China has stuck with its “COVID zero” policies throughout the pandemic, but a new highly transmissible variant is putting those policies to test. As most countries enter an endemic phase of the pandemic, which means that they are learning to live with COVID, China has begun imposing restrictions on factories throughout the country. In an already struggling economy, China’s disruptions that will lead to halting the production of Toyota cars and Apple iPhones will cause more problems for the supply chain. Theaters, cinemas and dozens of restaurants have been shut down in Shanghai as the northeastern region of Jilin banned its 24 million residents from leaving the province or traveling between cities.

Although this might seem as taking unnecessary precautions late in a pandemic for many people, China is actually facing its largest surge of COVID cases since the virus first emerged more than two years ago. Frightening outbreaks in two-thirds of the country’s provinces are putting into question the effectiveness of China’s sustained zero-tolerance policy towards COVID. This is particularly worrying because the vaccination rate among China’s older adults is comparatively low. Also, the country has far fewer intensive care hospital beds relative to its population than most industrialized countries, which means that a surge of hospitalizations due to COVID infections will cause an already fragile hospital system to collapse. Experts predict that a major outbreak would quickly overwhelm hospitals, especially in China’s vast rural areas.

With that being said, it is not completely fair to say that China’s policies have completely failed. The United States and other Western countries have seen much higher rates of infection and death since the pandemic started, and those countries still have higher rates currently. However, the seven-day average rate of new infections in China has more than quintupled in recent days, with the latest estimates putting it at 1,584 new cases.

For a country that had managed to have fairly low COVID cases in the last two years, this rise is particularly frightening. “Because of the large number of cases in a short period of time, it is inevitable that there will be some panic all over the country, and Shanghai is no exception,” leading infectious disease expert in China Dr. Zhang Wenhong said in a post shared on his social media account.

China was able to respond swiftly to the current surge in cases by deploying workers and resources to affected areas. For example, in Jilin Province, which is experiencing a huge surge, workers are building temporary facilities to house and quarantine thousands of people who may test positive for COVID. Across the country, thousands of workers are testing millions of citizens on a daily basis to ensure quarantining and treating people that are positive before they spread the virus even further. However, the testing program is finding it hard to keep up with the new surge.

“We have noticed that there have been problems such as long lines and slow test results at many testing sites in the past two days,” Deputy Director of the Shanghai Municipal Health Commission Lu Taohong said at a news conference watched anxiously by millions around China. Although the country’s policy has long been swift containment by locking down neighborhoods and regions, the system that made that possible in the past is becoming less effective.

With cities going into lockdown again, a sputtering economy and a tired population, it is difficult to imagine what China is going through. How the pandemic progresses from this point on will be a valuable lesson to health experts in the future.