In Shanghai, Leaving Home for Testing Means COVID Exposure
According to experts, China's mass public testing is spreading the coronavirus rather than controlling it
Washington — "Going down to get tested is really the only time when you encounter other people," said Jackson Nemeth, who lives in one of Shanghai's locked down neighborhoods. When Nemeth, a 27-year-old American from Cleveland, Ohio, arrived in Shanghai last September to start a job in China's financial center, he never expected that the bustling city would become a ghost town almost overnight. "Locked down since April 1. They told us originally that it will be a four-day lockdown. So, people got four days' worth of supplies, and since then until now, it's been exactly three weeks today," Nemeth told VOA Mandarin in a phone interview Thursday. "Pretty much every day they're finding positive (cases), which is just frustrating." According to Nemeth, people don't know when the lockdown will end. Nemeth, who has a master's degree in Chinese and a job connected to trade policy, lives in Shanghai's Jing'an district. Because authorities have been finding new COVID-19 cases each day, the neighborhood is now under complete lockdown. On April 11, Shanghai sectors were categorized into three types of zones — lockdown zones, controlled zones and precautionary zones — based on their total positive cases, according to the state-controlled . Some 11.88 million people live in lockdown zones, where residents must remain at home except in special circumstances such as a life-threatening illness. Shanghai, with more than 25 million residents, is China's most populous city. For Nemeth, getting a nucleic acid COVID-19 test is his only opportunity to leave home. A nucleic acid test is a diagnostic test for the virus that causes COVID-19. Dr. Amesh Adalja, a physician with Johns Hopkins Center for Health Security who focuses on emerging infectious disease, said that any social interaction is an opportunity for the virus to spread, and the omicron variant is highly contagious. "There are likely a lot of unknown chains of transmission circulating throughout (Shanghai), and the draconian methods the Chinese government has forced on its population provides no incentive for cases to come forward, especially mild ones," Adalja told VOA Mandarin via email last week. Adalja said Chinese authorities should be teaching the population harm reduction and risk tolerance, adding that they need to move away from "blunt authoritarian tools" that are not supported by science. "The exit strategy is to vaccinate their high-risk population with mRNA vaccines, deploy home tests, antivirals, and monoclonal antibodies," Adalja said. The mRNA vaccines — which include the Pfizer and Moderna versions — teach a person's cells how to make a protein that will trigger an immune response inside their body, , and have proven to be effective against COVID-19. Xinhua News Agency quoted Gao Chunfang, director of the Testing and Experiment Center of Yueyang Hospital, which is affiliated with the Shanghai University of Traditional Chinese Medicine, as saying that high-frequency nucleic acid testing is "very necessary" because all pathogens have an incubation period, and if the viral load is relatively low, the initial test may fail. China's zero-COVID policy, a countrywide COVID-19 control measure, has been in place since 2020. It has led to lockdowns in cities throughout the nation, but most notoriously in Shanghai. On March 28, China's financial hub imposed its first temporary lockdown, which blossomed into a widespread lockdown of indefinite length. And even as factory and logistical shutdowns threaten China's economic growth, Chinese President Xi Jinping has repeatedly ruled out moving away from the zero-COVID policy. According to the daily statistics released by the Shanghai Municipal Health Commission, on Tuesday, there were 1,606 new confirmed COVID-19 cases and 11,956 asymptomatic infections. Among the confirmed cases, 1,253 were previously reported as asymptomatic infections. The city's official death tally stands at 238 as of Tuesday, putting the fatality rate at 0.045%. Huang Yanzhong, a senior fellow for global health at the Council on Foreign Relations, points out those numbers may not give a complete picture of the outbreak's toll. Worldwide, the fatality rate of omicron for unvaccinated people over 80 years old is 20%, he said. "If you do the math, the death toll could be as high as 120,000," Huang told VOA Mandarin. According to Huang, because a large portion of the Chinese population has not been exposed to this virus, relaxing restrictions would lead to an immediate surge in cases and deaths. He stressed that to get out of this vicious cycle, China must protect the vulnerable population and build resilience to the virus. In the meantime, Shanghai undertakes daily polymerase chain reaction (PCR) and antigen testing of millions and accelerates transfers of people who test positive for COVID-19 to large quarantine centers. "I do think there is a real risk that the mass public testing is actually spreading COVID rather than controlling it," said Lawrence Gostin in an email. Gostin is a professor of global health law at Georgetown University and the director of the World Health Organization Collaborating Center for National and Global Health Law. "Antigen tests can also be done rapidly at home and is an important public health tool," Gostin said. "PCR tests require laboratories, and it poses a risk if people gather together for PCR tests." "Nucleic acid testing is carried out every day in the lockdown and controlled zones. However, the risk of cross-infection caused by this channel is very high, but this loophole has not been well prevented," said a netizen commenting on Weibo, a Twitter-like platform. "We are taking PCR tests daily. What's the scientific basis here? Are we just doing testing for fun?" asked another netizen. On April 6, Zhong Nanshan, a Chinese respiratory disease expert who was in charge of controlling a 2003 outbreak of severe acute respiratory syndrome, or SARS, and assisted in formulating the zero-COVID policy in early 2020, published a signed article in the journal National Science Review arguing that a long-term zero-COVID policy could not be achieved, and that China needed to reopen for normal socioeconomic development. Zhong said in the English-language article that because omicron is so contagious, long-term dynamic clearing, or maintaining a long-term zero-COVID policy, is impossible. The article suggests China should take control measures that include increasing the vaccination rate, prioritizing the use of antigen kits in the community, speeding up drug research and development, and conducting follow-up investigations on cases to adjust the minimum quarantine time. The Chinese translation of the article began circulating on the Chinese internet on April 19. On the same day, the Chinese government website posted an article saying its general policy of dynamic clearing remains unchanged. The article quoted China's Xi as saying that the zero-COVID policy protects people's lives and health to the greatest extent possible. Nemeth said that since the lockdown, people in his community have been taken away to quarantine centers almost every day. "I see people being taken away a lot," he said. "My desk is right in front of the window, and every day I see buses coming and taking away people with suitcases."