Chinese government response to COVID-19 facts for kids
During the COVID-19 pandemic in mainland China, the government of China under CCP general secretary Xi Jinping's administration pursued a zero-COVID strategy to prevent the domestic spread of COVID-19 until December 7, 2022. Aspects of the response have been controversial, with the zero-COVID approach being praised and the government's lack of transparency, censorship, and spread of misinformation being criticized. The government abandoned its zero-COVID policy on 7 December 2022.
After discovery of a cluster of patients with pneumonia of unknown etiology in Wuhan, Hubei Province, a public notice on the outbreak was distributed on 31 December 2019. Three days earlier on 28 December 2019, Chinese researchers in Beijing uploaded a fully mapped sequence of COVID-19's structure to the NIH GenBank, but the report was never publicly accessible due to it missing technical, non-scientific information required for submission despite NIH attempts to communicate with the report author. On 8 January 2020, a new coronavirus (SARS-CoV-2) was announced by Chinese scientists as the cause of the new disease; and on 10 January a nearly identical virus to the 28 December upload was sequenced and its genome made available online. On 17 January 2024, The Wall Street Journal released a report about the former 28 December upload that officially contradicted the Chinese government's claim that knowledge of the cause of the outbreak in the early weeks of January 2020 was unknown, and that information was shared as soon as it was available.
On 23 January 2020, the Chinese government banned travel to and from Wuhan, enforced strict quarantines in affected regions and initiated a national response. The epidemic in Hubei province peaked on 4 February 2020. Large temporary hospitals were built in Wuhan to isolate patients with mild-to-moderate symptoms, with the first opening on 5 February 2020. The epidemic was heavily concentrated within Hubei province and Wuhan. Through 22 March 2020, over 80% of the recorded cases in China were in Hubei province, with over 60% of cases nationwide occurring in Wuhan alone.
By the summer of 2020, China had largely brought the outbreak under control, ending widespread community transmission. After the initial outbreak, lockdowns and other restrictive measures were eased throughout China. The lockdown in Wuhan was lifted on 8 April 2020. It is estimated that the epidemic control measures held the death toll due to COVID-19 in Wuhan to under 5,000 from January to March 2020.
China was one of a small number of countries that pursued an elimination strategy, sustaining zero or low case numbers over the long term. Until late 2022, most cases in China were imported from abroad, and several new outbreaks were quickly controlled through intense short-term public health measures, including large-scale testing, contact tracking technology, and mandatory isolation of infected individuals. In the 18 months following containment of the initial outbreak in Wuhan, two COVID-19 deaths were recorded. In December 2022, the Chinese government ended its zero-COVID policy and mass testing following protests across the country.
In 2020 and 2021, China was the largest exporter of COVID-19 critical medical products. China was the world's largest exporter of face masks, increasing exports by around 600% in the first half of 2020. A number of COVID-19 vaccines have been developed in China, which have been used in its vaccination programme and international vaccine diplomacy. Through November 2021, China was the world's largest exporter of COVID-19 vaccines, with a cumulative share of around 40% of worldwide exports (totalling around 1.5 billion doses), according to the World Trade Organization.
China's response to the initial Wuhan COVID-19 outbreak has been both praised and criticised. In October 2020, The Lancet Infectious Diseases reported: "While the world is struggling to control COVID-19, China has managed to control the pandemic rapidly and effectively." The Chinese government has been criticized for censorship, which observers have attributed to a culture of institutional censorship affecting the country's press and Internet. The government censored whistleblowers, journalists, and social media posts about the outbreak. During the beginning of the pandemic, the Chinese government made efforts to clamp down on discussion and hide reporting about it, as such information was seen as unfavorable for local officials. Efforts to fund and control research into the virus's origins have continued up to the present.
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Zero-COVID policy, January 2020 – December 2022
China and a small number of other countries pursued an elimination strategy, also known as a "zero-COVID strategy" (Chinese: 动态清零; pinyin: Dòngtài qīng líng; lit. 'Dynamic Clearing'), which aimed to eliminate local transmission of the virus.
The initial public health response was successful in reducing transmission to near zero within China. In the 18 months after containing the initial outbreak, China had two COVID-19 deaths.
In March and April 2020, as lockdowns and other restrictions were eased, attention shifted to preventing imported cases from abroad from causing a resurgence of the virus within China. International flights to China were heavily restricted, and incoming travelers were required to undergo PCR testing and quarantine. Through November 2020, these quarantine measures prevented nearly 4,000 infected international travelers from entering the wider community.
In June 2020 the China CDC COVID-19 Emergency Response Team described its elimination strategy. The measures employed to contain new outbreaks include aggressive contact tracing, isolation of infected people, quarantine of their close contacts, large-scale nucleic acid testing and domestic travel restrictions from high-risk areas. Contact tracing is aided by the use of "health code" smartphone applications.
In order to detect new outbreaks early, routine PCR testing was carried out on all patients with fever or respiratory symptoms, medical staff and workers who handle imported goods. When an infected person was identified, all close contacts are required to undergo a 14-day centralized quarantine, with multiple rounds of PCR testing. During outbreaks, community-wide PCR testing was carried out in order to identify infected people, including those without symptoms. Community-wide screening was intended to rapidly isolate infected people from the general population, and to allow a quicker return to normal economic activity. Community-wide screening was first carried out from 14 May to 1 June 2020 in Wuhan, and as of 2021 was used in subsequent outbreaks in China.
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China's zero-COVID policy had implications for the 2022 Winter Olympics and Paralympics in Beijing. Protocols included a bio-secure bubble for international athletes separated from the Chinese public, with only local spectators at a strict capacity limit permitted to attend. Beijing has maintained one of the strictest COVID controls in the world, which is why thousands of people showed defiance against Chinese authorities by protesting at universities and in major cities. Their demands included not only freedom from constant Covid tests and lockdowns, but also an end to strict censorship and tight control of the Communist Party over all aspects of life.
Case and death count statistics
As of 2020, papers from academic journals and publishers such as Science, Nature, The Lancet, and Karger Publishers had regarded China's measures to domestically contain COVID-19 to be effective. A study in March 2020 published in Science Magazine concluded that the Wuhan travel ban and national emergency response may have prevented more than 700,000 COVID-19 cases outside the city. As of 31 December 2021[update], official statistics showed 102,083 cumulative confirmed cases and 4,636 cumulative deaths in mainland China. This corresponds to 3.2 deaths per million inhabitants.
A study published in The BMJ found that 4573 additional pneumonia deaths occurred in Wuhan from January to March 2020, compared with the same period in 2019. Outside of Wuhan, no measurable increase in pneumonia deaths was observed. Though there were confirmed COVID-19 deaths outside of Wuhan, the authors speculated that lockdowns suppressed influenza transmission sufficiently to offset these deaths.
A survey of seroprevalence conducted in April 2020 found that 4.4% of people in Wuhan had antibodies to SARS-CoV-2, indicating that they had been infected. Seroprevalence fell with distance from Wuhan, indicating that the initial outbreak had been largely contained to the city. Elsewhere in Hubei province, 0.4% of people had antibodies, while outside of Hubei province, less than 0.1% of people had antibodies. These results imply that in the first wave, approximately 500,000 people were infected in Wuhan, 210,000 people were infected in the rest of Hubei province, and 120,000 people were infected outside of Hubei province. A study conducted from March to April 2020 found that between 3.2% and 3.8% of people in Wuhan tested had antibodies to SARS-CoV-2. A study of Hong Kong residents evacuated from Hubei province in March 2020 found that 4% of them had antibodies to SARS-CoV-2.
In November 2020 British epidemiologist Ben Cowling said, "due to the compulsory testing when there is an outbreak, the case numbers in China tend to include a lot of mild or asymptomatic infections that would never have been identified in other parts of the world", which explains China's relatively low case fatality rate. Peer-reviewed antibody studies have found a seropositivity rate of around 3.8% for Wuhan inhabitants.
In May 2020, a commentary article in the journal Global Public Health examined the possibility of inaccurate death counts due to alleged political censorship, but concluded that due to the lack of any known deaths of Hong Kong or Taiwan residents in mainland China, which would be newsworthy, the discrepancy between the official and true death toll is likely not particularly large.
A May 2022 Nature article forecast in a model of China lifting its Zero-COVID policies around 1.5 million deaths, with 74.7% among the unvaccinated elderly (over-60) population. The peak demand for intensive care units would exceed capacity by a factor of fifteen.
On 23 December 2022 the Chinese Center for Disease Control and Prevention published its last daily COVID report, with zero COVID deaths across China.
On 22 January 2023 China's Center for Disease Control and Prevention said between January 13 and 19, 2023, 13,000 deaths were reported. 681 patients had respiratory failure due to Coronavirus infection, and 11,977 had died due to other infection.
Financial policies
On 1 February 2020, the People's Bank of China and other five departments jointly issued the notice on further strengthening financial support for the prevention and control of the epidemic, stating that relevant financial services will be further strengthened during the period affected by the epidemic. For those who are temporarily affected by the epidemic and facing difficulties, the document requires financial institutions to tilt their credit policies appropriately, flexibly adjust their loan repayment arrangements and reasonably postpone the repayment period. Those overdue due to inconvenient repayment during the epidemic period shall not be included in the record of credit investigation and breach of trust.
On 30 January 2020, the Ministry of Finance and NHC issued a notice on the financial guarantee policy for the prevention and control of the new type of pneumonia. The Central Government shall grant a subsidy of 300 yuan per person per day to those who are in direct contact with the cases to be investigated or confirmed who are involved in the diagnosis, treatment, nursing, hospital infection control, case specimen collection, and pathogen detection. For other medical personnel and epidemic prevention workers who take part in epidemic prevention and control, the Central Financial Department shall subsidize them at a rate of 200 yuan per person per day.
In February 2020, the Ministry of Finance, the General Administration of Customs and the General Administration of Taxation jointly announced that from 1 January to 31 March 2020, more preferential import tax policies would be implemented for imported materials used for epidemic prevention and control.
Food security
During the initial outbreak in Wuhan, the government took steps to ensure adequate food supplies in the city, including issuing permits for trucks to go to other cities to get food despite the lockdown.
In May 2022, premier Li Keqiang advised local officials not to allow COVID-19 control measures to affect the harvest, saying that "even if an outbreak is found during the harvest...reaping must go on".
Analyst Darin Friedrichs said that COVID-19 restrictions have caused problems for planting crops in the Northeast, amid "a delicate balancing act" between food security and zero-COVID.
Political leadership
Governmental meetings
On 20 January, Chinese Communist Party general secretary Xi Jinping ordered that great attention should be paid to prevention and control of the epidemic. The CCP also vowed to guide people's opinions with intensive publicity strategies and interpretations of current policies to ensure social stability. Premier Li Keqiang urged relevant ministries and localities to take a highly responsible attitude towards the People's health and resolutely prevent the spread of the epidemic. Premier Li Keqiang also called a meeting of the State Council's Executive Meeting and deployed the work of epidemic prevention and control.
On 21 January, Premier Li urged protection and encouraged the health care workers. The National Healthcare Security Administration decided to adopt a special reimbursement policy for confirmed patients and temporarily bring relevant drugs and medical services into the reimbursement scope of medical insurance. On 22 January, Vice Premier Sun Chunlan went to Wuhan to inspect the prevention and control of the epidemic.
On 26 January, the first meeting of the Central Leading Group for the Response to the Epidemic of Pneumonia Caused by 2019-nCoV infection prioritized the provision of urgently needed medical and health forces, protective clothing and face masks for prevention and control in Hubei Province and Wuhan and attached importance to the transport of daily necessities for residents and relief supplies to Hubei. It urged the local governments to enhance epidemic control including cancelling meetings and events, strictly quarantining confirmed and suspected infection cases, extending the Chinese New Year holiday and supporting online office and teaching. The Central Government promised to crack down on hoarding and profiteering in materials for disease prevention and control. Public Finance at all levels should fully guarantee such funds as prevention and control of epidemic situations and treatment of the patients.
Xi Jinping's actions
On 27 January 2020, Chinese Premier Li Keqiang, entrusted by Communist Party general secretary Xi Jinping according to the state Xinhua News Agency arrived in Wuhan to inspect and guide the epidemic prevention and control work. According to The Wall Street Journal, the appointment of Li who is considered a technocrat surprised some observers, given that he had been sidelined in recent years as Xi concentrated power and cultivated a populist ideological image. Some suggest that Xi was more at risk to the political fallout of the COVID-19 while Li could be a convenient political scapegoat. Li's visit to Wuhan earned high popularity on Chinese social media. Xi Jinping said that he personally commanded the fight against the COVID-19 outbreak when meeting with WHO director general in Beijing on 28 January 2020, but according to a report by The Guardian, he has not made any public presence since then, whilst social media posts mocking Xi's absence were promptly deleted by the censors.
On 10 February 2020, Xi publicly appeared for the first time during the outbreak at a residential community in Chaoyang, Beijing . Xinhua posted photos of Xi wearing a mask and said that the aim of Xi's visit was to learn about the situation of epidemic prevision and control at the grassroots level. It was his first time to interact with the people since the outbreak after he paid a short visit to Yunnan during 19–21 January as a tradition that China's leaders observed to visit the smaller towns and villages before the Spring Festival. He was said to chair a meeting on 3 February by the state media, but no pictures or videos were released. Xi also met Cambodian Prime Minister Hun Sen, the first foreign leader to visit China since the COVID-19 outbreak on 5 February.
On 15 February 2020, Qiushi, the CCP's main theoretical magazine, documented a 7 January order by CCP general secretary Xi Jinping regarding the COVID-19 outbreak at a CCP Politburo Standing Committee meeting, 13 days before the public was aware of the outbreak's severity. This appeared to reveal that Xi knew about and was directing the response to the virus on 7 January and raised important questions about whether it was the Central Government that dithered over the response, allowing the virus to spread across the country and eventually the world. However, Homare Endo, director of the Global Institute for China Studies, said a record of the same meeting released beforehand shows there was no mention of the epidemic. She said this indicated that Xi was forced to make "additions" retrospectively because of the public's anger over the death of Li Wenliang, who was arrested by the Wuhan police for early warning of an epidemic.
On 10 March 2020, Xi Jinping visited Wuhan, over one month after Premier Li Keqiang's visit.
At the 2021 G20 Rome summit, Xi called for greater international vaccine cooperation and vaccine equity. This included reiterating China's support for the World Trade Organization's intellectual property waiver, calling for mutual recognition of different COVID-19 vaccines and for developed countries to share vaccine technology with developing countries.
In February 2022, Xi expressed concern to Hong Kong officials over a COVID-19 outbreak Hong Kong, urging them to make containment their "main responsibility" to ensure stability. Amidst China's largest outbreak since 2020 in March 2022, Xi said that China would continue to follow the zero-COVID strategy. In April 2022, while a lockdown in Shanghai was ongoing, Xi again hailed China's zero-COVID approach during a speech, saying it had withstood the test of the 2022 Winter Olympics.
On May 5, 2022, Xi addressed the politburo on the current Covid policy, declaring the policy effective and calling for further implementation. In terms of compliance, he asked for "resolute struggle against all words and deeds that distort, doubt and deny our epidemic prevention policies."
Administrative accountability, January 2020
Since the outbreak of the epidemic, a number of government officials have been publicly held accountable for their dereliction of duty in the epidemic prevention in 6 provinces.
On 29 January 2020, Director of Huanggang Health Commission Tang Zhihong did not answer questions from media regarding the capacity of the local hospitals, current hospital usage, and testing capacity. After the clip went viral, the Party Committee of Huanggang removed Tang from her post the next day. On 1 February 2020, according to the Mayor of Huanggang named Qui Lixin, the city authority disciplined 337 of its officials and removed 6 principals who caused disadvantages to the epidemic prevention.
On 2 February 2020, Zhang Cong, Party Secretary of Xuanhua, Hebei was admonished. Zhang Guoqing, Deputy Party Secretary of Xuanhua and Guo Xiaoyi, the political commissar of the local police were given disciplinary actions by the Party. On the same day, Xiangshui, Jiangsu reported three cases of misconduct associated with illegal disclosure of personal data and dereliction of duty. Party secretary, Zhang Changyue and deputy director Gu Bing of the Zhangji Health Center and the director of the Xiangshui CDC were removed or disciplined.
Tang Hu, the director of the Health Bureau of the Nanhu New District in Yueyang, Hunan Province, Cai Junfeng, the deputy director of the Lengshuijiang Municipal Committee, Yang Wen, the deputy director of the municipal government office and He Yong, the deputy secretary of the Gutang Party Committee and township chief were suspended.
On 4 February 2020, Zhang Qin, the vice president of the Hubei Red Cross, was removed from his post while Gao Qin and Chen Bo of the Hubei Red Cross were given a warning. The deputy director of the Wuhan Municipal Bureau of Statistics, Xia Guohua was also removed from his post. The Secretary and Director of the Leading Party Group of the Wuhan Municipal Development and Reform Commission, the Secretary and Director of the Leading Party Group of the Wuhan Municipal Bureau of Statistics, Meng Wukang and the deputy director of the General Office of the Wuhan Municipal Government, Huang Zhitong are admonished.
In February 2020, the Chinese government reported 555 confirmed cases in prisons in China, and prison officials were fired as a result.
National day of mourning
On 3 April, the Chinese government declared 4 April, the Qingming Festival of 2020, a national day of mourning for those who died in the COVID-19 pandemic. At 10 a.m., people were asked to observe three minutes of silence while sirens and vehicle horns blasted out. Chinese flags were flown at half-mast across the country and at embassies overseas. All public entertainment were halted for the day.
Vaccination and medications
In July 2020, the Chinese government granted an emergency use authorization for COVID-19 vaccines developed by Sinovac Biotech and China National Biotech Group. The government also approved a vaccine developed by CanSino Biologics for use in the military. By mid-December, authorities said that over one million vaccine doses had been administered to over 650,000 people (the vaccines require two doses), with "no serious adverse reactions". By December, plans were in place to vaccinate more widely, beginning with high-risk groups. The vaccine rollout was delayed by limited supplies and vaccine hesitancy.
In January 2021, multiple Chinese state and Chinese Communist party-affiliated media outlets, including CGTN and the Global Times raised doubts about the efficacy of the Pfizer–BioNTech COVID-19 vaccine, calling for an investigation into the deaths of elderly people in Norway and Germany after receiving the vaccine. According to Reuters, the reports made allegations of "deliberately downplaying the deaths" and "using propaganda power to promote the Pfizer vaccine and smearing Chinese vaccines" and touted Chinese vaccines as "relatively safer due to their mature technology". As of February 2021 China had provided vaccines to 53 developing countries and vaccine exports to 22 countries. Foreign Minister Wang Yi criticized developed countries for hoarding vaccines and urged the international community to "promote fair and equitable distribution of vaccines".
In April 2021, the European External Action Service published a report that cited Chinese state media outlets for "selective highlighting" of potential vaccine side-effects and "disregarding contextual information or ongoing research" to present Western vaccines as unsafe.
In June 2021, China reached one billion of domestically produced vaccine doses administered, representing more than one third of the global total at that point in time. This is about 74 doses per 100 population, a similar rate to many European countries. In June 2021, China was administering nearly 60% of worldwide vaccinations. In August 2021, Xi Jinping announced China's vaccine diplomacy goals of providing 2 billion vaccine doses to other countries by the end of the year.
In August 2022, Pfizer signed an agreement to produce Paxlovid in China. In mid December 2022, however after the loosened restrictions and surging infections China Meheco Group signed an agreement with Pfizer to also import Paxlovid.
As of February 2023, China is not using any mRNA vaccines; in November 2022, it rejected a deal to import Moderna. In March 2023, China approved its first mRNA vaccine, made by the Chinese company CSPC Pharmaceutical Group.
International aid
China has sent tests, equipment, experts, and vaccines to other countries to help fight the pandemic. European Commissioner for Crisis Management Janez Lenarčič expressed gratitude and praised collaboration between the EU and China. Chinese aid has also been well received in parts of Latin America and Africa. Chinese-Americans also marshalled networks in China to obtain medical supplies.
On 13 March, China sent medical supplies, including masks and respirators to Italy, together with a team of Chinese medical staff. While the head of the Italian Red Cross, Francesco Rocca said these medical supplies were donated by the Chinese Red Cross, there were other sources that said that these were paid products and services. Chinese billionaire and Alibaba co-founder Jack Ma also donated 500,000 masks and other medical supplies, which landed at Liege Airport in Belgium on 13 March and then sent to Italy. Italian Prime Minister Giuseppe Conte thanked China for its support and assistance. A former Mexican ambassador Jorge Guajardo said that masks sent to China in January and February were being sold back to Mexico at 20 to 30 times the price.
A U.S. congressional report released in April concluded that "the Chinese government may selectively release some medical supplies for overseas delivery, with designated countries selected, according to political calculations."
On 18 May 2020, the Chinese government pledged US$2 billion to help other countries fight COVID-19 and to aid economic and social development "especially [in] developing countries".
China has also provided vaccines to other countries. In November 2021, the Chinese government pledged to provide 1 billion vaccine doses to African countries, including 600 million donated doses and 400 million other doses, in addition to the 200 million doses it had already provided. In the same announcement, Xi pledged additional investment in Africa and promised to send 1,500 public health experts.
Virus origin investigations
The central government has restricted the publication of some COVID-19 origins academic research. A directive was issued by the Ministry of Education's science and technology department, stating "academic papers about tracing the origin of the virus must be strictly and tightly managed", requiring that such papers be vetted by a State Council task force. An anonymous Chinese researcher said "I think it is a coordinated effort from (the) Chinese government to control (the) narrative, and paint it as if the outbreak did not originate in China. And I don't think they will really tolerate any objective study to investigate the origination of this disease." The researcher said that such a move would obstruct important scientific research. Yanzhong Huang of the think tank Council on Foreign Relations said, "it is no surprise that the government seeks to control related scientific research so that the findings do not challenge its own narrative on the origin of the virus and the government response to the crisis".
In April 2020, the broad scientific consensus was that SARS-CoV-2 originated in bats. The Chinese government's reluctance to participate in investigations has fueled speculation into the much less likely COVID-19 lab leak theory.
