Why it's so hard for China to exit "zero COVID"

The healthcare system is so unprepared that any major shift away from Covid Zero — which in China has meant frequent mass testing, swift quarantines, lockdowns and sealed international borders — risks a public health crisis.

In Ejin, home to about 30,000 in the Chinese province that borders Mongolia, several dozen infections in mid-October quickly overwhelmed the two local hospitals. Authorities had to transfer more than 140 patients by train to the provincial capital of Hohhot, over 1,000 kilometers (621 miles) away, according to local media.

Before long, the Hohhot team, too, was asking for help. To handle the influx of Covid cases — including a one-year-old infant, an 82-year-old and a dozen seriously ill patients — Hohhot’s main hospital for Covid enlisted help from other facilities. The center wasn’t “capable of handling this many patients all of a sudden,” a doctor overseeing the response told state broadcasters in early November.

The experience shows how vulnerable China’s vast yet patchy hospital network — hobbled by lopsided distribution of resources and under-investment — is to the virus.