China Faces Omicron ‘Tsunami’ If It Abandons Controversial Zero-Covid Policy, Researchers Warn


China faces an omicron “tsunami” that could overwhelm hospitals and kill more than 1 million people if it abandons its “zero-Covid” strategy, according to a new study published in Nature Medicine on Tuesday, as officials double down on the controversial policy despite worsening social and economic damages of such strict lockdowns.

Key Facts

Despite more than 90% of China’s population over 3 years of age being fully vaccinated against Covid-19 and around 54% having received a booster shot, an estimated 1.55 million people could die from the disease within six months if the country drops its policy of eliminating infections through strict lockdowns, according to the peer reviewed modeling study.

Leaving omicron unchecked, the model predicts a major Covid-19 wave between May and July with the potential to cause as many as 5.1 million hospital admissions and 2.7 million ICU admissions up to September 2022, with peak ICU demand nearly 16 times existing capacity.

The vast majority of deaths—nearly three quarters—would be among unvaccinated people aged 60 years old and up, the researchers found, primarily due to the significant gap in vaccination coverage among China’s elderly population.

China has reported fewer than 15,000 Covid-19 deaths since the pandemic began—including a full year without a single death, though experts question the reliability of China’s data—in pursuit of zero-Covid, relying on strict lockdowns, quarantines and testing to quash outbreaks.

While this approach may have worked in the past, it is much harder to implement with a variant as transmissible as omicron and the researchers said it is “questionable… whether and for how long” China can continue to follow a zero-Covid policy.


The researchers modeled several strategies China might use to move away from zero Covid and learn to live with the virus, including widespread use of recently-approved antivirals, enhanced testing, promoting booster doses and increasing vaccine coverage among the elderly. When lifting the restrictions put in place under zero-Covid, no strategy was sufficient on its own to completely mitigate the risk of omicron and no method was able to prevent hospitals from being overwhelmed or bring deaths down in line with the number killed by the flu each year. Increasing vaccination among the elderly and widespread use of antivirals should be priorities for future policy, the researchers said. In the long-term, policies should focus on improving ventilation, strengthening critical care capacity and developing highly efficacious vaccines, they added.

Key Background

China is one of the few places left in the world still pursuing a “zero-Covid” or “dynamic zero” approach to the pandemic. Compatriots like Australia, New Zealand, Singapore and Taiwan have abandoned the policy and acknowledged they cannot completely contain the virus and the fervent pursuit of the policy was a disaster during an outbreak in Hong Kong. In China, Beijing’s stringent adherence has stoked discontent and unrest among the millions locked down to prevent the spread of coronavirus, notably in Shanghai and Beijing. There is little end in sight and despite food shortages, accusations of inhumane treatment and signs of an economic downturn following weeks of lockdown in major cities, President Xi Jinping states officials will “unswervingly adhere” to the policy.

Further Reading

Once a zero-Covid poster child, Taiwan learns to live with the virus (Guardian)

The cost of China’s zero-Covid lockdown (FT)

Xi Jinping attacks ‘doubters’ as he doubles down on China’s zero-Covid policy (Guardian)

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