In China, Public Health Takes Back Seat to Politics

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The draconian nature of Shanghai’s lockdown over the past couple weeks has shocked observers worldwide and traumatized the city’s 26 million residents, most of whom remain forcibly confined to their homes.

Many are hungry and unable to acquire basic food staples. Some with chronic conditions are unable to obtain critical treatment, and some have died after being refused admittance to hospitals due to pandemic protocols.

This plight is not unique to the residents of Shanghai. Multiple other Chinese cities have imposed similar lockdowns since 2020, and more likely will in the coming months. Each lockdown seems to cause more harm than it prevents, yet governments throughout China continue to cling to this playbook.

That a government would knowingly and repeatedly wreak havoc on its people to contain a virus with such a low death rate would be surprising if the purpose of the lockdowns were to promote public health. But China’s “zero COVID-19” policy was never about the people whose livelihoods it disrupts. The real objectives were always political.

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That public health takes a back seat to politics comes as no surprise to anyone familiar with China’s ruling Communist Party. In China, the people exist to serve the government, not the other way around. While most officials would prefer not to throw their subjects’ lives into disarray, their careers depend on meeting key performance indicators.

General Secretary Xi Jinping has repeatedly made it clear that the most important key performance indicator is to keep the pandemic under control, and this incentivizes officials at all levels to keep infections as low as possible, regardless of the disruption this requires or its impact on society.

Xi’s “zero COVID-19” obsession is due in large part to the fact that, over the past two years, the propaganda apparatus, which he controls, has staked much of his and the party’s claim to legitimacy on the supposed superiority of these policies, which, despite their harsh nature, have enabled the country to consistently report a significantly lower number of infections than most other countries, while minimizing disruption to those not directly impacted by lockdowns.

With the highly-contagious omicron variant threatening to derail this narrative, Xi cannot afford to let a weak link anywhere in the country jeopardize his ambition to secure a precedent-breaking third term in power at the 20th Party Congress this fall.

This is all the more crucial given the likelihood that uncontained spread would result in mass fatalities among China’s elderly population. Over 130 million Chinese over the age of 60 are either unvaccinated or have not been boosted—that’s more than the entire population of Japan. Hong Kong’s outbreak in February and March highlighted the risk of this vaccination gap by infecting 1 out of every 7 residents and leaving nearly 6,000 dead, mostly unvaccinated seniors.

Anecdotal reports of unreported COVID-19 deaths at some Shanghai nursing homes indicate that China may already be grappling with this reality. However, the controlled environment of a citywide lockdown enables the municipal government to contain and minimize these reports, and it continues to classify 96% of cases as asymptomatic and report zero deaths.

The outbreaks in Shanghai and certain other locations are nothing compared to the number of infections and fatalities that would result if the government significantly relaxed its pandemic controls. It would also make it harder for the government to suppress inconvenient facts around infection rates and fatalities, which could discredit the propaganda narrative around Xi’s handling of the pandemic.

Given these stakes, the only condition under which these draconian lockdowns might be abandoned would be if key leaders—particularly Xi—came to assess that the political risks associated with keeping this approach outweigh the risks associated with abandoning it.

The widespread resentment toward the government—and even some instances of looting—that resulted from the Shanghai lockdown might give the impression that such a reassessment is warranted, but Xi does not appear to see it this way.

Previous experience in other cities shows that public resentment tends to dissipate after lockdowns are lifted, and is usually replaced by a sense of triumphalism about China’s model. If this precedent holds, then the successful eradication of the virus in the city may even bolster Xi’s and the Chinese Communist Party’s sense of legitimacy.

It is far from certain that the current situation will follow past experience. Nevertheless, Xi has met these challenges by doubling down on “zero COVID-19” policies. Provincial and municipal leaders throughout China will not dare deviate, especially in the run-up to the Party Congress, in which many of them are vying for promotions.

One such official is Shanghai’s Communist Party Secretary Li Qiang who, prior to the outbreak, was favored to gain appointment to the ruling Politburo Standing Committee.

Li is an important Xi ally, and his status as a Politburo member will likely shield him from the worst consequences of the city’s mishandling of the outbreak. Nevertheless, it is hard to imagine the chaos he has presided over in Shanghai not derailing his chances of entering China’s highest leadership body.

Provincial and municipal leaders throughout China will seek to avoid ending up in a similar predicament. As they enter the final stretch ahead of this fall’s leadership shuffle, Shanghai’s plight will likely drive them to lower the threshold for imposing similar lockdown measures.

Xi gave them their marching orders, and they have one overriding interest—to keep the pandemic under control regardless of the cost to the local economy and public well-being.

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