China faces open-ended health chaos | The covid multiplies by millions a day and hospitals collapse

China faces open-ended health chaos |  The covid multiplies by millions a day and hospitals collapse

In China, if something substantial happens in Shanghai, it is often replicated across the country. Official media estimate that 70 percent of the city’s 18 million inhabitants have just been infected in the first major wave of coronavirus, in a country that had almost dribbled the pandemic. This week, at least two hospitals in the city had hundreds of elderly people admitted with oxygen, occupying all the beds in emergency services. They even served on the sidewalk, the AFP agency testified.

In the capital Beijing, the situation is similar in a winter that has just begun. Now without sanitary restrictions, millions go to restaurants and shopping centers, some with 80 percent of their stores closed due to the pandemic crisis. In Shanghai the subway is full and in the coastal Bund people go shopping in droves. And there are queues to enter Disneyland and Universal Studios park.

The end of a harsh policy

The end of the covid-zero strategy on December 7 was so unexpected that in the first two weeks of the month the streets of the cities remained almost deserted: many had become accustomed to the semi-hermit life and feared contagion. But almost all of them have returned to normality, unlike the hospitals, which have completely lost it. The media almost do not report, but the situation sneaks through social networks. The chaos is just beginning and it would be far from the peak. The wave of infections was so fast that in certain hospitals most of the staff became ill and continue to work with fever.

In the first three weeks of free movement, the Government reported 25 deaths, something that does not match the images of queues at crematoriums. In Zhejiang province, one million daily infections have been officially reported and came to care for 408,000 patients with fever in one day, out of a population of 64 million. The English company Airfinity -consultant with a health profile- assumes that China would have 9,000 daily deaths from covid and the total would reach more than two million next year.

The greatest risk is in rural areas with poor health infrastructure and that would explode in the Lunar New Year holidays: 415 Millions of people will return to their place of origin between January 21 and 27, bringing the virus to their parents.

The weak point is the vaccination of the elderly. 66% aged 80 or over have been vaccinated once (the rest none). And less than half received the reinforcement. When vaccines appeared, essential workers were prioritized to minimize economic damage. The strategy towards the elderly was confinement. As it worked, they never hurried vaccination to the elderly, who tend to reject it for believing in ancient medicine. The zero-contagion policy prevented herd immunity. That is why China is facing the perfect storm, with the aggravating circumstance that its vaccines are not of the Messenger RNA type, the most effective. Although the official figure says that 90 percent of Chinese people are vaccinated, the average immunization level is relatively low.

a painful remedy

No transition, cut off radical precautions. It was not what the government wanted, but the protests at the end of November turned the tide. Demonstrations are common in China due to specific and regional problems. But these were simultaneous throughout the country for the same reason: the weariness that had been brewing for months. In addition to calling for an end to the confinements, a slogan heard in Beijing and Shanghai was “down with Xi Jinping”, something very daring. In parallel, the Chinese watched the World Cup with masses in unprotected stadiums.

If a case of covid appeared in a university, sometimes the students were locked up there for 20 days, crammed together almost without bathing. And it is in student areas where protests are most feared, as happened in 1989. Shanghai was quarantined for 6 months until last August. There were cities that did it for three days without a single positive case: it was a simulated catastrophe. There were also long lockdowns at Foxconn factories – Apple’s Taiwanese assembly company – to sustain production with zero risk, which ended in protests and clashes with the police.

A weak health system

It has become clear that the radical measures to stop the covid in China obeyed a specific logic and not the camouflage of a political control that lacked threats: if they were lifted, everything would overflow. Why the health system was not prepared. But the mobilizations set off alarm signals, not health but political.

When touring China and conversing with people, one argument is often heard: “our living conditions have improved a lot in the last decades and we want that to continue.” A political pact is looming in which a large part of the population demands economic success, in exchange for passivity or tacit support, prioritizing stability. If growth slows, there will be complaints in different ways: this equation is more or less the same in China since the time of Confucius, who theorized it. The virological results, even a little sketchy, were good. But not the economic ones: the lowest growth in 50 years. And the consequences in social mental health aggravated everything.

Almost three very hard years of intermittent confinement -sometimes three months- and daily tests, were the maximum that the Chinese stoics could endure. Xi Jinping stretched the rope of the social pact to the limit and saw it tremble: he released it without warning. Perhaps he has assumed paying a cost for what may happen: a minimum of one million deaths, 0.071% of the population (0.3% died in the US). But it doesn’t look like the numbers are going to be reported. The Chinese Center for Disease Control and Prevention will do it once a month with non-transparent criteria. This prompted a complaint this week from the World Health Organization. And about twenty countries began to demand a covid test from the Chinese to cross their border. It is feared that mutations will sprout in China.

Why so rigorous?

A possible explanation for the Chinese radicalism in the controls and their elimination is the centrality of Xi Jinping in the plot of power: his figure was consolidated in the last CCP Congress by retiring his internal opposition in the Central Committee, whose votes he needs to be re-elected every five years. He was proud of his covid-zero strategy and incorporated it into his geopolitical narrative: Chinese dominance of the virus would demonstrate the superiority of his political system. Knowing that a change would generate the current explosion, he kept the axis of governance from him. Until the unthinkable happened: protests the likes of which had not been seen since the Tiananmen Square massacre, of course smaller.

The official discourse was “we are saving lives” -which is demonstrable- and the West “is not interested in saving them” (at least Trump and Bolsonaro demonstrated it). The axiom of the Chinese model -growth at almost any cost- was pragmatically supplanted by another that read “covid-zero”. His US counterpart did not hesitate: “first, the economy.” And “vaccine nationalism” arose. China chose not to import them out of self-pride: it was to accept its superiority. And so he took care of his industry. They created nine vaccines -more than any other country- but less effective and not calibrated to the Omicron variant. They focused on massive tests before vaccination, something unsustainable in the long term. Xi was getting caught up in his own politics with little room for manoeuvre.

chinese efficiency

The other factor that put pressure on the pressure cooker was the way to ascend within the PCCH: the managerial logic of “efficiency” as a legitimizing criterion. If the Beijing directive was “covid-zero”, it had to be complied with. Regardless of how: local governments have some autonomy. That is why there were sudden closures of neighborhoods or cities due to few infections, without a unified criteria. The party cadres are tested in the management of cities and provinces: they are rotated and the previous step to the top is to govern Beijing or Shanghai. They are evaluated for the fight against covid. In this, the race of each mayor or governor is at stake to reach the Central Committee. This is how they ended up being “more Maoists than Mao”, preventing others: “at the slightest danger, we close everything”. It could happen that someone took a bus within the city and could not return home for weeks. Because with the Chinese population magnitudes, when a wave rises, there is nothing to stop it. But the harshness of the controls generated the feared popular irruption. When that wave loomed, the CCP applied pure Taoism: it let it come and rode it. He gave in instead of resisting.

Xi Jinping’s credibility

For the sinologist Federico Müller, the profile of the last Chinese presidents brings them closer to the ideal of the technocrat: all three were engineers. Since the Han dynasty, the head of state is understood as a disaster manager facing famines and flooding of the Yellow River. If in 2023 China suffers the pandemic horror that hit much of the West, that would imply that the covid-zero policy only served to postpone the tragedy. Xi Jinping clung to a strategy that may now be proven wrong. And this would affect his credibility, an axis of his legitimacy based today on health efficiency.


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