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Covid-19: Why China is sticking to “zero tolerance” public health measures

BMJ 2021; 375 doi: (Published 25 November 2021) Cite this as: BMJ 2021;375:n2756

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  1. Andrew Silver, freelance journalist
  1. New Taipei City
  1. aesilver360{at}

China’s covid strategy has been to identify and interrupt community transmission through swift containment measures, sometimes for whole cities. And, despite already vaccinating over 75% of the population, it seems to be sticking to this approach. Andrew Silver asks why

Maintenance of containment has greatly reduced the impact of covid-19 lives lost and socioeconomic progress, wrote researchers including George Gao, head of the Chinese Center for Disease Control and Prevention (CDC), in Nature Medicine in April.1

When people test positive for covid-19 in China they have to isolate, and authorities must implement targeted movement restrictions and PCR testing in geographical areas, working quickly to trace contacts who may have been exposed so that they too can be isolated. Authorities that don’t act quickly enough and people who don’t comply with covid-19 regulations face punishment.

Covid-19 measures led to the closure of Shanghai Disneyland, and testing was required before the guests already inside were allowed to leave.2 The government has also built a 5000 room quarantine facility on the outskirts of Guangzhou to house domestic and international travellers for at least two weeks of quarantine.3

In their paper,1 Gao and colleagues wrote that public health measures for covid-19 could change with the introduction of vaccines in China and elsewhere.

“PCR testing strategies will be adjusted to fit the changing epidemiological situation in China—probably one in which few or fewer non-pharmaceutical interventions will be needed for effective epidemic control,” the authors wrote. “Throughout 2020, PCR testing served the public well, helping to make and keep China nearly free of SARS-CoV-2 and providing socioeconomic space and time for vaccine development and long term prevention and control of covid-19.”

Today, however, China has already fully vaccinated over one billion of a total population of around 1.4 billion people, and some …

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