COVID-19 pandemic in mainland China
The COVID-19 pandemic in mainland China is part of the worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). China was where the first COVID outbreak occurred, the first where authorities imposed drastic measures in response (including lockdowns and face mask mandates), and was one of the first countries to bring the outbreak under control, at least temporarily.
The 2019–2020 COVID-19 outbreak in mainland China was the first wave of the disease, and was first manifested as a cluster of mysterious pneumonia cases, mostly related to the Huanan Seafood Market, in Wuhan, the capital of Hubei province. It was first reported to the local government on 27 December 2019 and published on 31 December. On 8 January 2020, a new coronavirus (SARS-CoV-2) was identified as the cause of the pneumonia by Chinese scientists.[5] By 29 January, the virus was found to have spread to all provinces of mainland China.[6][7][8]
By late February, the pandemic had been brought under control in most Chinese provinces. On 25 February, the reported number of newly confirmed cases outside mainland China exceeded those reported from within for the first time.[9] By mid-2020, widespread community transmission in China had been ended, and restrictions were significantly eased.[10]
Until late 2022, the Chinese government response included a zero-COVID strategy, which aims to eliminate transmission of the virus within the country and allow resumption of normal economic and social activity, making it one of few countries to pursue this approach.[11] By late 2020, China's economy continued to broaden recovery from the recession during the pandemic, with stable job creation and record international trade growth, although retail consumption was still slower than predicted.[12][13]
Infection rates increased in 2022, and on 3 April of that year, China reported 13,146 new cases of COVID-19 in the past 24 hours, which was the highest single-day total of new cases since the height of the 2020 outbreak.[14] Following nationwide protests in November and December of that year, the Chinese government relaxed many of its previous restrictions, effectively ending the zero-COVID policy and leading to a massive surge in cases.[15]
April 2020–December 2021
2020
On 2 April 2020, the government ordered a Hubei-like lockdown in Jia County, Henan, after a woman tested positive for the COVID-19. It is suspected that she may have been infected when she visited a hospital where three doctors tested positive for the virus, despite showing no symptoms.[70]
On 9 April, a COVID-19 cluster was detected in Heilongjiang Province, which started with an asymptomatic patient returning from the United States and quarantining at home. The US CDC reported that the infections were initially spread through a shared elevator used at different times, and led to at least 71 cases by 22 April.[71]
In early May, restrictions were tightened in Harbin.[72]
In June, an outbreak with 45 people testing positive at Xinfadi Market in Beijing caused some alarm.[73] Authorities closed the market and nearby schools; eleven neighborhoods in the Fengtai District started requiring temperature checks and were closed to visitors.[74] By this time, public health technology included special leaf blower backpacks designed to vent hot air onto outdoor surfaces.[75] By the evening of 23 June, Chinese Vice Premier Sun Chunlan declared that the situation had been brought under control.[76] China's traffic authorities vowed to strictly guard traffic out of Beijing: those with abnormal health QR codes or without recently-taken negative PCR test proof would not be allowed to take public transportation or drive out of the capital.[77][78][79]
On 26 July, China saw its highest number of daily cases since March, mostly from outbreaks in Xinjiang and Liaoning.[80] with 61 new cases, up from 46 cases a day earlier,[81] This increased to 127 daily COVID cases on 30 July.[82] The daily reported cases subsequently went down, to 16 on 23 August.[83]
In July, Xinjiang province and its capital Ürümqi were locked down in the wake of the discovery of new cases in the city.[84][85]
On 11 October, officials in Qingdao urged to carry out contact tracing and mass testing after 12 new cases were found connected to the Qingdao Chest Hospital. On 12 October, it was announced that Qingdao would test all 9 million of its residents.[86]
In October, 137 asymptomatic cases were detected in Kashgar, Xinjiang and were linked to a garment factory.[87][88]
On 18 December, a local case was reported in Beijing. It was the first local infection in 152 days in Beijing. As of 27 December, thirteen more cases have been detected.[89] Another outbreak linked to a traveler from South Korea was reported in Liaoning late December.
2021
In January 2021, many cities and districts in the province of Hebei, Jilin and Heilongjiang were put into lockdown to contain a new outbreak in the region.[90]
On 7 January, Dalian authorities reported 51 confirmed COVID-19 cases and 31 asymptomatic carriers.[91]
On 6 January, after reporting 63 new cases in the northern province of Hebei, of which 20 were infections and 43 asymptomatic cases locally transmitted, the local Government decided to lockdown the provincial capital city of Shijiazhuang, as most of the cases were detected there. On 9 January, the cities of Shijiazhuang and Xingtai with total population of 19 million, were placed under lockdown measures, with passenger trains suspended, as well as flights and coach service to Beijing at 300 km distance in north east direction.[92]
On 14 January, Wangkui County of Suihua City, Heilongjiang Province moved into lockdown after reporting 40 confirmed COVID-19 cases. The virus sample taken from the cases in Suihua is reported to be similar to the strain identified in Dalian.[93]
Also on 14 January, China reported the first death from the virus after eight months, a patient from Hebei. A team of experts from the WHO visited Wuhan to conduct investigations into the origin of the pandemic. They were also supposed to quarantine for two weeks prior to starting their inquiry.[94] On 15 January, the city of Langfang of Hebei was put into lockdown.[95]
By 18 January 11 regions in China were under de facto lockdown, including five districts in Heilongjiang and the cities of Gongzhuling and Tonghua in Jilin province.[96] On 20 January, residents of Daxing District of Beijing were banned from leaving the capital region.[97][98]
On 4 April, China saw the largest number of reported COVID-19 cases in over two months, with 15 new reported cases of local transmission in the city of Ruili on the Burmese border.[99] This followed a previous outbreak in Ruili in September 2020.[100] Unauthorized border crossings from Myanmar remain a concern, and the local government has started vaccinating Ruili residents to work towards herd immunity.[99]
On 29 May, authorities shut down some streets in Liwan District in Guangzhou due to an outbreak in Guangdong province.[101] Foshan's Shadi Airport has cancelled all flights and suspended operations from 12 June.[102]
On 6 June, Ruili was again put into lockdown after three local infections associated with the Delta variant.[103]
On 10 July, it was reported that the new outbreak has spread to 13 cities in five provinces including the capital Beijing. The cases were linked to cleaners who worked on a flight from Russia that arrived in Nanjing on 10 July 2021 who did not follow strict hygiene measures. Officials added that the highly contagious Delta variant of the virus was behind these new infections and there are worries about whether the Chinese vaccines would work against the Delta variant.[104]
On 21 July, another local cluster was identified in Nanjing after 17 airport workers have tested positive during a routine check up.[105] By 2 August, the outbreak, caused by fast-spreading Delta variant, has reached more than 20 cities. Zhuzhou, Zhangjiajie and Yangzhou were forced into lockdowns.[106] Some flights, trains and buses to Beijing have been cancelled to guard the capital against the new surge.[107]
On 11 September, another cluster of infections was found in Xianyou county of Putian, Fujian province.[108] Multiple clusters have also emerged in Bayan county of Harbin, Heilongjiang, the source of infections remains unclear.[109]
On 23 October, China reported the highest number of new cases since the September outbreak in Fujian, with domestic infections reported in Ejin Banner of Inner Mongolia and in Lanzhou, Gansu and new cases reported in Beijing, Ningxia, Jiangxi and Yunnan. Another outbreak by imported case was reported in the northern border town of Heihe, Heilongjiang province.[110]
On 26 October, the city of Lanzhou was put into lockdown after six new cases were detected.[111]
In early November, Dalian reported more than 80 cases of COVID-19, the first of which occurred in a warehouse worker in the Zhuanghe district of the city on 4 November. In response, on 8 November local authorities ordered all businesses handling imported chilled and frozen foods to suspend operations.[112]
In mid-December, the outbreak in the cities of Ningbo, Shaoxing and Hangzhou was developing at a "relatively rapid" speed, forcing closure of flights and venues.[113] The outbreak began to subside from mid December, with Hangzhou resuming low-risk status as of 21 December.[114]
On 22 December, the border city of Dongxing next to Vietnam has ordered residents to stay at home due to one COVID-19 case.[115] The strict measures resulted in severe backlog of trucks at the border crossings and disrupted trade, prompting the Vietnam government to complain.[116]
From 23 December 2021, the city of Xi'an with 13 million people was put into strict lockdown after local authorities reported more than 250 cases,[117] traced to the Delta variant by authorities.[114] The lockdown led to stressed healthcare and delayed or insufficient food deliveries to some parts of the city.[118]
On 26 December 155 domestically transmitted cases with confirmed symptoms were reported from Xi'an, contributing the largest part to the countrywide highest daily count since the outbreak in Wuhan, of 158 cases.[119] The city was placed into strict lockdown until 24 January 2022.
The city of Ruili bordering Myanmar was reported to have endured four lockdowns with 200 days in total in 2021.[120]
December 2022–January 2023 surge
Following the rapid scaling down of stringent zero-COVID restrictions, Beijing reported a surge in COVID-19 infections.[224][225] The Chinese central government's reported death statistics only include cases in which COVID-19 directly caused respiratory failure, which led to skepticism by health experts of the government's total death count.[226][227] Restaurants and food delivery services were reported to have closed due to too many workers being infected and pharmacies have been emptied of medicine and disinfectant solution.[228]
On December 10, reports of Covid surges in smaller towns across China have attracted nationwide attention. In Dazhou and Baoding, locals said that clinics are seeing an overflow in patients.[229] The Central Economic Work Conference, a key economic policy meeting, was subsequently postponed due to the spike in infections.[230] On 15 December, the National Health Commission has stopped reporting asymptomatic cases as it was "impossible to accurately grasp" the actual number of asymptomatic infections.[231]
On 20 December, the Chinese State Council narrowed its definition of what would be counted as a COVID-19 death, specifying that only deaths caused by pneumonia and respiratory failure would count toward the total number of fatalities resulting from SARS-CoV-2. This decision came as long lines of hearses appeared outside of crematoriums throughout China and medical students at universities nationwide protested for better pay and increased protections at overcrowded hospitals.[232][233]
On 22 December, a report by UK research firm Airfinity modelling based on regional Chinese data estimated that more than 5,000 people are probably dying each day from COVID-19 in China, with cases rising fastest in Beijing and Guangdong province.[234] Internal minutes from a meeting of China's National Health Commission held on 21 December revealed that as many as 248 million people in China might have contracted COVID-19 over the first 20 days of December and nearly 37 million people may have been infected on a single day.[235]
On 23 December, Qingdao's municipal health chief Bo Tao has been quoted in a news report that the city was seeing "between 490,000 and 530,000" new infections each day. On the same day, Dongguan's health commission declared on its Weixin account that the city had 250,000 to 300,000 people being infected every day.[236] Officials in Yulin, a city of 3.6 million people in Shaanxi province, logged 157,000 new infections with models estimating more than a third of the city's population had already been infected.[237]
On 25 December, the National Health Commission announced that it would no longer report daily COVID-19 figures.[238] Zhejiang provincial government said it is battling around a million new infections a day and expected the number to be doubling in days ahead.[239]
A New York Times report on 27 December shown patients in gurneys crammed into corridors in Tianjin's Medical University General Hospital. The report also highlighted a shortage of medicines and a staffing crisis in hospitals in several major cities.[240] As China reopened in December 2022, an analysis of obituaries by the Times also found that retired Chinese scientists and scholars had begun to pass away at higher rates than would normally be expected, adding to speculation that deaths had been undercounted.[241]
On 30 December, the World Health Organization asked the National Health Commission and the National Disease Control and Prevention Administration to share more data about its surge of cases, as some countries began to require negative COVID-19 tests for Chinese travelers amid fears of new variants of concern. The WHO also invited Chinese health authorities to share "detailed data on viral sequencing" ahead of a 3 January advisory meeting.[242]
On 3 January 2023, the People's Daily reported that up to 70% of Shanghai's population has been infected. In Ruijin Hospital, the volume of patients in the emergency unit has doubled to 1,600 people per day, 80% of them being Covid-related.[243] Reports emerged of hospitals in the city being overcrowded and funeral homes inundated with mourners.[244]
In a 4 January media briefing, Director Tedros Ghebreyesus of the World Health Organization stated that Chinese hospitalization and mortality data lacked transparency and timeliness, while reiterating the importance of viral sequencing during the outbreak and continued vaccination efforts.[245][246]
As of 6 January 2023, the infection rate of Henan province had reached 89 percent, according to Kan Quancheng, director of the province's health commission. This percentage of infections meant that roughly 88.5 million people had contracted COVID-19 within just one month of the country's reopening, though Kan noted that visits to fever clinics in the province had peaked on 19 December.[247]
On 11 January, infections had reached 64 percent of China's population, or 900 million people, according to a Peking University study which further specified that the largely rural provinces of Gansu, Yunnan, and Qinghai had infection rates of 90%, 84%, and 80%, respectively. Earlier in January, the Chinese CDC began to focus efforts on protecting less-developed regions of the country ahead of Chunyun, the world's largest annual migration, with roughly two billion trips expected around Chinese New Year, many taking place to and from the Chinese countryside.[248] Travellers were urged not to visit their elderly relatives to prevent them becoming infected.[249]
On 14 January, the Chinese National Health Commission reported 59,938 COVID-related deaths from 8 December 2022 to 12 January 2023, following complaints that it was withholding data. The figure includes 5,503 people who died of respiratory failure caused by COVID and 54,435 fatalities linked to other underlying illnesses. Up until this data disclosure, the official death toll in China had previously only totaled 5,241 people for the entirety of the pandemic.[250] Reuters reported that doctors were discouraged by hospital authorities from citing COVID-19 on death certificates.[251]
On 21 January, the Chinese CDC estimates that as many as 80% of people have been infected, hence the possibility of a rebound in cases in the next two or three months is low.[3] On 22 January, it reported nearly 13,000 COVID-related deaths in hospitals between 13 and 19 January.[252]
On 25 January, the Chinese CDC released data showing the infection wave had been past its peak, with severe cases and deaths in hospitals down almost 90 per cent since infection peak . During the peak, there were 128,000 critically ill COVID patients in Chinese hospitals on 5 January and the number of deaths in hospitals reached their highest point of 4,273 cases on 4 January.[253]
On 30 March, Chinese authorities announced a plan of random spot checks to be conducted at health facilities throughout the country in order to determine the future accuracy of local COVID data reporting amid global calls for more transparency during the winter surge.[254]
Zhejiang provincial data, reported on in July 2023, showed a 70% increase in cremations during the first three months of 2023, an increase of 99,000 cremations compared to the first quarter of 2022. This data was subsequently taken down from public sources.[255]
On 14 April, Chinese official data indicated that COVID-19 positivity rate went up slightly in early April, but specialists noted that it's "unlikely" China will see another wave of large-scale infections. Authorities have dropped mandatory mask requirements when using public transport, signaling the end of the pandemic according to CCDC epidemiologist Wu Zunyou.[256]
On 22 May, leading Chinese pulmonologist Zhong Nanshan contradicted earlier predictions and noted that the first major wave of infections following the reopening surge was beginning to build, with 65 million cases per week expected by the end of June. Zhong noted that China would soon release specific vaccines tailored toward the XBB Omicron subvariants, which were likely driving the latest wave.[257]
In November 2023, China's health authorities reported an outbreak of respiratory illnesses in several parts of northern China. The increase in these diseases was attributed the circulation of known pathogens, including SARS-CoV-2.