Cold and Flu Season Stirs Dread in China

Welcome to Foreign Policy’s China Brief.

Welcome to Foreign Policy’s China Brief.

The highlights this week: A surge in respiratory illnesses in China stirs public anxiety, Taiwan’s opposition deal breaks down ahead of the presidential election, and China’s government pushes banks to support property developers.


Hospitals in China are filling up with patients as respiratory illnesses surge among children, stoking fears among China’s neighbors. But the current outbreaks do not appear to be a new virus. Instead, they reflect three factors: a young population that lacks exposure to common viruses thanks to years of lockdowns, recurrent COVID-19 infections, and the rise of antibiotic-resistant bacterial infections, which are leading to rising pneumonia figures.

As Annie Sparrow wrote in Foreign Policy today, Chinese medical authorities are so far evasive and uncommunicative about the outbreaks. That is in part because of distrust between the United States and China in the wake of arguments over the origins of the COVID-19 pandemic. Chinese scientists both face political pressure not to talk to outsiders and feel stigmatized by Western accusations, such as the lab leak theory.

Their unwillingness to share details about the outbreaks is also because antibiotic resistance is embarrassing for China, which has long been aware of the problem but has done little to successfully combat it. Antibiotics are widely prescribed over the counter in China, leading people to use them at much higher rates than in the United States (where antibiotic prescription rates are already quite high). Antibiotics are also given in large quantities to livestock.

China’s current outbreaks aren’t likely to have a big impact on other countries for now, but the slow advance of antibiotic-resistant infections continues. Meanwhile, there is public dread within China about the rise in respiratory illnesses given the country’s recent history. It has been a year since mass protests broke out across China in response to the zero-COVID policy, which was abruptly lifted last December.

China ending the zero-COVID policy wasn’t just a response to the protests, but to the virulence of new COVID-19 variants that had repeatedly broken the government’s containment regime. The official COVID-19 death toll remains an undercount. As of Feb. 9, as COVID-19 spread across China, the number crept up to 83,150 dead since the start of the pandemic; independent evaluations of excess deaths between December 2022 and February put that figure at between 1 and 2 million.

In China, COVID-19 seems—as everywhere—to have become an endemic and recurring disease with an impact mitigated by vaccination and improved medical treatment. Despite initial concerns among scientists, Chinese vaccines seemed to be moderately effective and are now moving toward better mRNA models. Treatment with Paxlovid, initially hard to find in China, has become more common.

However, coverage of COVID-19 in Chinese media remains muted, with discussion of related policy still often subject to online censorship. The public trauma of extended lockdowns eventually became stronger than the fear of COVID-19. This month, workers disinfecting a street in full personal protective equipment in one city in Hebei province prompted panic that the measures might return. The country’s economic slowdown has also contributed to the public mood.

There is a case to be made—although it would depend on trustworthy statistics—that China’s long commitment to zero-COVID reduced the number of deaths from the disease well below what experts would expect in a country of 1.4 billion people. (By contrast, India’s COVID-19 death toll through the end of 2021 may have been as high as 4.7 million.) It is also possible that the huge costs of China’s lockdowns exceeded these hypothetical benefits.

But there’s no room for this debate under Chinese President Xi Jinping, and the official line remains that China’s COVID-19 strategy—which is closely associated with the leader—was a triumph. Yet unlike 2020, when a wave of patriotism followed the initial containment of the virus, even Chinese officials don’t seem to want to raise the issue. It is barely mentioned in the latest round of encomiums to Xi’s rule. That shiftiness makes talking to the outside world about real problems difficult, which doesn’t look promising for a future global crisis.


Taiwan election turmoil. The opposition deal in Taiwan has imploded, instead producing a rift between the two main opposition parties that led them to formally register separate candidates for the presidential election in January. Last week, a joint press meeting that was supposed to be an opportunity for reconciliation turned into an exchange of insults. (Taiwanese politics is often personal, with regular brawls in parliament.)

All of this leaves the ruling Democratic Progressive Party’s William Lai as the likely—although by no means certain—victor. Lai is narrowly ahead of the Kuomintang’s Hou Yu-ih in polls. (Billionaire Terry Gou, who was running as an independent, has dropped out of the presidential race altogether.) If elected, Lai is likely to deepen ties with the United States, as his recent selection of former Taiwanese envoy to the United States Hsiao Bi-khim as a running mate indicates.

Friendly U.S.-China talk. The softer language that followed Xi’s meeting with U.S. President Joe Biden this month is still going on, with Chinese state media publishing a series of articles on U.S.-China friendship and emphasizing Xi’s visit to Iowa decades ago. As ever, the stories emphasize that the United States is responsible for making the “correct” decisions —allowing Beijing plenty of room to return to aggressive statements when the relationship cools again.

Some Chinese commentators have called out the sudden shift of language from intense nationalism to relative friendliness. Others have stressed the need to improve China’s dire image in the eyes of the United States. Unfortunately, their answers are the same platitudes about “telling China’s story well” that have been part of the Chinese Communist Party’s Western media push for a decade, without success.



Real estate support. China’s government is still trying to prop up the crumbling real estate sector, instructing banks to give loans to support developers, which may include offering unsecured loans for the first time. (The industry needs 3 trillion yuan in loans just to cover unfinished homes.) The issue is of major salience for the Chinese Communist Party (CCP), since the country’s urban upper-middle class holds significant property—not only their own housing, but as their main form of investment.

This property-holding class is the bedrock of CCP support, and it includes many senior officials. New housing prices in China remain artificially high thanks to orders to developers from local governments; other housing prices have been falling, but homebuyers are reluctant to act. Meanwhile, Chinese authorities have asked the Ping An Insurance Group—which has close ties to the CCP elite—to take a controlling share of Country Garden, a nearly bankrupt developer.

Pipeline deal. China is reportedly putting pressure on Russia to get an even more favorable deal for the Power of Siberia 2 pipeline, with construction set to start next year and run through 2030. The project would significantly increase Russian gas exports to China, tying the two powers even closer together. But China has been taking advantage of Russia’s increasing exclusion from Western markets to lock in cheap prices for Russian liquid natural gas.

The maneuvering should remind Moscow that as much as Beijing likes to talk about solidarity, it also keeps a keen eye on the bottom line.

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