Chen Si/AP Photo
A delivery man arranges his orders in western Shanghai, where a coronavirus lockdown has caused food shortages and unrest, on April 4, 2022.
China is suffering its worst coronavirus outbreak of the entire pandemic. Despite brutal lockdowns that have seriously disrupted the food supply in Shanghai and caused a huge pileup of ships outside the city’s port, the virus is still spreading rapidly in the city.
It seems that a combination of bad luck and poor decisions, especially a failure to vaccinate its elderly, has left the Chinese government with a choice between a tsunami of death and massive social unrest—and it might end up getting both.
The main problem, as I covered previously, is that the omicron variant is so incredibly infectious (arguably the most contagious virus in human history) that it has crushed Zero COVID systems around the world. New Zealand, Australia, and Taiwan simply couldn’t stay ahead of new infections, and so cases have exploded in each. Now, it’s China’s turn.
Compounding this problem is the bizarre fact that China has left a huge proportion of its seniors unvaccinated. Where the aforementioned countries worked hard to vaccinate their populations as quickly as they could, especially older residents, only something like 80 percent of Chinese folks over 60 have gotten two shots, and just 55 percent have had a booster. Much worse, only about half of people over 80 have gotten two shots, and just 20 percent have been boosted.
This is a truly weird situation, and thus far one can do little but speculate on potential reasons for it. “I don’t think anyone outside of the inner circle of the Chinese regime can speak to that definitively,” Philip Ivanhoe, chair of the East Asian Languages and Cultures Department at Georgetown University, told the Prospect. “As someone who studies traditional Chinese thought and spends considerable time in China, it is something deeply at odds with widely accepted ideas about the status of elderly people,” he said.
Yet, some plausible explanations are apparent. The first is China’s decision to vaccinate people in high-risk jobs first, as part of its Zero COVID strategy. “I would note that the government, like many governments, was careful to vaccinate members of the military as a priority. The additional people they did vaccinate constitute the working population,” Ivanhoe said. As an emergency measure in this context, it makes some sense to focus on the people most likely to spread the virus rather than those most at risk of dying from it, since the whole point is to prevent infections entirely. Seniors were only included in the vaccine push as of March last year.
Second, China’s great success in preventing infection up until now ironically also limited research on its domestic vaccines, because with so few infections, it was hard to get data on effectiveness. “The vaccines developed in China were only tested in some developing countries outside of China because of the low prevalence of COVID-19 in China,” George Liu, China health program director at La Trobe University, told the Australian publication ABC. Procrastinating on the elderly, Ivanhoe said, “may well have had to do with possible effects of their vaccine … or a worry that there would be such effects.”
The U.S. and Europe, by contrast, had no such problem with their staggering volumes of cases, though studies have since shown the Chinese vaccines are quite safe.
Third, as a recent study revealed, is higher vaccine hesitancy among seniors. This may be a consequence of seniors’ education, attitudes, and distrust of conventional medicine. (Misinformation was a big reason why so few Hong Kong nursing home residents got vaccinated.) As well, the very fact that the initial vaccine rollout avoided seniors may have created an impression that the shots would cause side effects in older people. Government messages urging seniors to get vaccinated have reportedly been widely criticized even on heavily censored Chinese social media.
Finally, the Chinese government has been unable to produce its own mRNA shots, and thus far refused to import Western mRNA versions, apparently on nationalist grounds. “They are presenting to the world that they are doing well in vaccine development … it would be embarrassing for them to show the opposite to the Chinese people,” Hong Kong virologist Jin Dongyan told The New York Times. China’s domestic vaccines are less effective—though they are still effective at preventing hospitalization and death even against omicron, especially with a booster.
That brings us to today. Omicron is loose in China, and despite the brutal lockdowns that have caused food riots in some areas, the number of cases across the country is still soaring. Panicked by the death rate of seniors in Hong Kong, the Chinese government is now rushing to inoculate its seniors. But it will be too late, I fear, for many.
The Financial Times reports that cases in Shanghai are so far following the same exponential track as in Hong Kong, where a massive outbreak in a similarly unvaccinated elderly population caused terrible carnage. This renders China’s official statistics on deaths highly suspect—despite tens of thousands of cases over the last few weeks, at time of writing it has reported zero official deaths since early 2020.
Elsewhere, China appears to be playing whack-a-mole with the virus. On Monday, the Shanghai leadership unveiled plans to ease its lockdown in certain districts if they have no cases for two weeks. But the same day, Guangzhou, which had slowed the spread of omicron through tremendous effort in February and March, introduced new control measures when yet more community spread was discovered.
Panicked by the death rate of seniors in Hong Kong, the Chinese government is now rushing to inoculate its seniors. But it will be too late, I fear, for many.
It’s important to emphasize that none of China’s dysfunction excuses the failure of the U.S. (and almost all European countries) to carry out Zero COVID policies when they were possible in 2020 and 2021. If we had managed what New Zealand and Australia did—namely, stamping out spread followed by mass vaccination at the earliest possible date—literally hundreds of thousands of dead Americans would be alive today. China’s success at implementing Zero COVID was all the more impressive given its enormous size and fact that the pandemic started there.
But by the same token, America’s endless pandemic face-plants—most recently, failing to fund vaccination and testing—do not excuse China’s unbelievable dithering on vaccination. Once the coronavirus was established in multiple additional animal species in late 2020, eradicating the virus was impossible. Once omicron made COVID the most contagious virus ever, every country was going to face a wave of infection sooner or later, and mass vaccination is by far the most effective tool against that threat. China is a country with a police state that is reportedly capable of testing all 26 million residents of Shanghai in a single week. It simply beggars belief to think the Communist Party leadership couldn’t get virtually every person over 65 vaccinated at some point over the last year if they had made it a priority.
China’s early success at controlling the virus burnished the reputation of the Xi government, but as Americans well know by now, COVID brutally punishes any policy mistakes. Only a few countries handled the pandemic with anything like perfection, and neither the U.S. nor China is among them.
