The Chinese city of Xian is in full lockdown. More than 13 million people are confined to their homes with windows closed as the city sprays disinfectant and conducts mass testing amid a burst of COVID-19 cases. The 150 local cases reported for Sunday are a tiny number compared with those in the rest of the world; in a nation that has successfully maintained a “zero COVID” policy since hosting the initial outbreak, though, they represent a potential disaster.
It’s not clear whether the Xian cases are of the omicron variant, but it’s reasonably likely, given they’ve spread more quickly than any other outbreak in China since the initial Wuhan spread was contained. Whether China can hold the fort against an opponent moving more quickly than ever is a big question. Some of the Western coverage has had a gloating tone, as if China’s COVID-19 success is finally going to be pulled down to earth. But with hundreds of thousands of lives potentially at stake, how well the system handles omicron will shape a lot of China’s—and the world’s—2022.
One scenario is that omicron is so transmissible—almost as quickly spreading as measles—that China’s precautions simply can’t hold against it, no matter how extensive a moat of quarantine Chinese leaders put around the country. At some point, the virus escapes its containment and then spreads swiftly and widely enough that even China’s ultra-strict lockdowns are unable to stamp it out. Over the course of the coming months under this scenario, omicron case numbers grow to the millions or tens of millions.
A best-case scenario is that omicron is less deadly as a baseline, even to the unvaccinated. In South Africa and Denmark, cases spiked without concurrent rises in hospitalizations or deaths and also rapidly dropped off. But Denmark has a very high vaccination rate, and South Africa has had three earlier waves of COVID-19; the same results might not apply to a relatively unaffected Chinese population. The official claims are that China has had only 101,000 COVID-19 cases total—a drop in the bucket of 1.4 billion people. Even assuming that the official figures during the initial outbreak represented a significant and probably deliberate undercount, even a million cases, say, would still be insignificant in a country with a population as large as China’s.
What happens next depends on the level of protection given by China’s vaccines against omicron. While the mRNA vaccines used in the West haven’t been as effective against omicron transmission compared with earlier variants, they continue to provide strong protection against hospitalization and death—especially with a booster shot. The data for the Chinese vaccines is very incomplete so far, but early studies, even on booster shots, aren’t promising.
Even in a vaccinated population, a recent (but pre-omicron) Chinese study estimated that an outbreak on the scale of that in the United Kingdom or the United States could cause upwards of 10,000 or 20,000 severe cases a day. A lot would then depend on hospital resources and experience. China was able to cope with the Wuhan outbreak in part because of its ability to divert medical resources from across the country to the stricken city. A superspreading omicron that hit the whole country within a few weeks would be a nightmare—especially given that Chinese doctors, although world leaders in early treatment, don’t have the nearly two years of experience dealing with COVID-19 that clinicians in other countries do.
If omicron did get out of hand, there would be an initial, vast lockdown on the same scale as that imposed in late January 2020 during the initial outbreak. That would buy time and potentially save many lives—although at severe economic and social cost, as with the earlier lockdown. But given the transmissibility of omicron, easing up on the lockdown would be even harder—and there would probably be further outbreaks. Transitioning to a scenario where COVID-19 is increasingly treated as an endemic disease, as is now happening in other countries, would be an extremely politically tough decision that would need to come from Chinese President Xi Jinping himself.
Alongside the public health calamity would be a psychological shock—one that would have geopolitical consequences. China is, rightly, proud of its successful response to the coronavirus (even as the responsibility for covering up the initial outbreak goes unmentioned). There has also been plenty of gloating over the disasters elsewhere in the world. A serious outbreak would call all that into question.
The likely response would be to triple down on blaming the United States. The Fort Detrick conspiracy theory, which baselessly claims that the virus is the fault of the U.S. Army, is mainstream in China, taken as accepted fact by state media, and, according to friends of mine with young children, is being taught in elementary schools. China has been pushing the theory online worldwide, to little effect, but it seems, as best we can tell, to be believed by many people domestically—there’s little pushback against the idea online. That’s bad enough as things stand; if the United States were blamed for mass death within China, relations between the two superpowers could reach new lows.
I’ve outlined best- and worst-case scenarios, but here’s the marginally more likely outcome. The COVID-19 restrictions hold—but stretch the lockdown and quarantine system to its limit. Case numbers reach the low thousands in particular cities, but mass testing and lockdowns prevent wider outbreaks.
I think those predicting inevitable failure may be underestimating just how far China will go to keep the virus out. The country’s lockdowns have been more exhaustive, and more strictly enforced, than anywhere else in the world, backed by overlapping systems of both electronic and human surveillance. Nobody makes a better enforcer of small rules than the nosy, usually retired neighbors who make up part of China’s “residents’ committees”; at the same time, these intense networks can also be turned to purposes such as making sure that people in lockdown get food and medical help. Most of all, there’s a total willingness to use state power and to invent new rules—without any restriction on the government’s power—to do whatever’s necessary to achieve the ultimate goal.
The middle ground still comes with plenty of problems. China has had regular lockdowns in specific towns and cities throughout the last two years, but they’re going to have to become much more frequent to keep omicron out. That comes with a sharp economic cost, both to sustain businesses in the areas affected and because of the uncertainty it inflicts on the rest of the economy. And with omicron (and potentially its successors) likely to be endemic in the rest of the world, there’s no clear endpoint—until the Chinese government is confident enough in the quality of boosters and treatment to risk letting the virus in, which could be years off.
Many local Chinese governments are already struggling financially, not just because of debt burdens but in trying to pay routine expenses. The huge stimulus package of 2020 helped a lot, but similarly large spending might be needed to keep things going—especially given the ongoing real estate crisis. Every lockdown comes with a price tag.
Most of all, though, this will hit China’s trade—and with it, the global supply chain. Delays at Chinese ports due to COVID-19 regulations were a big contributor to the logjams of late 2020, which have eased somewhat but are still holding up major industries such as the automobile sector. Turnaround times went from 12 hours pre-pandemic to 16 days at big ports such as Shanghai’s. The increased precautions are already worsening that; a Delta flight turned around literally in midair since the company said it couldn’t afford to adhere to the new measures. Chinese flights are being canceled in huge numbers, both domestically and internationally, with airlines dropping more than 2,000 last Friday to Sunday. As China seals the gates tighter, its role as the world’s factory becomes more unsustainable.
Finally, there are two upcoming events badly endangered by omicron. The first is the annual Spring Festival travel period, known as chunyun, which usually sees hundreds of millions of people traveling across China to see their families. My guess right now is that Spring Festival travel, which this year would normally be at its heaviest during the first week of February (Chinese New Year itself is on Feb. 1), will be canceled entirely or at best severely discouraged by the government. That’s a blow to Chinese families—and to the economy, which usually gets a big boost from spending and travel during that week.
But even more important, from the leadership’s perspective, is the Beijing Winter Olympics, due to start the same week as chunyun. The NHL has already pulled out of the Olympics, citing the risk of omicron. The current policy is to allow vaccinated athletes in without quarantine, but given how effective omicron is at infecting the vaccinated, that doesn’t seem sustainable. Instead, China is likely to have to introduce at least a two-week quarantine period in the run-up to the Olympics for foreign athletes—during which time it would be extremely difficult for them to train. But without that, there’s the risk of a severe omicron outbreak among the athletes themselves. And one thing’s for certain: Don’t expect Xi to be shaking hands with any of them.
James Palmer is a deputy editor at Foreign Policy. Twitter: @BeijingPalmer