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| In early December, China suddenly reversed its “zero Covid” policy. That set off a wave of infections that has swept across the nation, overwhelming hospitals and funeral parlors. |
| Two events this month could further inflame the already raging outbreak. On Sunday, the country will reopen to tourists, and visitors will no longer be required to quarantine upon arrival. A few weeks later, China will celebrate Lunar New Year, the country’s biggest holiday — typically the largest annual migration of people on the planet. |
| For insight into the situation in China, I spoke with Keith Bradsher, The Times’s Beijing bureau chief. This interview has been edited for length and clarity. |
| For those who aren’t familiar, what was life like in China before the restrictions were removed? |
| Almost overnight, the rules changed on Dec. 7. Until then, people were at constant risk of being sealed in a hospital room for weeks if they caught a Covid infection. Until Dec. 7, people who even went to the same shop or eatery as someone who later turned out to be infected, or even passed an infected person on the street, could end up being taken away to a quarantine center for a prolonged stay, sometimes with meager food and sanitation, or sealed in their homes. |
| In big cities like Beijing or Shanghai or Shenzhen, it became necessary to line up every two or three days and sometimes daily at sidewalk booths for P.C.R. tests, all tracked by the health codes on our cellphones. |
| Because of the extreme sensitivity of the tests, an infected person could be kept in isolation for weeks or even months. And even after people left quarantine they could face permanent discrimination. There were some places that you weren’t allowed to go if you ever had Covid, like some government offices. |
| So what do things look like now? |
| After Dec. 7, life was transformed. The good news was that we could suddenly move around without worrying about being locked up in a hospital or quarantine center. But the cost in illness and death has been high. |
| We went from medics being responsible for detaining people to suddenly caring for a lot of sick people. We’ve gone from funeral homes allowing lengthy services for as many as 100 guests to lacking adequate cremation capacity and barely allowing immediate family members to say goodbye. |
| We’ve seen hospitals practically overflowing, with little space left for more sick people. There’s an acute shortage of ventilators. There is an acute shortage of ibuprofen. Even hospitals don’t have enough ibuprofen to bring down the fevers of the very sick. |
| All of these are scenes that were witnessed in the West when the pandemic first emerged in early 2020. But in China, it has been a surprise that there were not more preparations for the change in direction. |
| What do you mean? |
| The vaccination program nearly ground to a halt in late spring without ever reaching many of the country’s older adults, who tended to resist vaccination. Many thought they could hide indefinitely from the virus. Their faith in China’s vaccine industry had also been damaged by vaccine scandals before the pandemic, even though there is no evidence of safety problems for the Covid vaccines. |
| The spread of the virus is extraordinary because not only do you have a population with almost zero past exposure or immunity, but now — in a policy about-face — you have towns encouraging people to come to work even if they are positive for Covid, as long as they are not especially feverish. I’ve been talking to companies in northern China, and some have told me that anywhere from 80 to 100 percent of their staff members have been infected. |
| Why did China change its policy so quickly? |
| China faced several big challenges. There was mounting domestic unhappiness with the burden of quarantine and frequent testing, which resulted in street protests. China was also losing control of the virus even before the policy change on Dec. 7. The death rate began to spike upwards right after the loosening of restrictions, even though it takes the virus a couple weeks to reach the fatal phase. The immediate jump in activity at funeral homes suggested that there were a lot more people who were infected right before the policy change but were hiding at home. |
| Finally, the economy was in terrible shape through the autumn because people in China stopped going out to shop or to restaurants for fear of being infected. At the same time, overseas demand for goods from China was withering. |
| How are the Chinese people feeling? |
| Absolutely everyone seems to know some elderly person about whom he or she is deeply worried right now — because the threat of serious illness from Covid increases with age. The country is experiencing a terrifying surge, and yet cities are encouraging travel for Lunar New Year, which starts in less than three weeks. We will likely see surges in rural areas, where many of the residents are elderly. |
| What would a rural surge look like? |
| There was a study back in 2007 by the agriculture ministry which surveyed 3,000 villages. They found that in 90 percent of those villages, there were essentially no able-bodied people between the ages of 16 and 40 who had stayed. Almost all had gone to the cities to find jobs. So rural areas often have lots of grandparents raising grandchildren while the middle generation works in the cities. The fear is that just as the virus has raced through the population in Chinese cities, it will now race through Chinese villages in the next several weeks. |
| The other scary part in all of this is that this is the first wave, and it’s mostly being driven by earlier versions of Omicron. So people in China are acquiring resistance to Omicron subvariants that are already fading away globally. As China reopens its borders in the coming weeks, there is a possibility that the latest immune-evading subvariants may come next, as they have already become prevalent in parts of the United States. If that happens, residents may face further illness instead of a hoped-for single wave that quickly disappears. |
| What will China’s reopening mean for the course of the pandemic? |
| It’s unclear that this will cause new variants to emerge. Some scientists have said that what’s happening in China is less likely to affect the rest of the world because it’s basically exposing a low-immunity population to variants that have already circulated a lot globally. |
| I think the tragedy here is less of a global tragedy and more of a tragedy of China. It’s a tragedy of the loss of so much of its older generation, which is now being sacrificed in a race to reopen and restart the economy quickly. |
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