Xi’an lockdown brings heartbreak as pressure to contain outbreak grows

On Xiaohongshu, China’s Instagram-like platform, a user appealed for help on Sunday after a local hospital refused to admit her father, who had just had a heart attack, because they lived in a “medium-risk area” of the city.

She later updated the post, saying her father was allowed an emergency operation when his situation worsened significantly after several hours. “The delay was too long and rescue failed. I don’t have a father anymore,” she wrote.

Another video posted online showed a woman in a quarantine hotel on New Year’s Day, begging a Covid control worker for sanitary pads. In the post, viewed tens of millions of times before it was removed, the woman said she had tried to call multiple government departments to ask for menstrual products — to no avail.

The woman later posted that she had received supplies from quarantine workers and said she regretted filming the original video.

CNN cannot independently verify the authenticity of these videos and posts, and has reached out to the authors for comment, as well as the Xi’an municipal government.

The poignant accounts have sparked an outpouring of sympathy and anger online, with many questioning sacrifice in the name of epidemic control.

“No one cares what you die of — other than Covid-19,” one Weibo user posted.

Limits of zero-Covid

For most of the pandemic, China has managed to keep its caseload low with its “zero-Covid” approach — meaning no local transmissions — even as the rest of the world embraces living with the virus.

There have been occasional outbreaks, but officials have largely managed to contain them within a few weeks by following a playbook of mass testing, partial or full lockdowns, contact tracing, and quarantine. On Monday, the city of Yuzhou in Henan province, home to around 1.2 million residents, was also placed under lockdown after it reported three asymptomatic cases.

This stringent approach remains widely popular among the Chinese public, which “is used to a zero-Covid environment,” said Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations. “So many people have not been exposed to the virus, and given that the inactivated vaccines are not that effective in preventing new infections, zero-Covid becomes a self-justifiable strategy.”

The city confirmed 63 new locally transmitted cases on Wednesday, bringing the total caseload to 1,856 since December 9. Cases had hovered near or above 100 in previous days, before a significant drop to 35 on Tuesday.

But many Xi’an residents have pushed back on officials’ claims. Though the government has distributed food to some throughout the lockdown, others say they haven’t received their supplies, or have only been given food a handful of times throughout the two weeks.

“‘Zero community Covid’ is such a clever word as we just need to keep transporting patients and close contacts out until Xi’an’s cases are zero,” one Weibo user posted.

“If there are no people in the neighborhood, of course there is no community transmission there,” another user wrote.

Rising pressure

These measures, and the chaos unfolding for those stuck at home, bring into focus the burden borne by citizens for China’s Covid strategy, its questionable sustainability — and the increasing political pressure on local officials to bring outbreaks under control.

Officials who struggle to contain Covid flare-ups often face suspension or dismissal. Last summer, more than 40 local officials across the country were punished for failing to control a Delta outbreak that spread to more than half of China’s provinces. This week, the party secretary of Yanta district in Xi’an, one of the worst-hit areas, was also dismissed.

With these two events looming, “Xi’an officials were asked to achieve (zero community transmissions) by January 4,” said Huang. “That’s the kind of pressure these local officials are facing,” Huang added, referencing the dismissal of Yanta’s party secretary.

The chaos in Xi’an also reflects the difference in local governance capacity, he added — Shanghai, for instance, has a highly efficient and competent bureaucracy that allows officials to detect outbreaks early, conduct contact tracing quickly, and avoid the kind of city-wide lockdowns seen in Yuzhou and Xi’an.

In contrast, those two cities both have “relatively low local state capacity … to come out with a well-prepared plan for outbreak preparation, to deliver necessities to people in quarantine and under lockdown,” Huang said. “When the capacity is low, government officials are more likely to turn to heavy-handed, indiscriminate and even excessive measures that significantly raise the cost of implementing this (zero-Covid) strategy.”

The strategy has worked relatively well thus far in shielding most of China from the virus — but its limitations are also becoming increasingly clear.

“China is not epidemiologically or psychologically ready for the Omicron variant,” Huang said. “The problem is we don’t know whether (zero-Covid) can still be effective in dealing with more transmissible variants.”

And if outbreaks with transmissible variants spread to multiple cities across the country, “you’re going to see the cost, therefore the dissatisfaction,” he added. “The unhappiness is going to grow significantly at a national level — as well as the difficulty of implementing this strategy.”