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How China’s close contacts are piling pressure on Beijing’s zero-Covid policy

More than 1.3 million people in China have been under medical observation this week as close contacts of Covid-19 cases, the highest level since the epidemic erupted from Wuhan, and an increase of more than 300,000 in a few days.

The growing number of close contacts, driven by cases rising to near record levels, is putting enormous pressure on a Covid-19 policy that, unlike the rest of the world, aims to eradicate the virus rather than live with it.

China’s strategy has evolved since the beginning of the pandemic. While authorities have often relied on citywide lockdowns, most notably in Wuhan in early 2020 and Shanghai in 2022, they are also employing a sophisticated track and trace system that quickly quarantines close contacts of infection for “monitoring”. Medical”.

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The total number of close contacts is an important measure of whether the authorities are still able to control the virus in China. Meanwhile, evidence from Guangzhou, the epicenter of the recent outbreak, suggests that there is a gap between official guidance and reality.

How are close contacts traced?

In large Chinese cities, residents must take a PCR test every few days at booths set up on street corners to get a “green code” on their smartphone. Their phones should also be checked on most public transport and when entering buildings.

If a person tests positive, authorities can analyze the sites the person visited to track other people who have swabbed there. Close contacts can also be determined based on where a person lives or works.

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What happens to close contacts?

This month, amid rising cases, the government revised the approach it set in June when it published the ninth edition of its Covid-19 strategy.

Under the revised guidance, close contacts should be moved to a “central isolation place”, most often a hotel, where they must remain for five days, down from the previous seven. This is followed by three more days of observation at home.

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Local governments have invested in building temporary isolation facilities. In October, Shanghai confirmed it would build a 3,000-person facility on Fuxing Island at a cost of about $220 million, designed for both close contacts and positive cases.

One construction bidding website reveals dozens of other similar projects across China in recent months.

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However, government guidance also states that “special” cases may be allowed to isolate at home. They do not clearly define a special case, although each province has its own interpretations. In Hebei, children 14 years of age or younger are treated as special cases.

What is the reality on the ground?

When asked how many more than 1 million close contacts under medical observation were isolated in centralized facilities compared to at home, China’s National Health Commission directed the investigation to the Center for Disease Control and Prevention, which could not be contacted.

Central directive can be applied differently in different governorates. The example in Guangzhou, where there are thousands of daily cases, suggests that authorities are struggling to find capacity to meet centralized quarantine requirements. One resident, who asked to be identified as Victor, said his family were identified in close contact after eating at a restaurant where there was a confirmed positive case.

A temporary Covid quarantine facility in Guangzhou

A temporary COVID-19 quarantine facility in Guangzhou. The city is struggling to meet centralized quarantine requirements © cnsphoto / Reuters

He said his family was told to prepare for the quarantine hotel, but was later told there was not enough space there and that new quarantine sites had not yet been built. Instead, his door was locked and he and his family were isolated in the house.

Elsewhere, there is flexibility in the definition of close contact. If there is a positive case in a building in Beijing, the authorities mark the three floors above and below the case as close contacts and send those residents to central quarantine. Other floors are required for home quarantine.

When a single case was detected at Shanghai Disneyland this month, authorities closed the park and tested tens of thousands of people, but did not identify guests as close contacts. However, some close-contact Disneyland employees have been assigned and sent to centralized isolation facilities.

what happened after that?

The requirement to isolate close contacts was eased this month. But expectations of a reopening were downplayed after the city of Shijiazhuang, which had relaxed testing during the outbreak, reinstated stricter measures.

If the number of close contacts gets out of control, the government could impose much harsher lockdowns, as happened in Shanghai this spring. Such a decision may be made centrally, but it still has to be implemented by many local and city governments.

Even if the virus can no longer be controlled, it is unlikely that any shift from a model of elimination to one based on suppression will be evident. Instead, there are indications that elements of the first element may still exist.

A person working in labor outsourcing in Guangzhou, which recorded nearly 8,000 cases on Wednesday, said the city is hiring dozens of drivers to ferry close contacts to quarantine hotels to handle the growing number of contacts.

Additional reporting by Ryan McMorrow in Beijing and Gloria Lee in Hong Kong

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