China Travelogue #2

Living with Zero-Covid

Trustee Chair in Chinese Business and Economics  >  Trustee China Hand
By Scott Kennedy
The Omnipresence of Zero-Covid
The news of protests across China from the last couple weeks reflects the weariness of so many Chinese with the government’s Zero-Covid strategy. It’d be disingenuous to say that observers should have seen the online and street activism coming, but the build-up and subsequent outpouring of frustration are not surprising.
Zero-Covid has been the defining feature of China for the past three years – even more so than the growing tensions with the United States – re-shaping the country’s interaction with the rest of the world, travel within the country, the state of the economy, and the daily lives of absolutely everyone. The core idea of the policy, which is now quickly being unwound, has been to use a range of tactics to halt transmission of the virus between individuals. These tactics include: massive testing and tracing, isolation of positive cases and close contacts, screening to enter public spaces, dramatically reduced domestic and international travel, and mandatory quarantines of arriving visitors. Prior to the development of vaccines, many other countries practiced their own versions of Zero-Covid; but over the past year, the rest of the world has shifted from stemming the circulation of the virus to reducing its negative health effects through a combination of vaccines, therapeutics, expansion of healthcare facility capacity, and public education campaigns. Vaccinations in China have not been ignored – 93% of Chinese have had at least one dose (a higher rate than in the United States) – but for a variety of reasons, to be discussed below, China stuck with a plan to suppress the virus’s spread far longer than anyone else.
The unique endurance of Zero-Covid is why my visit to China this Fall was so unusual in the first place. Moreover, the policy affected every element of the trip, from quarantining to testing, from arranging meetings to scheduling travel from one region to another. You could say that Chinese had found a way to live with zero-Covid, but based on what I observed, for many it had become a dismal existence. That explains why protests broke out and why the government is in the middle of a 180-degree about-face.

                                                           Figure 1: Health Codes

Top left: Beijing Health Kit; Top right: Communication Travel Card; Bottom left: Storefront scannable code; Bottom right: Shanghai health code

Testing and Codes
It’s clear that since early 2020 Zero-Covid has trumped every other policy goal, including economic growth, and was pursued with a vigor and persistence few could have imagined. When I arrived in early September entering China's Zero-Covid universe was jarring because outside China, and especially in the United States, the pandemic is viewed as a historical phenomenon and lockdowns were far more temporary and localized. It began with the flight attendants wearing “big white” hazmat suits on my flight from Taipei to Beijing and continued throughout my stay until the moment my return flight from Shanghai took off.
The most frequent way I encountered Zero-Covid was through regular PCR testing and having to scan my phone to enter any building. Mobile testing stations were ubiquitous in both Beijing and Shanghai. In fact, there were stations right outside my hotels in both cities. That said, I could have tested at any station anywhere in either city. In fact, I took one test in the northern suburb of Changping when visiting friends. In Beijing, like all residents, I was required to take a PCR test once every 2-3 days, and I needed to receive a negative result to go about my daily schedule. In Shanghai, I tested almost every day because many facilities, particularly universities, required a negative test within 24 hours and for multiple days in a row.
In order to take PCR tests, I first had to download Covid apps onto my mobile phone. Like most, I had two kinds of apps on my phone: a “health kit” (jiankangbao, 健康宝) for the locality in which I currently resided (Beijing and later Shanghai), and the “Communication Travel Card” app (tongxin xingcheng ka, 通信行程卡) used to check-in at hotels and to enter transportation hubs, such as airports and train stations.  
I took my first regular PCR test on the second morning after being released from my 10-day quarantine. There was a small line of roughly 15-20 people in front of me, including some hotel guests and staff, but also people who just happened to be walking by and found this station to be convenient. I was worried it would take a while, but the line moved quickly, that is, until I got to the front. Stations are typically manned by two staffers, both in “big whites.” The first scans your ID card, and the other performs the test. But because I’m not a Chinese citizen and do not have a national ID number and card, the staffer had to enter my passport number and full name by hand each time. And I had to check that they had done so correctly, lest my results not go through, and my code not updated.
That meant the line lost its rhythm when I got to the front, and I apologized to those just behind me for holding them up. Once I was checked into the system, I then went around to the other side of the station, stood close to the window and lowered my mask. After quickly rubbing some antibacterial jell on her hands, the attendant took a fresh swab, gently brushed it against the back of my throat, and then put the swab in a test-tube.
To save money and materials, station attendees would put 10 people’s swabs into a single test tube, what is called a “mixed tube” (hunguan, 混管). You could ask and pay extra to have your swab placed in a tube of its own (danguan, 单管). If the “mixed tube” results came back positive, everyone in the tube would be individually re-tested. At a minimum, a positive initial result would mean taking another test and home quarantine, but if your re-test came back positive, you likely would be sent to a centralized isolation facility.
As I stood in line, I had what initially felt like a humorous thought. Knowing that my swab would be mixed with 9 others, I looked at people in line both in front of me and behind me, and for a moment considered whether I ought to be worried about having our fates intertwined. But I figured that, in actuality, more eyes would be turned on me, as the others in line, all Chinese, probably faced a greater, albeit small risk from being in the same test tube with me given my traveling from abroad and meeting with so many people. However, no one else ever gave me a strange look or showed any hesitancy about being in line with me, save for the extra time it took to input my personal information. Occasionally I struck up brief conversations while waiting, and it was clear that everyone tested because it was mandatory, not because they thought doing so might identify positive cases and protect society.
But international visitors were not always treated so even handedly. A foreign student I met told me that when he was in line waiting for his test a Chinese student, upon seeing that their two swabs would be put in the same test-tube, demanded that his own swab be put in a separate one. I was told that this happened on more than one occasion. If so, what I originally thought would be a moment of unity and comic relief in some cases surfaced people’s fears that manifested itself as prejudice.
Once I took the test, the sample was evaluated within a few hours and my status was updated overnight. Following my first test, the next morning when I looked at my phone, it showed that my result was negative – hence the screen was awash in green – and that it had been only one day since my last negative test. In subsequent tests, I discovered what felt like a way to game the system. When I took the test in the late afternoon, the following morning’s update reported that it had been zero days since my last negative test, essentially giving me an extra day without needing to test again. And so, whenever possible I tried to arrange my remaining tests in late afternoons.
After each test, I would worry until I received the results and think about the consequences of being positive. Having had 4 doses of the Pfizer vaccine, I was not concerned about getting ill; instead, I was only worried about how I would be treated, whether I’d be sent to a quarantine facility, be able to get in contact with my family and host, and be able to do my work. Luckily, every test I ever took came back negative, but others were not so lucky and endured terrible circumstances.
With the negative green screen on my phone, I could use my health kit app to scan a red-colored QR code found at the doorways of buildings and in vehicles. Building entrances were typically configured with a rope line or another way to channel people to enter one-by-one, and then a staffer stood at the post to ensure I scanned the posted code and that the result showed I was negative and had tested within the last three days. In hotels, I had to scan again to enter restaurants, lounges, and gym facilities. With possibly one or two exceptions, someone rigorously checked my status on every occasion. Arriving with a large group, showing you were in a hurry or acting like a VIP made absolutely no difference.
Entering universities was even more strictly controlled. In Beijing I had to provide a screenshot of my negative test results from within the last two days and fill out a form online. At Peking University, I even had to do a rapid antigen test right inside the main gate, and someone had to escort me throughout my time on campus. And despite us being alone, taxi drivers consistently required me to scan my app and verify my negative status. Although a nuisance, in some ways the consistent vigorous enforcement was impressive because everyone had to comply.  

                                                    Figure 2: Testing and Prevention

Top left: Beijing, beginning of PCR test station line; Top right: Beijing, PCR test station sign-in (left) and swab (right); Bottom left: Flight attendants on Taipei-to-Beijing flight; Bottom right: Shanghai, PCR test station.

A Skeptical, Exasperated Public
Perhaps the biggest surprise of my time in China was how frustrated most people I met were with Zero-Covid. I was also unprepared for how the griping and debate was in some ways similar to the contention and conflict the pandemic touched off in the United States and elsewhere, and quite different from the more unified – and effective – responses to the pandemic in Japan, South Korea, and Taiwan.
Most people I spoke with in China, including Chinese citizens and international business executives and embassy officials, agreed that during the first two years of the pandemic, Zero-Covid essentially worked. Yes, the measures were radical and trampled on people’s rights, but very few Chinese died from Covid-19 and the domestic economy operated relatively normally. Support was reinforced by the contrast with the United States and Europe, where millions lost their lives, either from the virus or due to other maladies exacerbated by the virus, and the pandemic exacerbated political and social fragmentation.
But that praise, even if grudging by some, dissipated when people talked to me about their recent experiences. The turning point was the wave of lockdowns in China in the first half of 2022. Almost everyone I met in Beijing had gone through some sort of lockdown, which forced them and their kids to stay home from work and from school. Restrictions varied across the city, solid information was hard to come by, and people had a hard time planning their daily activities. By the time I arrived, cases in Beijing were quite low, localized lockdowns had ended, and it was easy to move around the city and meet others face-to-face. But government offices were only partially open to outsiders, and access to universities was highly restricted. Travel between provinces was a roll of the dice. A couple of people who met me at my hotel showed up with a suitcase, explaining they were about to fly to another city. But by the end of our meetings, one  had received a text from their airline canceling the flight, and the other received a message from a co-worker at their destination warning them not to board the flight because cases were rising and they might not be allowed to return to Beijing on schedule.
But the restrictions in Beijing were not nearly as disruptive as those imposed on Shanghai, which commenced in late March 2022 and lasted until early June. A full summary of Shanghai’s situation is unnecessary, as residents there took to social media to record their treatment and complain about conditions, perhaps most famously summed up in the “Voices of April” (siyuezhisheng, 四月之声), a montage recording of Shanghai residents pleading for help. By the time I arrived in October, the massive lockdowns had long ended, but people gave a variety of signs they had yet to fully recover from the trauma they suffered from being stuck at home, mistreated by their neighborhoods’ leaders, the difficulty they faced obtaining food and medicine, or being taken away to quarantine facilities. One professor told me of an elderly colleague who had died of starvation because they didn’t know how to use their cell phone to obtain food. Tourist sites around the city had very few visitors. Usually packed solid on weekends, there was plenty of open space for me to walk along the Bund. One shop owner I spoke with lamented how they had to fire over half of their staff because business was so bad due to Zero-Covid.
Although the general lockdown was lifted by the time I arrived in Shanghai, unpredictable restrictions still occurred. Because of a small number of cases, Fudan University’s campus had its students stay in the dorms and attend their classes online. Although I had taken a long series of tests to get onto campus and deliver a lecture, I ended up speaking to students through Tencent’s video platform. More disconcerting, a public bus suspected of carrying a positive passenger was stopped in the middle of the city; another bus pulled up behind it, the passengers were marched from the first bus to the second, and then taken away to centralized quarantine facilities – with no warning whatsoever.
The effects of the Shanghai lockdown were felt far beyond the municipality’s 25 million residents. The lockdown disrupted supply chains throughout the China and beyond. Moreover, many people who live around the country have friends and family in the city. When the spring lockdown occurred, people desperately tried to help their loved ones, only sometimes with success. One friend of mine was only able to help his parents obtain medicine because his sister-in-law was a doctor and could obtain medications and had special permission to move around the city. Such experiences were commonplace, which was shocking given how developed Shanghai is.
People I met in Beijing and Shanghai were relieved that lockdowns had concluded, but they were still unhappy with the requirement to constantly scan and test. A bus crash in Guizhou that occurred in September while I was in China further galvanized opinion against Zero-Covid. A local official decided to bus residents who had tested positive late at night to a facility outside their jurisdiction to keep their official numbers of cases at zero. The crash, which killed 27 of the 47 people on board, was condemned on social media and held out as an Exhibit A of how the incentive structure for officials to comply with Zero-Covid was leading to tragedies.
The government’s regular insistence that Zero-Covid would remain in place only served to heighten anxiety that life might never return to normal. Long before Chinese were watching World Cup soccer matches, they could see how the rest of world had moved to a post-pandemic era, making their own situation even more galling to them.

                                                    Figure 3: Zero-Covid Incidents

Top left: Guiyang bus crash (CNN); Top right: Shanghai quarantine bus (Hector Retamal/AFP via Getty Images); Bottom left: Urumqi apartment fire (CNN); Bottom right: Anti-lockdown protests in Beijing (Noel Celis/AFP via Getty Images)

The Debate Over Vaccines and Zero-Covid
The broader unhappiness with Zero-Covid was part of a national debate I encountered about how to move forward. No one I met chose Zero-Covid their first policy choice, but a sizeable number of interlocutors, both in and out of government, said that Chinese authorities essentially had no choice but to continue with the policy for an extended period. They noted that although China had vaccinated over 90% of the population, a large proportion of elderly were either entirely unvaccinated or had not received a booster. Moreover, they pointed out that China’s smaller cities and countryside did not have adequate healthcare facilities, including hospital beds and medical staff, to take care of the many who would get sick if China suddenly dropped Zero-Covid. Some cited a study from May 2022 saying that over a million would die in such a scenario. Hence, these individuals counseled a very gradual opening, which could only come after more vaccinations and boosters occurred. 
This first group was outnumbered, though, by a larger proportion who thought China should rapidly expand vaccinations, including permitting use of mRNA vaccines developed in the West, and then begin to dismantle all of the elements of Zero-Covid one-by-one. Given the power of the national and local state and their willingness to use it to enforce compliance – watch the videos of “Big Whites” pulling people who tested positive or were close contacts from their apartments in Shanghai – many had a hard time understanding why Chinese leaders did not direct this power toward a more constructive end and impose a full-scale national vaccination mandate.

Some gave a “societal” explanation, arguing that China’s elderly are too stubborn and officials did not want to force them because it would hurt their reputation. Some pointed to Beijing municipality’s stillborn mandate from July 2022, which lasted all of a day before it was withdrawn.

More, though, offered one or more “political” explanations. Many suggested Xi Jinping simply liked Zero-Covid because it strengthened the Chinese Communist Party’s (CCP) hold over society and that a vaccination campaign would result in giving people back their personal freedom. Some thought a vaccination campaign would inevitably require acceptance of Western mRNA vaccines, and the leadership had likely concluded that it would rather endure a long period of isolation and an economic slowdown rather than rely on Western-supplied vaccines for such a critical need. Most cited basic nationalism as a reason, but a couple thought that China’s leaders may have been concerned that the West would restrict their patents and discontinue collaboration in the middle of a vaccine rollout. These people cited growing U.S. export controls as a source of concern as it could hypothetically leave China’s population in a vulnerable position.

Still others, who focus on politics, thought the problem wasn’t societal resistance or a top-down plan to protect Xi’s power or nationalism, but instead the consequence of earlier success, which gave many in the policy establishment, both senior politicians and public health experts, an undeserved degree of confidence about Zero-Covid’s efficacy; once they realized they should change and expand vaccinations, it was essentially already too late and there wasn’t much anyone could do to easily fix things.
A final category of people with whom I spoke neither defended Zero-Covid or pined for a vaccination campaign. Instead, they were vaccine-hesitant, or more simply, anti-vaxxers. Some opposed vaccines simply because they saw the risk of catching Covid-19 as very low, but many had doubts about vaccines in and of themselves. Many cited the low efficacy of China’s two widely used homemade vaccines, from Sinopharm and Sinovac. They also pointed to Chinese vaccines in the recent past that unexpectedly were found unsafe and dangerous. A subset of vaccine-hesitant Chinese were also deeply skeptical of mRNA vaccines. Those most concerned about all kinds of vaccines tended to be the most educated people I met. They would refer to the same arguments – and articles – anti-vaxxers in the United States cite. They even wondered aloud with me about whether mRNA vaccines would change their own DNA. Hence, they believe there were much better ways to keep themselves safe than to rely on vaccines at all.
I was not expecting to encounter such so many contending views about vaccines in China. But the debate also became a useful mirror for me to reflect on my home country. Although I’m personally not an anti-vaxxer and believe mRNA vaccines developed for Covid-19 are saving lives and a key to getting to a post-pandemic era, in my experience, expressions of vaccine hesitancy in China sounded less irresponsible and caustic than in the United States. Instead, it seemed to fit within a larger defense of personal rights against an oppressive state. This is a framing that American anti-vaxxers hold, but which their opponents do not find as legitimate given their own view of the United States as a pluralistic democracy in which science trumps political chicanery.
The End of Zero-Covid
When I was in China only a couple months ago, there was one area of clear consensus: Whether one liked it or not, Zero-Covid would be around for a while and not go quickly into the night. How wrong all of us were. People expected that even if the leadership kept Zero-Covid in place just to get through the 20th Party Congress without introducing any substantial changes, once they did decide to shift, changes would be introduced gradually and over the course of 6-12 months. That appears to have been the plan; the “20 Guidelines” announced on November 10, 2022, were framed “to optimize” Zero-Covid, not abandon it. But most read the measures as the beginning of the end, and when the subsequent rise in cases resulted in localized lockdowns, these expectations were challenged. Add in the Urumqi fire, the sight of maskless World Cup soccer fans in Qatar, and unhappy people confined together with each other and their highly capable mobile phones, and all the elements needed for nationwide protests were assembled.
The problem now is that those hoping for an end to Zero-Covid got what they wanted, but perhaps more quickly than would have been advised. The sudden lifting of restrictions, codified in a new 10-point plan, appears to have provided greater personal freedom for individuals, and the virus as well. With some planning and a clear communications strategy meant to address the concerns of a skeptical public, China could have exited the pandemic in an orderly way with a relatively flat curve and limited loss of life. Unfortunately, it appears that the leadership abandoned Zero-Covid in a matter of days, and the exit will be relatively chaotic and tumultuous. Provinces and cities appear to be taking very different paths.
Such a messy exit will have several consequences. The economic bounce from moving to a post-pandemic era will likely be tempered by the upcoming rise in cases and sickness, which will lead to temporary worker shortages, closures, and supply chain bottlenecks. This will add to strains already felt by a high unemployment rate among young people and a financial system struggling to absorb massive debt from the housing market. A chaotic exit may also affect China’s international relationships. It may take longer to convince foreign businesspeople, tourists and students to return to China, and China’s leadership may be more hesitant to expand diplomatic engagement with the United States while it is dealing with a major domestic health crisis.
Perhaps the most important aspect of the ongoing transition will be the effect on public sentiment. Chinese were widely unhappy with Zero-Covid and desperately wanted to move beyond it. There was no consensus on how to exit, but Chinese will certainly judge their political leaders harshly if there is a significant loss of life, the economy’s malaise does not lift, and China’s international reputation is further tarnished. Although the pressure cooker of Zero-Covid has been lifted, Xi Jinping and his new coterie of colleagues will now likely face a different type of mounting pressure. The question is whether they will respond with the kinds of practical solutions China’s technocratic system is capable of producing or a hodge-podge of uncoordinated steps wrapped in the kind of neo-Marxist ideological packaging Xi has shown an affinity for, particularly when times get tough. The people I met during my trip and the world will be watching closely.

Scott Kennedy is Senior Adviser and Trustee Chair in Chinese Business & Economics at the Center for Strategic and International Studies.
Related Trustee Chair Activity
Trustee Chair, “Exiting Zero-Covid: China’s Provincial Covid-19 Rules Tracker,” CSIS Trustee China Hand Blog, December 9, 2022.
Scott Kennedy, “Xi-Biden Meeting May Help End China’s Destructive Isolation,” Foreign Policy, November 14, 2022.
China Travelogue Series #1: A Long, Strange Trip: Arrival and Quarantine,” CSIS Trustee China Hand Blog, November 2, 2022.
Stephen J. Morrison, Yanzhong Huang, and Scott Kennedy, “China’s Zero Covid: What Should the West Do?” CSIS Commentary, June 27, 2022.
Yanzhong Huang and Scott Kennedy, Advancing U.S.-China Health Security in an Era of Strategic Competition (CSIS, December 2021).


Scott Kennedy
Senior Adviser and Trustee Chair in Chinese Business and Economics