In China, 37 million people are in Covid lockdown. Here’s what we know

Tens of millions of people are living under lockdown in China, as the country battles its worst Covid-19 outbreak since the early days of the pandemic.

This outbreak has spread far faster than previous waves of less infectious variants, with daily cases skyrocketing from a few dozen in February to more than 5,100 on Tuesday – the highest figure since the early 2020 outbreak in Wuhan.

The number may sound low compared to other countries, but it is alarmingly high for a nation that has attempted to stamp out outbreaks and chains of transmission with a strict zero-Covid policy throughout the pandemic.

A man walks across an empty road in Changchun, China, on March 14.

As of Tuesday, cases have been reported in 21 provinces and municipalities nationwide, including the national capital Beijing, and other major cities like Shanghai and Shenzhen.

The cases may still be in their thousands, but as of Tuesday 37 million people were in lockdown.

Here’s what we know about China’s outbreak.

How did this wave begin?

Cases began rising at the start of the month in a few provinces around the country, including Shandong in the east, Guangdong in the south, and Jilin in the northeast.

By March 6, experts were cautioning the situation was “severe” in some places – but they expressed confidence that “China still has the ability to control it,” state-run tabloid Global Times reported at the time.

JILIN, CHINA - MARCH 10: People line up for nucleic acid testing at a temporary Covid-19 testing site on March 10, 2022 in Jilin, Jilin Province of China. (Photo by Wang Jingxue/VCG via Getty Images)

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Jilin province, which shares a border with North Korea, soon became a major hotspot with a university cluster that prompted public outrage online after quarantined students complained of poor conditions while isolating on campus.

More than 4,000 of Tuesday’s reported infections were reported in Jilin. Nearly half of the total infections in this outbreak have come from that province – and cases there haven’t peaked yet, officials warned on Tuesday.

Authorities and state media say it’s still not clear how the first few outbreaks began.

But several factors – including cases imported from overseas and the prevalence of the Omicron variant – exacerbated the severity of the outbreak nationwide, said Global Times, citing Wu Zunyou, chief epidemiologist at the Chinese Center for Disease Control and Prevention.

What variant is spreading?

Omicron has been driving this surge. One of the reasons cases have spread so fast and are harder to trace is Omicron’s milder symptoms and shorter incubation time, according to state media.

The highly infectious variant has now replaced Delta as the dominant strain in the country, making up about 80% of recent cases, Wu told the Global Times.

A healthcare worker treats a Covid-19 patient on the Intensive Care Unit (ICU) floor at Hartford Hospital in Hartford, Connecticut, U.S., on Tuesday, Feb. 1, 2022. Connecticut's test positivity rate dropped this week and has remained below 10% and hospitalizations are below 1,100 for the first time since late December. Photographer: Allison Dinner/Bloomberg via Getty Images

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He added that experts are seeing both BA.1 – the original Omicron – and BA.2, a subvariant that was first detected in January and nicknamed the “stealth variant” because at first glance on lab tests it can look like other Covid variants.

BA.2 is about 30% more transmissible than BA.1, according to early studies from the UK and Denmark. It is now causing about 1 in 5 Covid-19 cases worldwide, with cases detected in dozens of countries including the US, according to the World Health Organization. BA.2 has been detected in the outbreak in Jilin, according to state-run news outlet CCTV.

It’s not yet clear whether it causes more severe disease, but some studies suggest it won’t likely lead to greater numbers of hospitalizations and deaths, partly because it emerged so soon after the original Omicron wave, so many people have protective antibodies, either from recent infection or booster shots.

Residents line for Covid-19 testing in Shenzhen, China, on March 14.

What lockdowns and restrictions are in place?

Five cities – collectively home to more than 37 million residents – are now under varying levels of lockdown.

Residents in Changchun, Jilin city, Shenzhen and Dongguan are banned from leaving their neighborhoods, except for essential workers and emergency services. Each household is only allowed to send one person to buy groceries every two to three days.

The fifth city, Langfang, went a step further in prohibiting all residents from leaving their homes except for emergency reasons.

Workers carry out out epidemic prevention and control disinfection work in Qingdao, China, on March 14.

Several of these cities have suspended public transport and indoor dining, closed schools and are conducting multiple rounds of mass testing for all residents. Jilin city kicked off its ninth round of testing on Tuesday, with photos showing residents lining up outside in the snow, bundled up tight.

Jilin province has also implemented travel restrictions, prohibiting residents from leaving the province or traveling between cities within the province.

But these lockdowns also pose a huge logistical challenge for the government, with CCTV reporting the province only has a few days’ worth of medical supplies in stock.

Authorities are now racing to boost health care capacity in hard-hit areas – for instance, building temporary treatment centers in Changchun and Jilin city, and deploying thousands of soldiers to help Covid control work, according to Global Times.

Will China stick to zero-Covid?

As increasingly infectious variants – Delta, then Omicron – spread in 2021, many countries abandoned the strict zero-Covid approach in favor of living with the virus.

China and its territories, including Hong Kong, also undergoing a severe wave, are the largest holdouts.

Though some Chinese leaders and scientists have hinted that China could eventually move away from the strategy, that likely won’t come anytime soon, if current rhetoric about bringing cases back to zero is any indication.

Han Jun, the governor of Jilin province, vowed on Monday to end all community transmissions within a week – prompting derision on Chinese social media, with many calling it an empty promise. Others urged him to address more pressing issues first, like the shortage of groceries and other essential supplies.

XI AN, CHINA - JANUARY 06: A medical worker wearing personal protective equipment (PPE) sprays disinfectant to a resident, who completed the quarantine period, at the entrance of a residential community under closed-off management on January 6, 2022 in Xi an, Shaanxi Province of China. (Photo by VCG/VCG via Getty Images)

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“Just think how people suffered when Xi’an aimed for ‘zero-community transmission,’” said one comment on the Twitter-like platform Weibo.

The city of Xi’an was locked down for more than a month from December to January, with some residents complaining they were unable to receive food, basic supplies like menstrual pads, and even emergency medical care – painting an image of local government dysfunction and prompting public outcry nationwide.

“It’s better to be fully prepared and then gradually (clear Covid transmission),” said the Weibo comment. “If we rush it, people will suffer.”