Beijing has to change its goal from zero Covid to zero death

China’s government looks to be starting to roll back its zeroCovid policy. But after three years of saying the strategy was the only way to go, experts say ending it will be a medical and political challenge.

Much of China’s new plan is riding on vaccinations, but this is where Beijing has great challenges. About 90% of China’s population is vaccinated, but among those over 60 only about 69% have had at least three doses. Above 80 years of age, the figure drops to about 40%.

On Tuesday, the national health commission announced a push to boost these numbers. Officials want 90% of people over 80 to have had at least one dose by January, and for 95% of those aged 60-79 to have had at least two.

China’s leaders have not allowed the import of foreign-made vaccines, relying on domestically developed vaccines based on an inactivated virus, which health experts say are not as effective when used exclusively. “China has the ability to do [medical research and development],” said Prof Chi Chunhuei, director of Oregon State University’s centre for global health. “Why they haven’t come up with a bivalent vaccine puzzles me. Perhaps they were too reliant on zero-Covid.”

Recent studies in the US showed that the most effective immunity protections in combating Covid were, in descending order: a combination of natural immunity and vaccination; natural immunity; vaccination, then neither. China’s population overwhelmingly sits in the bottom two categories.

“This is the major weakness in China’s situation,” said Chi. “Given [Covid] is unstoppable and is coupled with a much lower severity, the only way to stop it is through natural immunity.” But estimates of deaths if China were to open up range from hundreds of thousands to tens of millions.

“They have to change their narrative to change the policy,” said Chi. “They have to use their propaganda to change the narrative and say that facing Omicron, we’re going to shift gear from zero-Covid to zero death.”