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A woman shows her health status on a phone to a security guard, at an entrance to a shopping mall in Beijing, on August 23, 2021. Image Credit: REUTERS

Beijing: It’s been just over a month, and China has once again squelched COVID-19, bringing its local cases down to zero.

It was more difficult this time, even though the leaders of the world’s most populous nation used the same playbook they followed to quell more than 30 previous flare-ups since the virus first emerged in Wuhan 18 months ago. The arrival of the more infectious Delta variant has raised the stakes, as the pathogen refines its ability to escape curbs and flout vaccination.

The China model shows what it takes to get COVID-19 under control, and raises questions about whether other nations would be willing - or able - to follow the same steps.

Here’s what happened between July 20, when news emerged of a cluster of infections among airport cleaning staff in the eastern city of Nanjing, and August 23, when China once again reported zero cases.

Repeated mass testing of entire cities

China took testing to an unprecedented level during this go-round. Local authorities checked their populations repeatedly, around a dozen times in one city alone, to ensure every last infection was caught. In all, more than 100 million tests were administered. In the city of Yangzhou, some people were infected while waiting in line to get swabbed.

Quarantines also played a larger role. The Chinese capital of Beijing at one point was sealed to any other place with even just a single case. It also cut off trains and flights from hotspots around the country, even though the city ultimately posted fewer than 10 infections in the delta flareup.

Other regions introduced sweeping curbs, from barring entry for people from high risk areas to asking them to cut short vacations. Most had to remain isolated at home - a rule that was strictly enforced - before returning to work and school. More than 200 neighbourhoods were labelled high- or medium-risk, triggering sweeping curbs that disrupted lives and businesses.

A Peak and a plunge

First there was one asymptomatic infection at the airport in Nanjing. The next day, there were more than a dozen. By the end of that week in July, daily infections had climbed to nearly 50, suggesting exponential spread across more than 1,000 kilometres. In less than three weeks, daily cases ballooned to more than a hundred, scattered across half of the nation. Then it ended, almost as quickly as it began. The number of infections dropped to single digits the next week amid tightening curbs.

The blazing spread of the delta variant across the country became the biggest test of China’s COVID-19 control model. Ultimately it penetrated nearly 50 cities across 17 provinces and reintroduced the virus to Wuhan, which had been COVID-free for over a year.

Still, China eliminated the virus in about a month, roughly the same time it took to quell previous outbreaks, like the one at the start of 2021 in the northern provinces that totalled some 2,000 cases. In comparison, cities in Australia have undergone as many as six lockdowns, keeping more than half of the country’s 26 million people confined to their homes, without gaining control of the virus. In the US, which has never succeeded in containment, relying instead of vaccination, booster shots are likely to roll out in a few months to shore up protection against its delta resurgence.

China is also keeping all those infected alive so far. In the viral hotspot Jiangsu province, critical cases at one point rose to as many as 18, raising fear that the country could soon report fresh Covid fatalies in more than six months. Yet many of them have since seen their disease moderate.

Economic Setback

The containment-at-all-costs approach is weighing on the world’s second largest economy. Consumption and manufacturing slowed in July, with further weakness expected for August when infections peaked and measures to control them intensified. Investment banks from Goldman Sachs Group Inc. to Nomura Holdings Inc. cut their growth projections.

COVID-19 zero vs co-existence

More infectious variants and their rampant spread are making the eradication of COVID-19 less and less likely. That’s becoming a global consensus, driving decisions to learn to live with the virus in countries from Singapore to Australia and New Zealand that previously sought to eliminate it.

Still, China has proven its ability to keep the pathogen at bay, and it has vowed to continue to safeguard its people, regardless of the effort or expense. Health minister Ma Xiaowei told the state news agency Xinhua on August 16 that authorities planned even stricter measures intended to spot incursions of the virus from abroad more quickly.

The health minister also reiterated COVID containment as a priority that provides strong guarantee to economic development and sound investment environment. He vowed to resolutely contain the outbreak from spreading further and strengthen the hard-earned achievement from China Covid control efforts.

Although cases are back to zero, it’s unknown how long that status will last. Some new cases over the past few days were reported in places like Shanghai, far from the most recent outbreak’s hotspots.

With the delta variant swirling globally, making herd immunity an impossibility, China is finding itself isolated in its zero tolerance approach. It’s clear it can stamp out the virus. The question remains if it can rejoin the world.