Xi’an lockdown brings heartbreak and dysfunction as political pressure to contain outbreak grows

As the locked down Chinese city of Xi’an claimed victory this week in its fight to contain the community spread of Covid-19, harrowing tales of loss and despair have emerged on social media – highlighting the immense human cost of China’s zero-Covid policy. The city of 13 million has been under strict lockdown since December 23, as it grapples with the country’s worst coronavirus outbreak since Wuhan, the original epicenter of the pandemic. But local authorities have faced a public outcry over perceived incompetence, and disproportionately harsh measures that critics say harm the lives of those they are supposed to protect. Over the past two weeks, Chinese social media has been flooded with posts from residents who say they have not received food, basic supplies, even medical care – painting an image of local government dysfunction as pressure builds on local officials to contain Covid just weeks before major Lunar New Year festivities and the Beijing Winter Olympics. One heavily pregnant woman was allegedly turned away from a hospital on New Year’s Day because she didn’t have a valid Covid-19 test, according to a post from a user who said she was the woman’s niece. A video posted on January 3 shows the woman sitting outside with a pool of blood around her feet. She was finally admitted two hours later – but suffered a miscarriage, said the post, shared widely on Chinese micro-blogging platform Weibo before it was deleted. A staff member from Xi’an Gaoxin Hospital, where the woman sought care, told CNN they were investigating the incident, and that the hospital had initially turned away the woman in accordance with the government’s Covid-19 regulations, but declined to comment further. On Xiaohongshu, China’s Instagram-like platform, a user appealed for help on Sunday after a local hospital refused to admit her father, who had just had a heart attack, because they lived in a “medium-risk area” of the city. She later updated the post, saying her father was allowed an emergency operation when his situation worsened significantly after several hours. “The delay was too long and rescue failed. I don’t have a father anymore,” she wrote. The woman posted her encounter in more detail on Weibo on Wednesday night. Her emotional account immediately went viral, attracting 630,000 “likes” and was shared more than 110,000 times as of Thursday. Another video posted online showed a woman in a quarantine hotel on New Year’s Day, begging a Covid control worker for sanitary pads. In the post, viewed tens of millions of times before it was removed, the woman said she had tried to call multiple government departments to ask for menstrual products – to no avail. The woman later posted that she had received supplies from quarantine workers and said she regretted filming the original video. CNN cannot independently verify the authenticity of these videos and posts, and has reached out to the authors for comment, as well as the Xi’an municipal government. The poignant accounts have sparked an outpouring of sympathy and anger online, with many questioning sacrifice in the name of epidemic control. “No one cares what you die of – other than Covid-19,” one Weibo user posted. Following the public outcry, Xi’an officials told a news conference Wednesday that hospitals “must not use the excuse of epidemic prevention and control to avoid treating patients,” including critical patients like pregnant women. On Thursday, Xi’an authorities said the general manager of Xi’an Gaoxin Hospital has been suspended, staff involved in the incident had been removed from their posts, and ordered the hospital to apologize to the public. The ruling Communist Party’s disciplinary watchdog in the city also issued an internal warning to the head of the Xi’an Health Commission as well as two other public health officials. But these actions have failed to quell outrage. On Weibo, the top-rated comment under a state media post about the punishment said: “This just goes to show: Covid-19 might not kill you, but bureaucrats can.” Limits of zero-Covid For most of the pandemic, China has managed to keep its caseload low with its “zero-Covid” approach – meaning no local transmissions – even as the rest of the world embraces living with the virus. There have been occasional outbreaks, but officials have largely managed to contain them within a few weeks by following a playbook of mass testing, partial or full lockdowns, contact tracing, and quarantine. On Monday, the city of Yuzhou in Henan province, home to around 1.2 million residents, was also placed under lockdown after it reported three asymptomatic cases. This stringent approach remains widely popular among the Chinese public, which “is used to a zero-Covid environment,” said Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations. “So many people have not been exposed to the virus, and given that the inactivated vaccines are not that effective in preventing new infections, zero-Covid becomes a self-justifiable strategy.” In a statement on Monday, the Xi’an government acknowledged “some problems” in providing residents daily supplies, but said it was “improving the situation.” Community transmission in the city “has been brought under control” and the rapid spread of the virus “has been contained,” said state-run news agency Xinhua in an article on Wednesday, citing local authorities. The city confirmed 63 new locally transmitted cases on Wednesday, bringing the total caseload to 1,856 since December 9. Cases had hovered near or above 100 in previous days, before a significant drop to 35 on Tuesday. But many Xi’an residents have pushed back on officials’ claims. Though the government has distributed food to some throughout the lockdown, others say they haven’t received their supplies, or have only been given food a handful of times throughout the two weeks. Others pointed out that rates of community transmission may be distorted, with more than 42,000 residents taken to government quarantine facilities. Videos of the quarantine sites, showing spartan rooms with metal bunk beds and no mattresses, have sparked further criticism online. “‘Zero community Covid’ is such a clever word as we just need to keep transporting patients and close contacts out until Xi’an’s cases are zero,” one Weibo user posted. “If there are no people in the neighborhood, of course there is no community transmission there,” another user wrote. Rising pressure These measures, and the chaos unfolding for those stuck at home, bring into focus the burden borne by citizens for China’s Covid strategy, its questionable sustainability – and the increasing political pressure on local officials to bring outbreaks under control. Officials who struggle to contain Covid flare-ups often face suspension or dismissal. Last summer, more than 40 local officials across the country were punished for failing to control a Delta outbreak that spread to more than half of China’s provinces. This week, the party secretary of Yanta district in Xi’an, one of the worst-hit areas, was also dismissed. This pressure had been in place for much of the pandemic, with the ruling Communist Party often hailing the success of its zero-Covid strategy as an ideological and moral victory in comparison to Western countries that struggled to control their own outbreaks. But that pressure is now intensifying as February approaches – bringing with it the Winter Olympics, a major point of national pride, and Lunar New Year, the country’s biggest annual holiday, when hundreds of millions of people typically travel domestically. With these two events looming, “Xi’an officials were asked to achieve (zero community transmissions) by January 4,” said Huang. “That’s the kind of pressure these local officials are facing,” Huang added, referencing the dismissal of Yanta’s party secretary. The chaos in Xi’an also reflects the difference in local governance capacity, he added – Shanghai, for instance, has a highly efficient and competent bureaucracy that allows officials to detect outbreaks early, conduct contact tracing quickly, and avoid the kind of city-wide lockdowns seen in Yuzhou and Xi’an. In contrast, those two cities both have “relatively low local state capacity … to come out with a well-prepared plan for outbreak preparation, to deliver necessities to people in quarantine and under lockdown,” Huang said. “When the capacity is low, government officials are more likely to turn to heavy-handed, indiscriminate and even excessive measures that significantly raise the cost of implementing this (zero-Covid) strategy.” The strategy has worked relatively well thus far in shielding most of China from the virus – but its limitations are also becoming increasingly clear. “China is not epidemiologically or psychologically ready for the Omicron variant,” Huang said. “The problem is we don’t know whether (zero-Covid) can still be effective in dealing with more transmissible variants.” And if outbreaks with transmissible variants spread to multiple cities across the country, “you’re going to see the cost, therefore the dissatisfaction,” he added. “The unhappiness is going to grow significantly at a national level – as well as the difficulty of implementing this strategy.”