Covid Lockdown In China

Shanghai announced Saturday that it will allow businesses in all sectors to resume operation starting on June 1 and released a package of supportive policies to reboot local economy as the city’s worst-ever Covid-19 outbreak has been largely contained after two months of strict lockdown.

However, as of Monday, the local government has not yet fully lifted restrictions to allow people to freely commute between their communities and workplaces, and public transport services have also not been completely resumed.

Local authorities have said that, starting on Wednesday, all sectors including small and medium businesses can restart their operations without the need to seek government approval. Major industries have been gradually resuming their operations with approval from the government since early May.

The financial hub also aims to reboot its local economy, which was devastated during the lockdown, with a package of 50 measures including tax relief, rent reduction and exemption, as well as support for exporters and foreign investors.

But residents across the megacity of 25 million are not yet been allowed to move freely. According to a notice posted on social media, residents in the Pudong New Area town of Gaoqiao could only move around within the premises of the township on Monday and Tuesday. In a community in the central district of Jingan, residents must show proof of a negative nucleic acid test result before going out.

In mid-May, Shanghai announced its three-phase plan for businesses to fully reopen and life to return to “normal” by the end of June after all the city’s 15 districts have achieved the goal of no community spread — meaning no new cases were found among residents who weren’t already in quarantine — for the past three days.

A notice posted on social media says residents in the Pudong New Area town of Gaoqiao are only allowed to move around within the premises of the township on May 30 and 31. Photo: Social media

Contact reporter Lu Zhenhua (zhenhualu@caixin.com) editor Michael Bellart (michaelbellart@caixin.com)

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After a grueling six-hour walk, Chen Peng finally arrived at the vicinity of the Shanghai Hongqiao Railway Station early Thursday morning, only to discover a queue stretching for nearly 2 kilometers of travelers waiting to enter the station.

The railway station is a key transport hub for intercity travel, for leaving and arriving in Shanghai. With the city easing lockdowns, many had flocked to the station to proceed with travel plans that were hijacked by Covid restrictions.

Although Chen had endured a long morning, the long queue did not deter him. “I’ve thought of giving up several times, but I told myself (I) must leave Shanghai, (I) can’t stop … This motivated me to pursue heading to my destination,” Chen said.

People walk to Hongqiao Railway Station on May 19. Photo: Courtesy of interviewees

After grabbing a bite by the roadside, Chen collected himself and joined the queue, where he waited another two hours.

Like Chen, Shanghai’s two-month lockdown had been the stuff of nightmares, and the move toward a full reopening plan have galvanized many to push ahead with the travel plans at all cost, whether it is to reunite with their families or go to other cities for work.

Paying a premium

Pan Ziying’s university entered a lockdown on March 13 and students were barred from leaving campus. On April 4, the university escalated the restriction asking Pan and others to stay at their dormitory. The students couldn’t use delivery or takeaway services too. Thus, Pan had to survive on boxed meals delivered by volunteers, the student told Caixin.

“I had nightmares of hiding from zombies, vampires, and taking refuge in a subway station, but I had never imagined that I would eat boxed meals in a room for two months,” said Pan.

On May 10, Pan saw light at the end of the tunnel, when the university announced that students were allowed to leave Shanghai. She then decided to return to her hometown in Nanjing, East China’s Jiangsu province. But getting a train ticket became her next challenge, as seats were limited and sold out within seconds after going on sale.

People wait to be released at the first checkpoint on May 19. Photo: Courtesy of interviewees

In the end, Pan had to pay a premium for a ticket through a travel agent — an additional 100 yuan ($15). She also had to take an unlicensed car to Hongqiao station, where she and other passengers paid a total of 1,100 yuan to the driver.

Spending the night in a converted parking lot

Unlike Pan, there are those who failed to leave Shanghai. Zhao Yang was due to leave the city on May 16, but he missed his train. One major reason was that he wasn’t able to complete the procedures required to enter Hongqiao station in time.

Zhao told Caixin the train he planned to get on was meant to depart at 12:07 p.m. Even though he got to Hongqiao station an hour before time, he did not foresee the long line of travelers waiting to get their Covid test results checked, before entering the station.

Zhao was one of about two dozen people who failed to catch up the train that day, he said. He was later taken to a makeshift facility converted from a parking lot, where no beds were provided.

Despite the discomfort, Zhao said he slept, while some others sat up all night.

Passengers stranded at a railway station in Shanghai gather at a makshift waiting area converted from a parking lot on May 16. Photo: Courtesy of interviewees

When asked about how the others with him were stranded, Zhao said they missed the train for various reasons. “Some people’s (negative) test results had expired, some hadn’t been able to get their new test results, some experienced incidents on the way (to the station), and others, like me, missed the train’s departure time.”

“It’s not easy for everyone to get here,” he said.

Contact reporter Wang Xintong (xintongwang@caixin.com) and editor Bertrand Teo (bertrandteo@caixin.com)

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Shanghai is removing metal barriers around the city used to seal off streets and entrances to residential buildings as the largest city in China eases pandemic restrictions after Covid-related lockdowns lasting more than a month and a half.

Public transportation will resume Sunday, starting with four of the city’s 20 subway lines and 273 bus routes, basically covering all of the major districts, airports, train stations and hospitals in the city, an official said Thursday at a press conference. The government is studying plans to allow private vehicles and taxis back on road, the official said.

Since April 22, metal barriers primarily made from mesh fencing or thin sheets of metal were put up around the city to block streets and entrances to apartment complexes where Covid-19 cases were reported. The move drew criticism that the barriers posed fire hazards.

Several districts recently issued notices to remove road barriers to resume normal production and living, Caixin learned. Reporters saw that many metal fences in the Pudong district were demolished, and workers said they would remove all remaining fences in the next few days.

Meanwhile, small and medium-sized enterprises (SMEs) in Shanghai still face difficulties reopening. Only a small number of companies have resumed operation as many don’t meet pandemic prevention requirements, Deputy Mayor Zhang Wei said at the press conference.

The SMEs' resumption rate, which includes offline and online activities, is about 65%, lower than that of large corporations, said Wu Jincheng, director of the Shanghai Commission of Economy and Informatization.

Catering, entertainment and logistics companies are among those hit hard by the epidemic, Wu said.

Now through the end of May, reopened companies are required to operate under closed-loop or half closed-loop systems, in which workers sleep on site, Zhang said. In areas where no Covid cases are reported, eligible companies are allowed to provide shuttles for employees to commute between work and home. Starting in June, normal transportation between companies and residential communities in areas without epidemic risks will resume, Zhang said.

Shanghai reported 671 new cases and one death Wednesday, down 16% from the previous day, according to the local health authorities.

Contact reporter Denise Jia (huijuanjia@caixin.com) and editor Bob Simison (bob.simison@caixin.com)

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What’s new: Shanghai announced Tuesday that it has achieved the goal of no community spread in all of its 16 districts, a key milestone in its over two-month battle with Covid that could embolden authorities to further ease restrictions.

The city hit the milestone three days before the target of Friday. This means all of the city’s new cases in the past three days were found among those in centralized quarantine or confined to their homes.

Zhao Dandan, deputy director of the Shanghai Municipal Health Commission, made the announcement at a press conference, while saying some 860,000 residents are currently stuck at home. The financial hub has struggled to contain its worst ever Covid-19 outbreak, reporting 823 local infections Monday, all in quarantine, local authorities said.

The background: The announcement came just a day after the city authorities said they had laid out a three-phase plan to gradually lift restrictions by the end of June, including a weeks-long lockdown which has triggered discontent among residents.

On Monday, local authorities said 15 of the city’s 16 districts had stamped out community spread.

Quick Takes are condensed versions of China-related stories for fast news you can use.

Contact reporter Wang Xintong (xintongwang@caixin.com) and editor Lu Zhenhua (zhenhualu@caixin.com)

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What’s new: Postal and courier services in Shanghai have slowly resumed to one-sixth of normal capacity as the city gradually eases Covid restrictions after more than a month of lockdowns.

Average daily delivery volume in the city reached 1 million parcels, and most courier companies were allowed to resume operations, including China Post, SF Express, Cainiao, JD Logistics, UPS and FedEx., an official at the Shanghai Postal Administration said Thursday.

Sixteen parcel distribution centers in the city resumed operations, with five more to follow soon, said Yu Hongwei, deputy director of the Postal Administration. The city will soon issue a second list allowing more postal and courier companies to resume operations, Yu said.

The context: Delivery disruptions caused by strict virus control measures sparked public outcries in the city of 25 million as people faced difficulties accessing daily necessities during the month-long lockdown.

On May 8, the municipal government listed 21 major delivery and logistics operations that were cleared to resume services as the city gradually pushes toward reopening.

Shanghai residents interviewed by Caixin said services resumed at major e-commerce sites, but delivery schedules remained uncertain.

“Some consumers might still be frustrated since there are still bottlenecks and difficulties," Yu said.

Quick Takes are condensed versions of China-related stories for fast news you can use.

Contact reporter Han Wei (weihan@caixin.com) and editor Bob Simison (bob.simison@caixin.com)

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The patient was delirious and vomiting, but Lin Mao and her fellow emergency room doctors were terrified of treating him.

The 67-year-old had tested positive for Covid-19 and was waiting for another test to determine whether it was a false positive, clearing him for admission to their hospital in Shanghai.

Lin feared the repercussions of overriding Covid rules to treat the man, even though his “situation was critical” she told Caixin.

Lin ended up treating him in the lobby as the hospital’s Covid-19 isolation ward was full. But it was too late, Lin told Caixin. He died.

Lin’s story was just one example of the struggle faced by local hospitals to find a balance between saving critically ill patients and reducing the risk of infection among their staff.

Shanghai, grappling since the beginning of March with what has become China’s worst Covid-19 outbreak since early 2020, has seen medical workers, including those in its emergency departments, come down with the virus.

Such cases have prompted local hospitals to implement regular control measures, such as closing their emergency departments to be disinfected. Although these measures, triggered by concern over hospital infections, have affected all kinds of patients, the risk they have posed to critically ill patients has been especially hard to square with the need to save lives in emergencies.

China had 7.8 million hospital medical workers and 3.8 billion patient admissions to outpatient and emergency wards in 2019, according to the National Health Commission.

The balancing act taking place across Shanghai this spring offers a glimpse at what hospitals elsewhere could face if local officials can’t prevent Covid from spiraling out of control, with medical staff and the patients they treat caught between strict pandemic controls and their side effects — which are sometimes calamitous.

Delay in treatment

Caixin has reported how some patients, such as those experiencing acute life-threatening symptoms or suffering from advanced cancer, have been denied admission into hospitals due to Covid restrictions. A few have died following a delay in treatment.

However, some patients have found that even after getting admitted, they’re unable to get treatment due to concerns that the virus will spread throughout the hospital, or even a lack of beds and staff resources.

After Sun Yu, a Shanghai resident, took her mother to Shanghai Seventh People’s Hospital on April 13, doctors determined that the older woman was suffering from kidney disease and in urgent need of dialysis, but didn’t treat her, Sun told Caixin. Instead, the hospital asked her to seek treatment elsewhere as its nephrology ward was being used to treat Covid patients.

Sun and her mother went to another hospital and were asked to go to its emergency department, where they slept in the lobby as no hospital beds were available. In the week they stayed there, her mother didn’t receive a single dialysis session, leaving her with shaky limbs and unable to walk, Sun said.

Nurses said the delay in treatment was caused by a lack of staff as many were treating Covid patients in the emergency department, according to Sun. The department couldn’t bring in additional staff due to concerns that newcomers would get infected, she said.

A patient receives treatment in the emergency room of Shanghai Oriental Hospital on April 20. Photo: Bao Zhiming/Caixin

Rising risk of infection

A hospital doctor told Caixin that some medical staff in Puxi, the part of central Shanghai west of the Huangpu River, have been infected. Caixin learned that hospitals outside that area have also reported cases.

Amid a rise in hospital infections, emergency departments have come under the spotlight as many of them — not designated for Covid patients — are admitting patients with and without the virus and are involved in patient transfers.

One hospital staff member told Caixin that an outbreak occurred at work after the virus “broke through the defenses” of the emergency department. “(The virus) was spreading too fast,” she said.

One major reason for the infections was that protective gear couldn’t keep medical workers safe, according to the above-mentioned doctor.

Emergency department staff were provided with N95 masks, face shields and protective clothing, according to a government statement. But the highly contagious omicron variant could still breach these, and the cost of upgrades was too high to be workable, the doctor said.

Lin was among those experiencing kit issues. When she treated the critical patient on April 11, sweat soaked through her protective clothing and for over six hours she couldn’t change, Lin said.

In such conditions, the risk of Covid-19 infection would likely have increased. Jiang Ning, a doctor with the Shanghai branch of the Chinese Center for Disease Control and Prevention, said at a press conference on May 4 that protective gear should not be used for more than four hours in a row. And it should be taken off as soon as there are signs of contamination or damage, Jiang noted.

Notwithstanding other factors, lifesaving itself can put doctors at risk of infection.

A doctor from Shanghai East Hospital told Caixin that procedures involved in saving a patient often generate large amounts of aerosols — tiny solid particles or liquid droplets in the air — and these can quickly spread Covid to those nearby if the patient carries the virus.

As in most cases doctors can’t avoid close contact with patients, “the risk of infection is hard to control,” the doctor said.

On May 5, Zhongshan Hospital of Fudan University resumed all types of outpatient and emergency services. Photo: VCG

Testing managerial capabilities

To prevent the virus from spreading, some hospitals’ emergency departments have closed after finding one or more cases.

Others have stayed open, no matter the cost. A doctor in Pudong New Area told Caixin his hospital’s emergency department remained open, while Covid cases had been found across the hospital.

As emergency departments are vital for critical patients, how to reduce the risk of infection among hospital staff has become a key issue for ensuring access to treatment.

Lu Xiao, deputy chief physician of the emergency department of Zhejiang University School of Medicine’s Second Affiliated Hospital, suggested using rapid antigen testing to determine whether a patient should be admitted. China’s “zero-Covid” policy currently requires patients to have a negative nucleic acid test result within 48 or 24 hours of hospital admission.

Although antigen testing has a 5% to 10% chance of returning a false positive, it is effective at filtering out Covid patients in emergency departments, Lu said.

Patients could take successive antigen tests at home, on the way to the hospital and upon arrival to reduce errors and screen out real Covid sufferers from those with false positives, a Puxi doctor said.

This was echoed by Lin, who said that if critical patients spend too long waiting for a nucleic acid test result, they could miss their optimal treatment window.

And in response to some hospitals facing a lack of resources, Li Shaodong, former deputy director with Jiangsu Commission of Health, said that “China’s existing medical resources are fully capable of meeting the demand for emergency medical care in the pandemic.”

However, “whether the resources can be reasonably utilized tests the organizational and managerial capabilities of authorities and health administrators at all levels,” he noted.

Lin Mao and Sun Yu in this article are pseudonyms.

Contact reporter Wang Xintong (xintongwang@caixin.com) and editor Heather Mowbray (heathermowbray@caixin.com)

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Shanghai has relaxed lockdown conditions in six districts since Sunday, amid a decline in the financial hub’s daily local infections over the past few days.

Gu Honghui, Shanghai’s deputy secretary-general, told a Sunday press conference that residents in the districts of Jinshan, Fengxian, Chongming, Qingpu, and Songjiang can move freely inside their district, which means residents can visit grocery stores and hospitals, as well as take public transportation. The five districts are non-downtown districts that have reached zero-Covid status at the community level.

A sixth district, Putuo, also met the zero-Covid status target, but there are limitations as Putuo is considered a downtown district. While residents can roam around their neighborhood, they are only allowed to visit designated shops.

Attaining zero-Covid means a district has not reported any new infection cases for three consecutive days.

Over the past week, Shanghai’s local infection plunged from 16,980 cases on April 25 to 7,333 cases on Sunday. As of Sunday, its daily infection case has stayed below the threshold of 10,000 for two consecutive days, and the daily asymptomatic total has also been under the threshold for five straight days.

The municipality government categorizes the city into three types of areas based on varying levels of risk from Covid. First, for communities that have reported Covid cases in the past seven days, residents will be barred from leaving their homes. Second, residents in communities with no reported infections in the past week will no longer be confined to their homes, but they can’t leave their communities. Third, residents in compounds with no Covid cases detected in the past 14 days can move about more freely, but must adhere to social distancing rules.

Beyond the six districts, residents in communities in the lowest-risk areas — no Covid-cases detected in the past 14 days — can visit grocery stores or pharmacies in designated time periods.

As of April 30, about 1.5 million Shanghai residents are classified as residing in the lowest-risk areas and will see an easing of restrictions, Gu added.

A Songjiang resident told Caixin that her residential community has distributed passes to each family to allow one member to go outside of the community once per day.

But for residents in other two types of risk areas, which have reported Covid cases in the past seven to 14 days, the lockdown policy remains the same. As of April 30, more than 9 million people live in these areas, according to Gu.

Since Sunday, Shanghai has been setting up daily nucleic acid testing sites across the city as the municipal government is pushing key businesses and enterprises to resume operations. As of April 30, the government has listed 1,854 companies for reopening under strict Covid-control measures. Most of the companies are from automotive, medical, semiconductor, and new chemical material sectors.

An industry insider told Caixin that more enterprises will be allowed to restart production after the Labor Day break, which lasts from April 30 to May 4.

Industrial output in Shanghai slumped 7.5% year-on-year in March, the first monthly decline in two years, after stringent lockdown measures halted production in most factories, Wu Jincheng, chairman of Shanghai’s economic planning agency, said at a previous news conference. Shanghai is responsible for 3.8% of China’s GDP.

 Read more  
Cover Story: Shanghai’s Rocky Road to Rebooting

Contact reporter Manyun Zou (manyunzou@caixin.com) and editor Bertrand Teo (bertrandteo@caixin.com)

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