China must switch from mass testing to vaccinations to move on from its wasteful zero-Covid policy

After two months of anger, frustration and economic loss, China's financial and manufacturing hub of Shanghai finally began to exit its draconian Covid-19 lockdown on Wednesday. Relieved residents had their freedom back, but have nevertheless been left to count the cost - as the authorities remain steadfastly unapologetic.

The municipal government did issue a "thank you letter" this week to the city's 25 million residents, in which it promised to do its best to restore normal life and help recover losses. There was no apology for the hardships caused, however.

China's leaders presumably feel vindicated that their zero-Covid policy - with all the mass testing, quarantines, aggressive contact tracing and expensive lockdowns that entails - has triumphed yet again.

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But the Shanghai saga has clearly shown that this costly strategy is no longer socially or economically sustainable and needs to be optimised, no matter how well the whatever-it-takes-approach may have served China in the past. Public sentiment on the virus, and the government's plans for dealing with it, have shifted significantly.

Unfortunately, any public discussion of this topic is now a political taboo, as the leadership attributes the success of its virus suppression policy to the institutional strength of the Communist Party's authoritarian model of governance.

At a meeting in early May, in fact, China's top leaders made it clear that they "would resolutely fight" any attempt to "distort, question or dismiss China's anti-Covid policy".

There is still much room for improvement, however - making an outright ban on discussing the policy counterproductive, to say the least.

Take China's latest move to double down on mass testing, instead of promoting vaccinations, as a case in point.

Since May, the central government has spent billions of yuan on setting up testing booths in cities across the country, with the aim of having one within a 15-minute walk of every resident. At the time same time, the authorities are seeking to build permanent hospitals in all major cities to quarantine and treat Covid patients.

The idea is that, by requiring citizens to produce proof of a negative Covid-19 test within 48 or 72 hours of entering a public space, officials in cities such as Beijing and Shanghai will be able to quickly identify and contain the spread of the virus without having to impose any more harsh citywide lockdowns.

It would seem the Chinese government intends to make street-corner testing booths as permanent a feature as the convenience stores that dot every major city.

But is this the best use of precious manpower and other resources? It's a question that needs to be asked, yet won't be amid official intolerance - and the rush to squash outbreaks of ever more contagious and stealthy virus variants.

On the streets of Beijing, "the Big Whites" - as the medical workers clad in suits of personal protective equipment are known - may operate from hastily constructed shacks for the moment, but these will soon be replaced by custom-made testing booths. Authorities in Zhengzhou, capital of Henan province, have ordered more than 4,000 of these booths for 46,800 yuan (US$7,000) each, or nearly 190 million yuan (US$28.5 million) in total.

For many less affluent cities, daily testing has become a financial burden they cannot afford. Until recently, the central government had tacitly allowed local authorities to tap the state medical insurance fund to pay for testing, but last month cash-strapped local authorities were told they must cover the expenses themselves.

The relentless pressure to produce faster results, meanwhile, has forced some testing companies to commit fraud. In Beijing alone, the police have investigated and shut down at least three commercial testing labs, accusing them of malpractice leading to inaccurate results.

And all the while, attention and resources are being diverted away from promoting vaccinations - particularly among vulnerable groups such as the elderly.

Chinese officials have long justified the country's zero-Covid policy by saying it protects the vulnerable. Yet this stands in stark contrast with China's efforts to get its older citizens vaccinated, which have been entirely unsatisfactory from the outset.

Less than half of the country's over-80s are double jabbed. A fact that is not obvious from official data, which shows an overall vaccination rate of 89 per cent, or around 83 per cent for over-60s.

Much has been written on why China's elderly remain unvaccinated. Many of them are afraid the vaccines will do more harm than good, while others believe that staying indoors most of the time will protect them from the virus.

Further contributing to their reluctance is suspicion of China's home-grown vaccines, with their low efficacy rates, and the government's refusal to import foreign-made jabs. Neither has it escaped the public's attention that none of China's top leaders has publicly acknowledged being vaccinated, despite all of them being older than 60, in a country where people are constantly reminded to follow the leadership's example.

Some local authorities have tried an array of inducements to get the elderly vaccinated, including offering cash or eggs in return for a jab. But the central government appears to lack a national coordinated plan to promote vaccinations.

Whatever their shortcomings may be, vaccines have been proven to save lives and reduce severe illness. It is high time that China shifted its resources from mass testing to vaccinations.

Wang Xiangwei is a former editor-in-chief of the South China Morning Post. He is now based in Beijing as editorial adviser to the paper.

This article originally appeared on the South China Morning Post (SCMP).

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