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By Wanyuan Song-BBC News
China has seen its first deaths from Covid-19 in six months, and thousands more people are catching the disease, despite the government’s strict lockdown policy.
The World Health Organization (WHO) has said China should rethink its strategy.
Covid rising across China
On Sunday 20 November alone, there were 26,824 new cases recorded in China. That is close to the peak back in April 2022.
Three people in Beijing are reported to have died from Covid-19 over the past few days.
New Covid cases have been reported throughout China. Guangdong, in the south, is the worst affected region.
What are China’s lockdown rules?
China is no longer imposing a national lockdown and has relaxed a number of previous measures.
However, the central government is telling local authorities to impose strict lockdowns in their areas when they detect a Covid-19 outbreak – even if only a handful of cases are found.
Mass testing is being carried out in places where cases have been reported. People found to have Covid-19 are isolated at home or placed under quarantine at a government-supervised facility.
Businesses and schools are closed, and so are all shops except for those selling food.
It is one of the toughest anti-Covid regimes in the world and lockdowns last until no new infections are reported.
Tens of millions of people have been living under some kind of lockdown since the latest wave of Covid-19.
Guangzhou, a southern city of nearly 19 million people, recently ordered a five-day lockdown for Baiyun, its most populous district.
Some rules, however, have been relaxed.
Those found with Covid-19 are now kept in isolation for only eight days, rather than 10 – five days at an isolation centre, plus three days of isolation at home.
China is also now allowing international arrivals for the first time since March 2022. Inbound travellers need to take a Covid test 48 hours before they arrive.
Why is China still trying to achieve zero Covid?
Unlike other countries, which have accepted they will have to live with the disease to a certain extent, China is following a policy it calls “dynamic zero” – taking dynamic action wherever Covid-19 flares up in order to eradicate it.
China’s government argues that this policy saves lives, because uncontrolled outbreaks would put many vulnerable people at risk, such as the elderly.
Strict lockdowns mean China’s death toll has stayed low ever since the start of the pandemic – the official figure is now just over 5,200.
This reported figure equates to three Covid deaths in every million in China, compared with 3,000 per million in the US and 2,400 per million in the UK.
What effect have zero-Covid policies had on China’s economy?
In recent months, lockdowns have taken place in several cities at the same time.
These include Shenzhen, a city of 17.5 million, which is the centre of China’s technology sector, and Shanghai, a city of 26 million which is China’s manufacturing, trade and financial hub.
Lockdowns have led to factories and ports being shut for long periods, and they have affected a number of joint ventures with foreign companies.
This means that China’s economy has grown by only 3.9% over the past year, compared with China’s growth target of 5.5% for 2022.
It is also affecting businesses and consumers in the rest of the world, who have come to rely on China for supplies of goods.
A lockdown at the Foxconn plant in Zhengzhou has affected the production of iPhones, leading to fears of a worldwide shortage of them.
Factory closures have also led to fears of a shortage of toys worldwide in the run-up to Christmas.
Why does the WHO think a zero-Covid policy is wrong?
China was seen as an example of a country handling the virus relatively successfully at the start of the pandemic.
But the WHO has said it is very hard to contain the current Omicron variant spreading across China because it is more infectious than other variants.
“The virus is evolving, changing its behaviour,” said Dr Tedros Adhanom Ghebreyesu of the WHO. “With that… changing your measures will be very important.”
Chinese President Xi Jinping says the zero-Covid policy is “scientific and effective”, and the government has said the WHO’s suggested change of policy would “inevitably lead to the deaths of a large number of elderly people”.
Is more vaccination the answer?
Only about half of people in China aged 80 and above have received their primary vaccinations, with fewer than 20% of them having secured a booster.
Fewer than 60% of the 60-69 age group is fully vaccinated. China has been urging the elderly to get vaccinated.
People in these older age groups are the most likely to die from Covid-19.
There are also doubts over whether the two main vaccines used in China, Sinovac and Sinopharm, are really effective.
Both use inactivated virus to prompt an immune response.
Studies suggest they provide little protection against infection by the Omicron variant, even after two doses.
The US and other Western nations have offered China mRNA vaccines, which might be more effective – but they have not been widely used in mainland China.
Additional reporting by Jeremy Howell.