Chinese doctors raise questions over Beijing’s Covid contact tracing policy

Three leading Chinese health scholars have challenged government monitoring of mobile phone location data to identify close contacts of Covid-19 cases, in a rare instance of public opposition to the nation’s draconian pandemic prevention strategy.

The trio is led by Chen Fujun at Huaxi No 4 Hospital in the south-western city of Chengdu, which imposes travel restrictions and mandatory tests for mobile phone users who came within 800m of a confirmed case for more than 10 minutes.

In a letter dated November 8th and seen by the Financial Times, Chen and doctors Li Jiayuan and Wang Chuan wrote that the programme could lead to "an overuse of medical resources, growing public panic and the disruptions of people's normal life and work".

“We should consider the sustainability of these measures,” said the doctors, who suggested the pandemic may be here to stay.

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Since the onset of the pandemic in China, public criticism of the government's response has been severely restricted by censorship and fears of reprisals. Some journalists have been jailed for reporting on Beijing's early mishandling of the virus while other critics have been hit by waves of online attacks from nationalists.

The doctors’ criticism highlights the growing challenges faced by the Chinese government as it sticks to its “zero Covid” containment strategy despite repeated outbreaks of the highly contagious Delta coronavirus variant.

Yanzhong Huang, a public health policy expert at the Council on Foreign Relations in New York, said Chengdu’s measures were “excessive” and reflected poor risk assessments by the authorities. The government, he added, seemed to believe that the country’s only two options were “zero cases or ... [a] worst-case scenario where the entire healthcare system is overwhelmed and social stability is undermined”.

Chengdu’s latest initiative was adopted after a nationwide outbreak that began in late October infected more than 1,000 people in dozens of cities.

Despite having only 33 new cases since the end of last month, Chengdu authorities began forcing local residents, whose cell phone signals showed they had been near confirmed cases, to self-quarantine for three days and pass two Covid tests before they could return to normal life.

Within three days of implementing the rules, Chengdu police had identified 82,000 people who they believed had been in the vicinity of just nine people with confirmed Covid infections.

Close contacts

Some provinces have imposed even stricter regimes. Changsha, the capital of central Hunan province, has reported just two new cases since mid-July. But in October it said residents whose mobile phone data put them near confirmed cases would have to take three Covid tests over seven days before they could travel freely.

Other countries, such as Singapore and South Korea, have used mobile phone location data in their efforts to contain the spread of the virus. But none of them has defined close contacts as broadly as Chinese cities have.

Singapore, one of the world’s most active adopters of contact tracing, considers people close contacts only if they come within two metres of a confirmed case.

The three Chengdu doctors said the city’s enhanced contact tracing programme would identify many people as close contacts even though they had only a very slim chance of getting infected. “There should be a limit for the scope of [close contact] screening,” the doctors said, adding that local officials should refrain from “inappropriate use of big data” to fight the pandemic.

The doctors did not respond to requests for comment. Local authorities maintain such inconveniences are inevitable so long as China maintains its zero Covid policy.

“We would rather mislabel a thousand close contacts than miss a single real case,” said a Chengdu public health official, who asked not to be identified. “That is for the sake of the public interest.”

But people identified by Chengdu’s surveillance system are also sceptical about its effectiveness.

Lucy Yang, a Shanghai-based financial consultant, was baffled when she received a text message from the Chengdu Centre for Disease Control and Prevention on November 7th that labelled her a close contact of a Covid case. Although she had only briefly been in Chengdu two weeks earlier, she was subjected to travel restrictions and had to pass two Covid tests within 72 hours.

“I had a one-day trip to Chengdu on October 22nd and the city’s first confirmed case during the latest outbreak wasn’t until October 28th,” Ms Yang said. “The tracing system clearly has an accuracy problem.” – Copyright The Financial Times Limited 2021