机的）活动梯

参考例句：

• The children love ramping about in the garden. 孩子们喜欢在花园里追逐嬉戏，闹着玩。
• Have you ever seen a lion ramping around? 你看到过狮子暴跳吗？

30 vaccinations   

n.种痘，接种( vaccination的名词复数 )；牛痘疤

参考例句：

• Vaccinations ensure one against diseases. 接种疫苗可以预防疾病。 来自《简明英汉词典》
• I read some publicity about vaccinations while waiting my turn at the doctor's. 在医生那儿候诊时，我读了一些关于接种疫苗的宣传。 来自《简明英汉词典》