The COVID-19 pandemic in China is part of the worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). China was the first country to experience an outbreak of the disease, the first to impose drastic measures in response (including lockdowns and face mask mandates), and one of the first countries to bring the outbreak under control.
The first wave of the disease manifested as the 2019–2020 COVID-19 outbreak in mainland China, beginning with a cluster of mysterious pneumonia cases, mostly related to the Huanan Seafood Market, in Wuhan, the capital of Hubei province. It was first reported to the local government on 27 December 2019, and published on 31 December. On 8 January 2020, a new coronavirus (SARS-CoV-2) was identified as the cause of the pneumonia by Chinese scientists. By 29 January, the virus was found to have spread to all provinces of mainland China. The virus was first confirmed to have spread to Hong Kong on 23 January 2020, thus originating the COVID-19 pandemic in Hong Kong. Confirmed cases were generally transferred to Princess Margaret Hospital's Infectious Disease Centre for isolation and centralized treatment. On 5 February, after a five-day strike by front-line medical workers, the Hong Kong government closed all but three border control points – Hong Kong International Airport, Shenzhen Bay Control Point, and Hong Kong–Zhuhai–Macau Bridge Control Point remaining open. The first case of the disease in Macau was confirmed on 22 January 2020, originating the COVID-19 pandemic in Macau. The city saw nine more cases by 4 February, but no more cases until 15 March, when imported cases began to appear. Until 26 April 2021, the city had 49 cumulative confirmed cases of COVID-19, all of those having recovered, and no deaths from the disease. Stringent government measures have included the 15-day closure of all 81 casinos in the territory in February; in addition, effective 25 March, the territory disallowed connecting flights at its airport as well as entry by all non-residents (with the exception of residents of mainland China, Hong Kong, and Taiwan), and from 6 April, the Hong Kong–Zhuhai–Macau Bridge was closed to public transport and most other traffic.
Government response From the start, the Chinese government response pursued a zero-COVID strategy, which aimed to eliminate transmission of the virus within the country and allow resumption of normal economic and social activity; by late 2021 it was one of few countries still pursuing this approach.
On 1 February 2020, the People's Bank of China announced it would temporarily suspend the inclusion of mortgage and credit card payments in the credit record of people impacted by the pandemic. Private financial credit scoring companies, including Sesame Credit, suspended financial credit ratings. Various cities established mechanisms to incentivize companies to provide pandemic relief, with measures including whitelisting (referred to in China as redlisting) for those donating funds and supplies with benefits like simplified administrative procedures, increased policy support, or increased financial support. Following a speech by Xi Jinping emphasizing areas of regulatory compliance, provinces and cities promulgated regulations emphasizing heavy penalties for price hikes, violence against doctors, counterfeit medical supplies, refusal to comply with pandemic prevention measures, and wildlife trade violations.
By late February 2020, the pandemic had been brought under control in most Chinese provinces. On 25 February, the reported number of newly confirmed cases outside mainland China exceeded those reported from within for the first time. By the summer of 2020, widespread community transmission in mainland China had been ended, and restrictions were eased there. As of October 2020 China's economy continued to broaden recovery from the recession during the pandemic, with stable job creation and record international trade growth, although retail consumption was still slower than predicted.
By August 2021, China had donated 700 million vaccine doses abroad, an amount more than all other countries had combined.
In 2022, infection rates increased, and on 3 April 2022, China reported 13,146 new cases of COVID-19 in the past 24 hours, which was the highest single-day total of new cases since the height of the 2020 outbreak.
Mainland China
Based on retrospective analysis published in The Lancet in late January 2020, the first confirmed patient started experiencing symptoms on 1 December 2019, though the South China Morning Post later reported that a retrospective analysis showed the first case may have been a 55-year-old patient from Hubei province as early as 17 November 2019.
The outbreak went unnoticed until 26 December 2019, when Zhang Jixian, director of the Department of Respiratory Medicine at Hubei Xinhua Hospital, noticed a cluster of patients with pneumonia of unknown origin, several of whom had connections to the Huanan Seafood Market. She subsequently alerted the hospital, as well as municipal and provincial health authorities, which issued an alert on 30 December. Results from patient samples obtained on 29–30 December indicated the presence of a novel coronavirus, related to SARS.
On 22 January 2020 Hubei launched a Class 2 Response to Public Health Emergency. Ahead of the Hubei authorities, a Class 1 Response to Public Health Emergency, the highest response level was announced by the mainland province of Zhejiang on 23 January. Around 23 January 2020, stringent measures such as lockdown of Wuhan and the wider Hubei province and face mask mandates were introduced, which lowered and delayed the epidemic peak according to epidemiology modelling. Guangdong and Hunan followed suit later on the day. On the following day, Hubei and 13 other mainland provinces also launched a Class 1 Response. By January 29, 2020, all parts of mainland had initiated a Class 1 Response after Tibet upgraded its response level on that day.
Within three weeks of the first known cases, the government built sixteen large mobile hospitals in Wuhan and sent 40,000 medical staff to the city. Implementing these measures made Chinese perceptions of the government's response more favorable.
Yet, by 29 January, the virus was found to have spread to all provinces of mainland China. Hubei Province party secretary Jiao Chaoliang was removed from office for failing to contain the outbreak. On 31 January 2020 the World Health Organization declared the outbreak a Public Health Emergency of International Concern. A severe shortage of face masks and other protective gear led several countries in February 2020 to send international aid, including medical supplies, to China.
In June 2020, the Sinopharm BIBP vaccine (BBIBP-CorV) was authorized for emergency use in China. On July 22, 2020, Chinese authorities started the emergency use of COVID-19 vaccines. As of July 2022, it was estimated that about 89.7% of the country's population had received a vaccine, and about 56% of the population had received a booster dose.
China was one of a small number of countries that have pursued an elimination strategy, sustaining low case numbers between the 2020 outbreak until early 2022. China's response to the initial Wuhan COVID-19 outbreak has been both praised and criticised. Some have criticised the censorship of information that might be unfavorable for local officials. Observers have attributed this to a culture of institutional censorship affecting the country's press and Internet. The government censored whistleblowers, journalists, and social media posts about the outbreak. During the beginning of the pandemic, the Chinese government made efforts to clamp down on discussion and hide reporting about it. Efforts to fund and control research into the virus's origins and to promote fringe theories about the virus have continued up to the present. In October 2020, The Lancet Infectious Diseases reported: "While the world is struggling to control COVID-19, China has managed to control the pandemic rapidly and effectively." By late 2020, China had contained the first wave of COVID-19.
E-commerce contributed substantially to China's COVID-19 pandemic response by facilitating fast delivery of personal protective equipment, food, and daily use consumer goods during lockdowns.
Ultimately, lockdowns in China were highly effective in reducing the spread of COVID-19; for several years, there was wide public consensus in China that the benefits outweighed the costs.
December 2022 surge Nationwide protests broke out in November 2022 amid growing discontent among residents over the zero-COVID policy and the resulting economic costs. Following the easing of the Zero-COVID strategy in December 2022, Beijing reported a surge in COVID-19 infections. It was reported that restaurants and food delivery services had closed due to staff infections, and pharmacies had been emptied of medicine and disinfectant solution. On 22 December, a report by UK research firm Airfinity modelling based on regional Chinese data estimated that more than 5,000 people were dying each day from COVID-19 in China, with cases rising fastest in Beijing and Guangdong province. Internal minutes from a meeting of China's National Health Commission held on 21 December revealed that as many as 248 million people in China might have contracted COVID-19 over the first 20 days of December, and up to 37 million on a single day.
On 23 December 2022 Qingdao's municipal health chief Bo Tao stated that the city was seeing "between 490,000 and 530,000" new infections each day and on the same day, Dongguan's health commission declared on its Weixin account that the city had 250,000 to 300,000 people being infected every day. Officials in Yulin, a city of 3.6 million people in Shaanxi province, logged 157,000 new infections with models estimating more than a third of the city's population had already been infected. On 25 December 2022, the National Health Commission announced that it would no longer report daily COVID-19 figures, and Zhejiang provincial government said it was battling around a million new infections a day and expected the number to be doubling in days ahead.
Special administrative regions Hong Kong
Hong Kong was relatively unscathed by the first wave of the COVID-19 outbreak and had a flatter epidemic curve than most other places, which observers consider remarkable given its status as an international transport hub. Furthermore, its proximity to China and its millions of mainland visitors annually would make it vulnerable. Some experts now believe the habit of wearing masks in public since the SARS epidemic of 2003 may have helped keep its confirmed infections at 845, with four deaths, by the beginning of April. In a study published in April 2020 in the Lancet, the authors expressed their belief that border restrictions, quarantine and isolation, social distancing, and behavioural changes such as wearing masks likely all played a part in the containment of the disease up to the end of March. Others attributed the success to critical thinking of citizens who have become accustomed to distrusting the competence and political motivations of the government, the World Health Organization, and the Chinese Communist Party.