More than two years into the pandemic, most countries are striving to live alongside COVID-19, accepting the virus as part of everyday life. China, where the pathogen first emerged, exists in an alternate reality, wedded to a zero-tolerance strategy that’s growing harder to maintain.

Despite firmly closed borders and a vaccination rate near 90%, the highly transmissible omicron variant has been reported in seven out of 31 provinces and all of China’s biggest cities. Port disruptions and citywide shutdowns are increasingly common, and on Monday, the government signaled it’s bracing for more: The central bank cut its key interest rate after the economy posted its weakest quarter since the beginning of the pandemic.

The human costs are rising, too. In the city of Xi’an, at least two people died and two women miscarried, barred from medical treatment by zealous enforcement of COVID-19 lockdown protocols that began just before Christmas. The official tally of daily infections there, on the other hand, remains in the dozens, with zero deaths.