everyone, continuous, outbreak or not

A 1 or a 2: that should be on Liang’s phone. Preferably a 1, then she feels more at ease. If there is a 3 next to her health code, she is no longer allowed to enter her office. “I’ve heard that some colleagues were in that situation,” said Liang, a thirty-something who works in central Beijing. “They were asked to go back home and then work from home or take a day off.”

Liang, who only wants to use her last name in a foreign newspaper, stands in line with a colleague for a PCR test, to reset the counter on her phone. They have to be tested every 48 hours, just like everyone else in Beijing, otherwise they won’t be allowed in anywhere. Some residents report that without a valid test – 1 or 2 days old, not 3 – they are not even allowed to enter their own neighborhood.

They aren’t that strict in Liang’s neighborhood, but they are at work. So every two days she queues at the PCR testing station at the foot of her gleaming office tower. Normally it only takes ten minutes, but today almost half an hour, in the sweltering sun. Annoying? “Ah well, we’re used to it, we’ve found our rhythm,” says Liang. ‘Nothing can be done about it. It’s a government requirement.’

‘Normalized testing’

Continuously testing the entire population: that is the new way in which the Chinese government wants to control Covid. The tight testing regime applies not only in Beijing, but in at least eighteen major cities in China, with a total of 200 million inhabitants. Only the rhythm varies: from every two, three or five days to every week. If infections appear in a city, the pace is increased to every 24 hours.

‘Normalized testing’, as the Chinese government calls it, aims to prevent lockdowns as Omikron’s zero-covid policy is put to the test. By continuously testing the entire population, even when there is no outbreak, the government wants to detect infections before they can spread. So that the zero-covid policy can continue without radically damaging the economy.

Chinese state media are proud to report on the logistical tour de force behind the test campaign: thanks to tens of thousands of test stations and laboratories, China can now process 57 million test tubes per day, compared to 1.26 million in March 2020. With ten samples per tube, that means a capacity of 570 million people per day. ‘You can get tested quickly, free and easily throughout the country’, says the China Daily† “Up to three times a week.”

Who’s going to pay for this?

But smaller Chinese online media are questioning the new testing policy. Medics question its efficiency, as no PCR test is 100 percent reliable, and fear that the long lines may even lead to additional infections. The biggest objection: the price tag. According to economists, this test bonanza could cost the Chinese government 0.9 to 2.3 percent of gross domestic product (GDP). Who’s going to pay for this? And who benefits from it?

The starting signal for ‘normalized testing’ was given at the beginning of this month. Deputy Prime Minister and ‘zerocovid’ chief Sun Chunlan then announced that every city with more than 10 million inhabitants should introduce so-called ’15-30 test circles’: every resident must be able to find a test station within 15 minutes’ walk and be tested there within 30 minutes. On apps, residents can see the nearest test points and the current waiting times.

In Beijing, the 15-minute walk is no problem: you almost trip over the test points. On street corners, in parks, on wide sidewalks: everywhere you see long lines of people, waiting in front of blue or red pavilion tents, under which test personnel in white protective suits are sheltered from the sun. Volunteers in blue doctor’s aprons urge those waiting to keep two meters away.

Many people feel rushed

The rows stand out in an otherwise empty city. Beijing’s zero-covid regime was eased over the weekend, but schools and restaurants are still closed, many residents still have to work from home, and restrictions are now being applied at the neighborhood level. The streets are unusually quiet; every now and then a spray truck with disinfectant drives by. On the wide sidewalks, children play badminton and restaurants sell takeaway. Seats are cordoned off with ribbons or fences.

The waiting time of 30 minutes is less obvious: residents say they have lost an average of 15 minutes, but sometimes they have to wait for hours. Complaints are made on social media: the test may be free, but the time in line also costs money. Many people feel rushed, as if they are playing in a video game and need to ‘extend their lives’ every 48 hours. As if they have a ‘best before date’, ‘shorter than that of a loaf of bread in the supermarket’.

Liang and her colleague also admit that they sometimes get a little nervous and get tested more often than strictly required. If they see a collection station without rows, they quickly pick up an extra test. “The results don’t always come quickly, so it’s reassuring to do it more often than necessary,” says Liu, Liang’s younger colleague. According to government instructions, results should be on your phone within six hours, but that doesn’t always go well.

All that testing costs a lot of money. According to Soochow Securities, the implementation of ‘normalized testing’ in all major cities in China would cost €236 billion annually, 1.5 percent of China’s GDP. A calculation by the Japanese bank Nomura comes to 0.9 to 2.3 percent. “That’s thirteen times the bridge from Hong Kong to Zhuhai and Macau,” financial think tank Zhiku said in an article, citing one of China’s most expensive infrastructure projects.

State media argue that a lockdown costs much more and that systematic testing therefore saves money. But the question is who will foot the bill. The national health insurance company, which reimburses PCR tests in the event of outbreaks, recently announced that ‘normalized testing’ is not under its responsibility. This means that the bill will end up with local governments, which have much less income this year due to economic setbacks.

‘Their economies will be in even worse shape’

In some cities the test rounds appear to be paid from the budget for poverty reduction or infrastructure works. Local governments are “swiping important resources away from their economic growth to spend them on testing,” said Andrew Collier, director of research firm Orient Capital Research. Financial Times† “Their economies will be in even worse shape than they already were.”

The winners of the test boom are the major laboratories in China, including private companies. Although the fee per test has fallen sharply recently, money is being made in the sector like water. The four market leaders recorded a turnover growth of 199 to 1,203 percent in 2020. Test company Yunkang Group, which was still loss-making in 2019, reported profit margins of 63.6 and 56.8 percent in its stock prospectus for the past two years.

Where much can be earned, abuse is lurking. Three labs in Shanghai and Anhui were suspended last month after reporting a striking number of false positives. In Beijing, three labs are suspected of mixing test tubes to save time and money. Six employees and three officials are being prosecuted and more checks have been announced.

Critics fear that there are cowboys among the labs, who have obtained contracts through government relations and now have an interest in reporting positive cases. “If money-hungry private capital is introduced into normalized testing and there isn’t enough control, no one will know when this epidemic will end,” an anonymous medical company employee told the news site. Jimian News†

The construction of permanent test kiosks in Shanghai and Hangzhou also shows that ‘normalized testing’ will not disappear from China any time soon. And in Beijing, fixed test containers have been put into use since this week. Even Liang and Liu, patiently waiting in line, don’t quite like it. “Once a week, that’s acceptable,” Liang says. “But if we have to test every 48 hours for a longer period of time, then it becomes difficult.”