A COVID-19 outbreak in the city of Shanghai, China began on February 28, 2022, and ended on August 7, 2022. The outbreak was caused by the Omicron variant and became the most widespread in Shanghai since the pandemic began two years prior. Authorities responded with mass COVID-19 testing and a strict lockdown of the city in an effort to uphold China's zero-COVID policy; the latter marked the largest one in the country since the lockdown of Hubei in early 2020. The outbreak caused substantial economic and social disruption across Shanghai with consequences felt elsewhere, and led to the spread of COVID-19 to other parts of China, including Beijing, Guangdong, and Hunan.
Background
The COVID-19 pandemic is an ongoing viral pandemic of coronavirus disease 2019. It began in early 2020 as an outbreak in Hubei province, China, which prompted a strict lockdown. The Chinese government's response since then has been to pursue a zero-COVID strategy, aiming to eliminate the virus altogether. However, the increased transmissibility of the SARS-CoV-2 Omicron variant that emerged in late 2021 has posed challenges.
Since 2020, nearly 40% of international arrivals to China came through Shanghai. Shanghai also had a relatively large number of imported cases. By March 14, the number of cases reported as coming from outside mainland China was 4345, compared to 473 local cases. Shanghai authorities had previously taken a "more relaxed" approach to the pandemic compared to other Chinese cities. Doctor Zhang Wenhong of the Shanghai Medical Treatment Expert Group, said the control of COVID-19 in Shanghai is like "catching a mouse in the ceramic shop", and said maintaining a normal manufacturing industry and public life is important. Due to the Omicron variant, Shanghai's COVID-19 response had been challenged.
Outbreak
On February 28, a 56-year-old vaccinated woman came to Tongji Hospital with a fever and was confirmed positive on March 1. This case became patient zero in the outbreak. After confirmation of her case, her dance group had at least 8 people test positive as well.
After confirming a positive diagnosis, the risk levels of some areas of Shanghai were raised from "low risk" to "middle risk". According to Shanghai's information office, the main source for the spread of the outbreak was the Huating Hotel, a previously designated quarantine site for inbound travelers. In response, the Shanghai World Expo Exhibition & Convention Center was converted into a temporary hospital on March 26, 2022. By March 27, just before Shanghai started area-separated testing, a total of 16,013 people had tested positive for COVID-19. Additional temporary quarantine centers in the Shanghai New International Expo Center opened on 29 March 2022.
By April 8, there had been a total of 131,524 people tested positive, with a single severe case. About 90 percent of the cases were "asymptomatic".
By April 17, according to China National Radio, Shanghai had 16 severe cases, all having pre-existing health conditions, with only 1 of them being vaccinated. On the same day, officials reported 3 deaths of COVID-19 infected patients, with all deaths also being linked to other underlying health conditions, such as diabetes. On April 18, officials reported 7 more deaths with ages ranging from 60 to 101; 6 of them were aged above 70.
On April 22, officials announced they would escalate COVID lockdown restrictions and further tighten lockdown measures. Some of the new measures include evacuating people to disinfect their homes and placing electronic door alarms to warn if infected people are trying to leave.
By April 30, officially all of the deaths were caused by other severe symptoms. On the same day, the first fangcang quarantine hospital (fang1cang1 方舱, literally "portable building") was officially closed.
Graphs
Total amount of positive casesDate0100,000200,000300,000400,000500,000600,000700,0003-13-143-274-94-225-55-18Total amount of positive casesCumulative positive cases during the 2022 Sh...
Amount of new casesDate0500010,00015,00020,00025,00030,0003-13-143-274-94-225-55-18Amount of new casesAmount of positive cases per day during the ...
Data source: National Health Commission of China
Government response to the outbreak
Lockdown
On February 28, 2022, the introduction of travel restrictions was announced by the Shanghai Municipal People's Government and negative PCR testing within 48 hours of travel became mandatory. In addition to the negative PCR testing, travelling from "control areas" to "prevention areas" was conditioned by a 14 days mandatory quarantine at citizens' own residences (quarantine in commercial facilities such as hotels did not qualify) within the "prevention area". On March 15, Civil Aviation Administration of China announced that international flights into Shanghai would be diverted to other cities.
Shanghai decided to adopt "area-separated and batch-separated control" (Chinese: 分区分批防控) starting on March 28. On March 27, many markets got crowded, with some scholars arguing these conditions were due to city closure. This was extended on April 1. Some media suspected that cases were underreported. Wang Keyu, a staff member at Huashan Hospital stated that (locally-available) COVID-19 vaccines offered weak protection against the Omicron variant, and that a wide range of COVID-19 testing control was important and necessary. By March 29, over 9.1 million people had been tested by roughly 17,000 testers in roughly 6,300 testing areas. By April 1, over 18 million people had been tested.
From April 1, most areas of Shanghai were under three-level control. The levels were "closed areas" (封控区), "control areas" (管控区), and "prevention areas" (防控区) and typically spanned the size of a residential complex, later (in June) granulizing into individual buildings.
On April 5, the lockdown was expanded to encompass the entire city, affecting the population of 25 million. On April 11, Shanghai published the list of closed areas, control areas, and prevention areas. On April 11, Shanghai officially announced all areas are under three-level control and clarified. Closed area contains people who tested positive for COVID-19 in the neighborhood, the "7-7" quarantine policy is required to follow, during 7-day closing period, if there was no people who tested positive, the restriction will be the same as the restrictions of a "control area". People in control areas can, with limit, collect essential supplies within the neighborhood. Neighborhoods which are listed as prevention areas have no reported case within 14 days. People in prevention areas should only travel within the street. In practice, additional restrictions are levied by the local residents' committee.
Since April 22, Shanghai officials said Shanghai have to follow the "static management" (静态管理) policy
On April 27, Shanghai officials announced that some hospitals in Shanghai will temporarily suspend their service.
On May 6, multiple areas (including "prevention areas") was put into a so-called "silent period" (静默期), banning all entry and exit, including delivery shipment. The stated rationale was that some positive cases appeared in prevention areas, and for a "final assault" (攻坚) on the case count. On May 17, another wave of "silencing" started, this time spanning the entirety of multiple districts, again under the name of a "final assault".
On May 6, In Shanghai, which is entering its second month of lockdown, city officials said cases have been declining since Apr 22 and its outbreak is under control.
From May 29, plans were announced to ease the lockdown on June 1. The adjustment entails:
- People entering public areas and taking public transport must now show a negative PCR test result taken with 72 hours. The original requirement was 48 hours. The standard for leaving the city remains unchanged: negative PCR test taken within 48 hours must be shown along with a negative antigen test within 24 hours.
- A ban on residents' committees adding additional restrictions in all areas except those marked "closed", "control", "mid-risk", and "high-risk". This has attracted criticism from these committees, who claimed that their extra restrictions were not their own decisions, but unwritten telephone orders from above.
- Lockdown measures on businesses are to be lifted as an effort to help the economy that has been hit hard with strict restrictions.
The adjustments were made to "promote epidemic prevention and control as well as economic and social development, and resume work and a return to normal life," the city official added in the May 29 press conference. City officials also emphasized that the term "lifting the lockdown" (解封) is not to be used, as "static management" is not "lockdown" (封城).
The lockdown was lifted at midnight June 1, with many rushing to the grocery store to restock on food. Shanghai declared that it would do its best to recover the losses caused by the epidemic.
On June 3, four neighborhoods in Jing'an and Pudong were put back into "closed" lockdown and designated as "mid-risk" due to seven new cases found the prior day. On June 7, some more areas are restricted to "closed" area.
In early July, many cases reported is related to a person who visited illegally operated KTV.
Mass testing and Isolation
On March 4, Shanghai instituted a policy of mass COVID testing. In every building with a positive COVID-19 case, all residents were required to undertake individual "nucleic acid" COVID tests. Other areas undertook pooled COVID-19 testing.
Shanghai residents were required to undertake nucleic acid tests throughout the lockdown, ranging from multiple times per week to once per day. Tests were initially posted on the Health Cloud APP, but over the course of the lockdown migrated to mini programs on Alipay or WeChat. Tests were required for all regions regardless of risk, and would generate a colored health code (Chinese: 健康码; pinyin: jiànkāng mǎ). Each district was responsible for implementing their own system around the code Green codes were issued to people with negative antigen tests, yellow for close contacts of positive cases or those who did not test, and red for positive cases. Enforcement of health codes was left up to individual districts and communities; some locations forbade residents from leaving their neighborhoods regardless of the health code.
Residents that refused COVID testing would see their health code turned red. Some neighborhoods threatened permanent red-code status for those who refused or resisted transportation to a quarantine center, with one location promising on April 12 that such people would "never be rehabilitated" (永不摘帽).
Shanghai authorities converted schools, residential buildings and other structures into quarantine facilities when designated facilities ran short on space.
Education
As the caseload in the outbreak was growing, there were messages like "Shanghai will stop school" on Weibo. On March 8, a Shanghai official denied the possibility, but for students absent due to COVID-19 the platform "Air Class" would allow for education to continue. On March 12, in-person school was suspended, with students able to participate using platforms such as "Shanghai V-Class" or "Shanghai Education" instead. On May 7, Official announced the National College Entrance Examination in Shanghai would be extended to June, Senior High School Entrance Examination in Shanghai would be extended to July, with lab and English speaking test sections being removed and counted as a full credit towards final score.
Shanghai Ministry of Education stated all middle and high school student could come to school before June 14.
Transportation
On April 13, the Public Security Bureau of Shanghai announced that people in prevention areas must not enter "closing areas"; nonessential automobiles would also be prohibited.
Law enforcement
On March 22, two people posted information on a group chat saying Shanghai was about to perform a "city closure"(feng1cheng2 封城). The next day, the public security bureau of Shanghai investigated both for the crime of posting false information intentionally. On March 26, Wu Fan, the vice-principal of Shanghai Medical College stated that Shanghai would not go into lockdown because of how much the city contributed to the economy of China.