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Rapid response to:


Covid-19: Hong Kong reports world’s highest death rate as zero covid strategy fails

BMJ 2022; 376 doi: (Published 17 March 2022) Cite this as: BMJ 2022;376:o707

Rapid Response:

Is it time to end China’s “zero covid” policy?

Dear Editor,

China reported 3,602 new cases of covid-19 on March 14, 2021, a record high since the covid-19 epidemic subsided in mainland China; [1] despite this number of new cases per capita remain relative low in comparison with most countries. However, the Chinese government persists in the "zero tolerance" policy. Besides quarantining foreign residents at entry for over one and a half months, domestic residents live under the shadow of a sudden lockdown at any time. [2] Although early on, this insistency on the "zero covid" policy achieved remarkable control on the number of reported daily new cases, it did not stop the spread of the virus, nor did it eradicate covid-19 within the country. Citizens are apprehensive and live in fear because of this policy. [3] A few days ago, the local government quarantined millions of homes of several cities experiencing new cases of covid-19. They placed electronic door sensors on many homes, and authorities accuse people who leave their houses of endangering public safety and threaten collective quarantines. [4] In some border cities, with resident vaccination rates reaching 97%, the city is still under lockdown and intensive testing. One-year-old residents in the city in these areas have been tested 74 times. [5] The government also shows no mercy to animals and has euthanized the pets of quarantined and treated patients. [6]

The Chinese government displayed determination and capability by implementing lockdowns and large-scale testing at the beginning of the pandemic. However, two years into the pandemic, most countries reevaluated lockdown strategies and chose to coexist with covid-19. Still, the Chinese government chooses a policy of full eradication. [7, 8] In the context of global collaborations and exchanges, can this hardline be sustained? This stubborn choice is strengthened by agitating public opinion against scientists who speak against the policy. Organized mobocracy coupled with the laziness of local rulers makes it increasingly difficult to express a contrasting view. We hope that the covid-19 control policy can truly stand on the side of protecting lives and social-economic development, rather than with “political goals and intentions,” leading to the public opinion siege against scholars who suggested coexistence with covid-19.

Zhi Qu[1], Zhong Huang[2,3], Dong Qu[4]

Professional affiliations of the authors:
1 Institute of Epidemiology, Social Medicine, and Health System Research, Hannover Medical School, 30625, Hannover, Germany.
2 Institute of Neuroanatomy and Cell Biology, Hannover Medical School, 30623 Hannover, Germany
3 Center for Systems Neuroscience (ZSN) Hannover, 30559 Hannover, Germany
4 Institute of Legal Medicine, Hannover Medical School, 30625, Hannover, Germany

1 截至3月14日24时新型冠状病毒肺炎疫情最新情况 2022. Available at: Accessed March 18, 2022.
2 Yuan S (2021). China doubles down on COVID-zero strategy. Al Jazeera, 27 October 2021. Available at: Accessed November 15, 2021.
3 Johns Hopkins Coronavirus Resource Center. China - COVID-19 Overview - Johns Hopkins 2021. Available at: Accessed November 15, 2021.
4 GNEWS. The Epidemic in Dalian Is Severe. 400,000 People’s Homes Were Affixed With Seals “Stay at Home” - GNEWS 2021. Available at: Accessed November 15, 2021.
5 Wang V, Dong J (2021). Near-Daily Covid Tests, Sleeping in Classrooms: Life in Covid-Zero China. The New York Times, 5 November 2021. Available at: Accessed November 15, 2021.
6 (2021). Pet cats killed in Chinese city after COVID infection, triggering social media anger. Reuters Media, 29 September 2021. Available at: Accessed November 15, 2021.
7 Foo C de, Grépin KA, Cook AR, et al. Navigating from SARS-CoV-2 elimination to endemicity in Australia, Hong Kong, New Zealand, and Singapore. The Lancet 2021;398(10311):1547–51.
8 Wang V (2021). Why China Is the World’s Last ‘Zero Covid’ Holdout. The New York Times, 27 October 2021. Available at: Accessed November 15, 2021.

Competing interests: No competing interests

18 March 2022
Zhi Qu
Research Scientist
Zhong Huang, Dong Qu
Hannover Medical School
Carl-Neuberg-Straße 1