COVID-19: Shanghai’s “targeted anti-epidemic” approach

The total number of confirmed positive and asymptomatic cases in Shanghai has exceeded 70,000 in the current outbreak, which was caused by the Omicron variant of the novel coronavirus. This figure is higher than China’s Hubei Province, the site of the original novel Coronavirus outbreak, which has reported 68,391 confirmed COVID-19 cases since 2020. However, it is worth noting that Shanghai has not reported any COVID-19 deaths or severe cases so far, casting doubt on China’s “dynamic zero” epidemic prevention policy.

It was previously believed that Shanghai might make a compromise and choose a limited “coexistence with the virus” in the face of the epidemic with the majority of asymptomatic cases, and explore a “precise fight against the epidemic” for other provinces and cities across the country.

However, the number of confirmed cases and asymptomatic infected persons increased rapidly, and nucleic acid screening in grids and fragmented areas failed to control the epidemic. On April 2, Sun Chunlan, a member of the Political Bureau of the CPC Central Committee and vice Premier of The State Council, went to Shanghai to investigate the epidemic prevention and control work, and set the tone for the general policy of epidemic prevention in Shanghai, that is, to adhere to the “dynamic zero” general policy.

On April 3, 10,000 medical workers from other places arrived in Shanghai, some of them in makeshift hospitals treating asymptomatic and mildly infected patients. Starting from the morning of April 4, all Shanghai residents were required to take nucleic acid tests within one day according to the official requirements.

Shanghai, with a population of about 25m, is China’s largest city. Based on the market cost of nucleic acid mixed test of 10 YUAN per person, the government will spend about 250 million yuan on nucleic acid test in one round. Earlier, several rounds of nucleic acid tests had been carried out in sections of Shanghai.

From 00:00 to 24:00 on April 3, Shanghai reported 425 newly confirmed COVID-19 cases and 8,581 asymptomatic COVID-19 cases, accounting for nearly 70% of the total in China, according to the Shanghai Municipal Health Commission. In a month, the number of asymptomatic cases in Shanghai rose from single digits to this point, and the trend continues to rise.

“Compared with Wuhan, Shanghai is better prepared and experienced,” Chen Erzhen, the head of the medical treatment team at the Shanghai quarantine center and the leader of the third medical team sent to Hubei, was quoted as saying in the state-run People’s Daily on April 2. The scale of the outbreak is larger than that of Wuhan, but the severity of the disease is lower. Chen Erzhen also stressed that the virulence of the omicron variant strain has decreased and its transmission power has increased, and the transmission speed is very fast, so there are more and more asymptomatic infected people, which increases the difficulty of control and puts great pressure on them.

For the past two years, Shanghai has been following a prudent policy of “catching mice in a ceramic shop” in response to the Delta virus strain — that is, controlling the epidemic with minimal social cost, allowing rapid tracking and ensuring the normal operation of the city’s production and life. Therefore, when all major provinces and cities in China adopted the policy of “lockdown”, Shanghai’s “precise response to the epidemic” won unanimous praise from public opinion and the public.

However, after the current outbreak in Shanghai, public opinion has been divided on Shanghai’s targeted response to the epidemic, and the Shanghai model has attracted much criticism. “Shanghai’s positive tests are clearly out of control, proving that the Shanghai government’s targeted epidemic prevention policy is a failure,” said one Weibo user. This proves that Shanghai’s leading cadres must be reorganized immediately, and then the city’s leading cadres will meet to reflect on the problems and apologize to the whole nation.”

There are no high-risk areas in Shanghai, even though the city has recorded about 70,000 confirmed and asymptomatic cases. As of April 4, more than a dozen provinces and cities in China had confirmed cases due to the spillover from Shanghai. Residents affected by the spillover of the epidemic in Shanghai derided its “precise fight against the epidemic” as “precise spillover”. According to China’s National Health Commission, a total of 1,366 local positive cases and 11,771 asymptomatic infections were reported from 00:00 to 24:00 on April 3.

As the COVID-19 pandemic enters its third year, western societies are gradually opening up and returning to normal. In responding to the outbreak, Chinese policy makers have tried to avoid direct use of the term “lockdown,” to avoid criticism for the heavy social and economic costs of strict quarantine policies. Shanghai is no exception. At the end of March, Shanghai took control of the city’s new and old districts, Pudong and Puxi, with the Huangpu River as its boundary, in an attempt to wipe out social gatherings.

Shanghai is sending asymptomatic infected persons and mild cases to makeshift hospitals and isolation centers for treatment. Before the reinforcement of 10,000 medical staff in Shanghai, medical staff in the whole city were transferred to support nucleic acid testing, which led to the outflow of medical resources and the occurrence of secondary medical hazards.

At the beginning of April, the parents of newborn babies infected with novel Coronavirus reported on the Internet in China that they had been separated from their babies and that their children had been sent to a centralized quarantine site, where they were at risk of cross-infection and other diseases due to poor care. People from all walks of life have called for parents to be allowed to accompany infants in isolation.

Shanghai authorities said in a press conference on April 4 that if the parents of children are also positive, they can live in the child care area and receive observation and treatment together. Children infected with the virus will receive treatment at public health centers if their family members do not meet the accompanying requirements and the child is younger than 7 years old. Other older children and adolescents, as well as younger infected children whose parents are eligible to accompany them, will be isolated and treated mainly in centralized centers.

On March 23, a nurse in the obstetrics department of Shanghai Oriental Hospital suffered an asthma attack at home, which could not be relieved even after self-medication. His family drove him to the hospital where he worked, but he was not treated in the hospital due to the epidemic prevention and control needs. Her family took her to another hospital for treatment, but her illness delayed and she passed away. On March 25, Shanghai Oriental Hospital said it was deeply saddened by the nurse’s death and expressed condolences to her relatives.

On March 30, a video circulated on the Chinese Internet showing 120 doctors refusing to lend defibrillators. In the video, the photographer asks the 120 doctors on the bus, “Would it kill you to change?” . This is the most real portrayal of doctors facing life and death decisions of patients after the squeeze on medical resources in Shanghai.

The video shows an elderly man suffering from a severe asthma attack at home in Shanghai. His family immediately called 120 for help. But the ambulance parked downstairs was waiting to take the neighbor to the hospital. The asthmatic man’s family tried to borrow the ambulance’s defibrillator, but the doctor refused. The elderly with asthma died because they missed the best time for treatment. On March 31, the Health commission of Shanghai Pudong New Area released the results of an investigation, saying that although the doctor was on emergency duty at the time, he had improperly handled the situation and had been suspended.