中国是时候改变“零容忍”防疫政策了

中国是时候改变“零容忍”防疫政策了

It’s Time for China to Change Its Covid Strategy

ILLUSTRATION BY JORDAN AWAN; PHOTOGRAPH BY CATHERINE FALLS COMMERCIAL/GETTY IMAGES
“How lucky I was born in China,” a young Chinese scholar declared last month in his WeChat. He was proud: Following the worst domestic Covid-19 outbreak since Wuhan, China had brought daily new case counts down to a few dozen.
一位年轻的中国学者上个月在微信里说:“生在中国,我真是太幸运了。”他很自豪:国内最严重的新冠疫情在武汉暴发之后,中国已将每天的新增病例数减少到几十个。
The case numbers — when contrasted with the United States, which has less than a quarter of China’s population yet daily average cases above 130,000 — might not seem too concerning on their own. But they illustrate that China’s zero-infections policy is no longer working as designed. At the outset of the pandemic, the policy successfully drove down cases — and was adopted by other countries — but the Delta variant changed the game and shows that this strategy no longer fits. It’s time for China to change tack, as the socioeconomic and public health costs now outweigh the benefits with this highly transmissible new variant. If it doesn’t, China and its people will suffer.
美国的人口不到中国的四分之一,日均病例却超过13万,与之相比,中国的病例数字本身可能并不令人担忧。但它们表明,中国的零感染政策已不再像设计的那样奏效。在疫情暴发之初,这一政策成功地减少了病例——并且被其他国家采用——但德尔塔变种改变了局面,它表明这一策略不再适用。现在是中国改变策略的时候了,因为这种高传染性的新变种带来的社会经济和公共卫生成本现在已经超过了收益。如果不进行改变,中国及其人民将遭受损失。
While other countries were still in the grips of the pandemic, China by early April 2020 had managed to get the virus under control within its territory. It implemented a zero-infections policy, under which the identification of even one local Covid case would trigger draconian measures in order to reset local cases to zero. To fend off imported cases, China imposed some of the world’s toughest international travel restrictions.
在其他国家疫情仍在肆虐的情况下,中国在2020年4月初已经成功地在其境内控制了病毒。它实施了零感染政策,在该政策下,即使在当地发现一个新冠病例,也会触发严厉的措施,以将当地病例重置为零。为了防止输入病例,中国实施了一些世界上最严格的国际旅行限制
China is not the only country to pursue a zero-tolerance approach toward Covid-19. Other countries that did, like New Zealand, are also now seeing less success. But few would dispute that China’s authoritarian government, with unrivaled power and resources, is in a much better position than almost any other nation to quickly eliminate new cases and make the strategy work. So the fact that the policy isn’t working as intended is bad news for China and any other country aiming to fully stamp out the virus in the same manner.
中国不是唯一一个对新冠疫情采取零容忍措施的国家。其他国家,比如新西兰,现在也没那么成功了。但很少有人会提出质疑,中国威权政府拥有无与伦比的权力和资源,几乎比任何其他国家都更有能力迅速消除新的病例,让该战略发挥作用。因此,该政策没有按预期奏效的事实,对中国和任何其他希望以同样方式完全消灭病毒的国家来说都是坏消息。
For more than a year, the policy showed good results. Small and sporadic outbreaks were usually quelled before cases could spread to other regions. Local officials relied on the extreme-measures songbook: They launched mass testing for Covid-19, used QR codes to trace and control people’s movements and rounded up entire neighborhoods for mandatory quarantine.
一年多来,这项政策取得了良好的效果。小范围和零星的疫情通常在疫情蔓延到其他地区之前就被平息了。当地官员依靠极端措施守则:他们启动了大规模新冠检测,使用二维码追踪和控制人们的活动,还围住整个社区进行强制隔离。
Then came the Delta variant. An outbreak that started in Nanjing, in China’s eastern Jiangsu Province, on July 20 quickly spread to at least 17 provinces, causing the worst outbreak since Wuhan. Now more than a month has elapsed since the first Nanjing cases were identified — and the Chinese government still has been unable to completely break the domestic transmission chain. As of Sunday, there were still three intermediate-risk Covid areas nationwide, according to the government’s classification system. In Yangzhou, which became the new outbreak epicenter in Jiangsu Province, residents were prevented from leaving their homes for a month and underwent at least 12 mandatory rounds of nucleic acid testing.
然后德尔塔变种出现了。7月20日,始于中国东部江苏省南京的疫情迅速蔓延到至少17个省份,这造成了自武汉以来最严重的疫情。目前,南京首例确诊病例已过去一个多月,而中国政府仍未能完全打破国内的传播链。根据政府的分类系统,截至上周日,全国仍有三个新冠中风险地区。在江苏的新冠疫情中心扬州,居民被禁止离家一个月,并接受了至少12轮强制性核酸检测
The failure of such high-profile and high-powered measures to bring a speedy end to this outbreak highlights the diminishing returns of the zero-tolerance approach.
这些高调和强有力的措施未能迅速结束这场疫情,凸显出零容忍做法的收益递减。
There also are signs that approach is becoming counterproductive: Some 10 percent of the cases in Yangzhou were traced to a site for Covid testing.
也有迹象表明,这种做法正在产生适得其反的效果:扬州大约10%的病例感染源锁定在一个进行新冠检测的站点。
There are worrying long-term secondary effects, as well. Increased absenteeism, drops in employee productivity and disruption to supply chains threaten overall economic growth in China. Newly released data from the National Bureau of Statistics suggest that strict lockdown measures during the recent Delta variant outbreak have contributed to a slowdown in the Chinese economy, sending nonmanufacturing activity into contractionary territory for the first time since February 2020.
还有令人担忧的长期副作用。旷工率上升、员工生产率下降和供应链中断威胁着中国的整体经济增长。国家统计局最新发布的数据显示,最近德尔塔变种疫情期间的严格封锁措施导致中国经济放缓,非制造业活动自2020年2月以来首次进入收缩范围。
Some Chinese health experts have begun to question the zero-tolerance strategy, though the government has not looked kindly upon it. A teacher in Jiangxi Province was detained for 15 days in August for suggesting that Yangzhou experiment with a different approach to epidemic control. Dr. Zhang Wenhong — dubbed China’s own Dr. Anthony S. Fauci — said China should learn to coexist with the virus, though later backtracked.
一些中国卫生专家已经开始质疑这种零容忍策略,尽管政府对此不以为然。江西省一名教师在8月被拘留15天,原因是他建议扬州尝试一种不同的方法来控制疫情。被称为中国的安东尼·S·福奇(Anthony S. Fauci)的张文宏曾说中国应该学会与病毒共存,尽管后来他又改口了。
One rationale for sustaining the existing approach has been to buy time for China to reach herd immunity through vaccination. Delta makes this argument irrelevant. Zhong Nanshan, a top public health adviser, said China can achieve herd immunity with around an 80 percent vaccination rate. But he appears to have used an unrealistically high efficacy rate for Chinese vaccines. Based on my calculations, reaching herd immunity is not possible with the existing vaccine regimen in China. It’s likely there will continue to be some cases, though vaccination can still prevent the most severe impacts of the disease. It’s no wonder, then, that a senior official with China’s C.D.C. admitted that the country could continue to experience outbreaks even after reaching 80 percent vaccination.
维持现有方法的一个理由是,为中国通过接种疫苗实现群体免疫争取时间。德尔塔变种使这个论点变得无关紧要。公共卫生高级顾问钟南山表示,中国可以通过大约80%的疫苗接种率实现群体免疫。但他似乎对中国疫苗有效率有着高到不切实际的估计。根据我的计算,在中国现有的疫苗方案下,达到群体免疫是不可能的。尽管疫苗接种仍然可以预防该疾病最严重的影响,但仍有可能继续出现一些病例。因此,难怪中国疾控中心的一名高级官员承认,即使在达到80%的疫苗接种率之后,中国仍可能继续暴发疫情。
But sticking with the current approach would transform China into a hermit nation that could be dangerous. If there are low levels of natural immunity and vaccines are less effective at protecting against new variants of the virus, then reaching zero infections will not be possible as the country opens up.
而坚持当前的做法将把中国变成一个封闭国家,这可能是危险的。如果自然免疫水平较低,且疫苗对新变种病毒的保护效果较差,那么随着中国的开放,实现零感染将是不可能的。
China can’t afford to keep its borders closed forever. And the pandemic is not over. Given the still-low and unequal coverage of Covid vaccines worldwide and the rampant spread of the Delta variant, this pandemic may last another two years or more.
中国承担不起永远关闭边境的代价。疫情还没有结束。鉴于全球范围内新冠疫苗覆盖率仍然较低和不均衡,以及德尔塔变种的猖獗传播,此次大流行可能还会持续两年或更长时间。
Other governments already have shifted to policies aimed at “living with,” not eradicating, Covid-19. Singapore turned to a strategy of phased and contingent reopening backed by mass vaccination. Even Australia, arguably the most zealous liberal democracy in pursuing a zero-tolerance strategy, now has proposed a road map to reopen. China would be wise to take heed and pivot. A strategy focused on preventing severe cases and deaths and administering vaccines with high efficacy would be in China’s best interest, both in the short and long term.
其他国家政府已经转向旨在“共存”而不是根除新冠病毒的政策。新加坡转而采取大规模疫苗支持下的分阶段和临时性重新开放的策略。就连澳大利亚这个可以说最热衷于追求零容忍战略的自由民主国家,现在也提出了重新开放的路线图。中国明智的做法是注意到这一点并做出调整。专注于预防重症和死亡并接种高效疫苗的战略,无论从短期还是长期来看,都最符合中国的利益。

黄严忠(Yanzhong Huang)是美国外交关系委员会全球健康高级研究员、西东大学(Seton Hall University)外交与国际关系学院教授,著有《有毒政治:中国的环境健康危机及其对中国的挑战》一书。

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