Comparing COVID-19 Case Trajectories in the U.S. and China

Figure #1: Monthly New COVID-19 Cases in US vs China Analysis

FIgure 1 Monthly New COVID-19 Cases in the U.S. vs China compares the monthly number of newly confirmed cases in countries, the United States and China from late 2019 through 2022.

To understand how national health policies shaped economic recovery, we begin by examining the pandemic’s epidemiological baseline.  Specifically, Figure 1 compares monthly COVID-19 cases in the U.S. and China, illustrating how each country’s policy approach shaped the severity and timing of outbreaks. These contrasting case patterns provide essential context for understanding why their tourism sectors recovered at such different speeds.

The United States, as represented in dark orange, exhibits large, repeated waves of confirmed COVID-19 cases, with significant surges in late 2020, mid-2021, and a dramatic peak in early 2022, which reached to nearly 20 million new cases in a single month. Although the magnitude of these waves fluctuates, case counts consistently remain in the millions. 

In contrast, China’s trend in infection cases (shown in blue) remains extremely low and nearly flat for most of the timeline, with monthly cases staying in the hundreds and thousands until a brief spike in mid-2022, reaching to almost 3 million new cases, followed by another decline. Across the entire period, the U.S. curve is defined by volatility and high case volume, while China’s curve remains almost entirely suppressed. 

Before interpreting these trends, it is important to acknowledge the limitations of the dataset, as also discussed in our data critique. The dataset comes from a global repository that standardizes numbers from national reporting systems, but these systems vary widely. In other words, countries differ in testing availability, case definitions, reporting rules, and certification practices; thus, cross-country comparisons must be considered and approached with caution. For the United States, case data may fluctuate because reporting is highly decentralized.  States and counties follow different testing strategies and may experience backlogs, delays, or inconsistent reporting practices, creating artificial spikes or dips in the timeline. In China, we see that the data appears smooth and consistently low, but this may reflect incomplete reporting. Strict testing protocols, centralized data control, and concerns about transparency raise the possibility of undercounting, especially during periods when anecdotal reports describe sizable outbreaks. These limitations do not negate the usefulness of the visualization, but they do inform how the trends should be interpreted. It is possible that China’s “zero tolerance” approach reflects a similar pattern of relatively consistent confirmed cases, but the true numbers may exist on a higher scale. 

This visualization also raises further questions. Why do some regions and periods of time experience dramatic spikes while others see sharp declines? More importantly, how did these evolving case patterns affect broader social and economic activity over time?

Inbound Tourism Arrivals and Inbound Tourism Expenditure

To provide context, inbound tourism arrivals refer to the number of international visitors entering a country, whereas inbound tourism expenditure measures how much these visitors spend while traveling inside that country.

Viewed together, these two indicators reveal how the demand for international travel returned in China and the United States from 2018 to 2023. Although one reflects volume and the other reflects spending, both show the same underlying pattern: the two countries recovered on completely different timelines because of their contrasting COVID-19 policies.

Both countries began with strong pre-pandemic tourism levels. In 2019, China recorded 165.5 million arrivals and 35.8 billion USD in inbound spending, while the United States had 169.3 million arrivals and 199.0 billion USD in expenditure. In 2020, both countries experienced a collapse. Arrivals dropped to 27.5 million in China and 44.8 million in the United States. Spending also fell sharply to 10.0 billion USD in China and 72.5 billion USD in the United States.

From this point onward, the trajectories reflect the differences between the U.S. mitigation strategy and China’s Zero-COVID containment strategy. The United States began reopening earlier. After the October 2021 announcement that travel restrictions would be lifted and the November 2021 removal of the China travel ban, U.S. arrivals rose to 66.6 million and spending began rebounding to 71.4 billion USD. By 2022, expenditure climbed to 136.9 billion USD, and by 2023 it reached 213.1 billion USD, surpassing pre-pandemic levels. These early increases align with the U.S. decision to accept high infection risks in exchange for economic activity, which is central to our research question.

China followed a different path. International travel restrictions that began in February and March 2020, along with strict quarantine requirements that extended throughout 2021 and 2022, kept inbound arrivals near zero for three consecutive years. China’s arrivals remained between 25 and 27 million from 2020 to 2022, while expenditure stayed below 12 billion USD. Only after China ended quarantine for international travelers in January 2023 do we see signs of recovery. By 2023, arrivals reached 35.5 million and expenditure rose to 24.8 billion USD, but both remain far below the 2019 baseline.

These paired charts directly connect to our research question. They show that the U.S. mitigation strategy enabled an early, gradual return of visitors and spending, while China’s containment strategy produced a delayed rebound that did not begin until its borders reopened. The divergence supports our thesis that the financial recovery of the tourism sector was not merely shaped by global trends. It was the direct consequence of policy philosophies that prioritized either economic mobility or public health protection.

Inbound Arrivals Recovery in China and the U.S. and Expenditure Recovery in China and the U.S.

The recovery index allows us to compare tourism rebounds in China and the United States on a proportional basis relative to their own pre-pandemic levels. For each year, we calculate the index by dividing the arrivals or expenditure for that year by the 2019 value and then multiplying by one hundred. This method removes the scale differences between the two countries and highlights how quickly each approached its 2019 baseline. It shows not only whether tourism increased or decreased, but how fully the sector restored itself after the initial collapse.

When viewed through this index, the divergence between the two countries becomes even clearer. In 2020, both countries dropped sharply, which matches the early policy actions in the timeline, including China’s January to March 2020 implementation of strict border controls and the United States’ declaration of a public health emergency and travel ban on China. After this shared collapse, the United States shows a gradual return toward the 2019 baseline. By 2021, U.S. arrivals recovered to 40.24 percent and expenditure reached 36.43 percent. These early increases align with the October and November 2021 policy changes when the U.S. announced the lifting of major travel restrictions and reopened to vaccinated international travelers. By 2022, the United States had regained nearly seventy percent of its pre-pandemic tourism spending, and by 2023 its tourism expenditure surpassed the 2019 benchmark entirely. The index shows a steady upward trajectory, which reflects the U.S. mitigation strategy that allowed mobility and tourism activity to resume earlier despite elevated COVID-19 case counts.

China’s recovery index reflects the opposite policy logic. China maintained strict international travel controls and quarantine requirements through 2020, 2021, and most of 2022. As a result, its arrival recovery stayed between fifteen and twenty-seven percent across these three years, and its expenditure recovery remained below thirty-two percent. These flat values match the timeline entries that document China’s prolonged entry restrictions, limited international flights, and continued quarantine rules. Only after January 2023, when China officially ended quarantine for inbound travelers and relaxed testing rules, did the index rise. Even then, China’s arrival recovery reaches only 21.84 percent and expenditure reaches 69.21 percent, both still far from the 2019 baseline. This delayed rebound shows how Zero-COVID policies, designed to prioritize public health protection, restricted tourism activity long after most countries had reopened.

These recovery index charts support our research question clearly. The United States and China did not simply experience different speeds of recovery due to global conditions. Their proportional rebounds were shaped by their national strategies. The U.S. mitigation approach supported earlier and more continuous tourism restoration, while China’s containment strategy produced a multi-year stagnation followed by a late and incomplete rebound. The index makes visible the direct connection between public health policy and financial recovery in the tourism sector, which is central to our thesis about how policy philosophies defined the economic trajectories of both countries.

Figure #6: Tourism Sector Recovery / Output Levels

Building on these national-level recovery patterns, the Tourism Sector Recovery and Output Levels visualization disaggregates U.S. tourism recovery across individual industries relative to their 2019 baseline, revealing a highly uneven post-COVID rebound. High-volume sectors such as traveler accommodations, air transportation, and food services not only recovered but exceeded pre-pandemic output levels, reflecting strong domestic demand and early reopening policies that prioritized economic mobility. In contrast, industries more dependent on international visitors or dense in-person activity (such as rail transportation, sightseeing services, and performing arts) remained well below baseline levels. This divergence illustrates how, even as aggregate tourism activity rebounded, specific sectors continued to experience lingering effects of travel restrictions, reduced international mobility, and persistent caution around large gatherings.

Together, this sector-level unevenness reinforces the central role of policy in shaping recovery outcomes: while the U.S. mitigation strategy enabled an early return of domestic tourism activity, it did not fully offset losses in segments tied to international travel and mobility restrictions observed earlier in the policy and case timelines.

Figure #7: Stringency Index

Travel and Tourism Satellite Account (TTSA) output data and quarterly COVID-19 policy indicators from the OxCGRT datasets for China and the United States are integrated to create visualizations that measure stringency. By aligning tourism outcomes with disaggregated policy measures, particularly international travel controls, internal movement restrictions, and stay-at-home requirements. While both countries experienced sharp declines at the onset of the pandemic, the United States’ earlier relaxation of mobility restrictions coincides with a significant rebound in inbound spending and sector activity beginning in 2021. In contrast, China’s prolonged border closures and sustained restrictions were reflected through high stringency values, corresponding with multiple years of near-zero inbound tourism.

The Stringency Index visualization illustrates how average national stringency changed quarter-by-quarter. The United States exhibits a sharp spike in early 2020, reaching a peak stringency index near 62 in Q2 as lockdowns and stay-at-home orders were enacted nationwide. However, U.S. restrictions rapidly eased after mid-2020, falling below 20 by early 2021 and remaining low through 2023. This reflects an early policy shift toward reopening, even as case spikes persisted.

China’s trajectory is the opposite: although its initial restrictions were slightly lower than those of the U.S., China maintained consistently elevated stringency throughout 2020–2022, particularly in mobility-focused policies tied to its “Zero-COVID” strategy. Not until 2023 does China’s index meaningfully decline, coinciding with the rollback of mass testing, quarantine rules, and domestic movement controls. This early divergence (rapid reopening in the U.S. versus prolonged containment in China) forms the foundation for their contrasting tourism recoveries.

Figure #8: Comparing Key Areas of Stringency Between China and the US

Stringency is measured into four core policy areas: contact tracing, international travel controls, internal movement restrictions, and stay-at-home requirements, providing a more granular view of which interventions most directly shaped each country’s tourism trajectory. The visualization that compares key areas of stringency between China and the U.S. shows that the policy indicators are ordinal variables from the Oxford COVID-19 Government Response Tracker, coded on a 0–2 scale, where 0 indicates no measures, 1 indicates partial or recommended measures, and 2 indicates strict or mandatory enforcement. As a result, the y-axis extends to 2 to reflect the full range of policy intensity rather than a normalized index. Monthly values represent averages over time, capturing changes in enforcement severity within each period. 

The starkest contrast appears in international travel controls: China maintains values near the maximum across nearly every quarter until late 2022, signaling near-complete border closure, while the United States never surpasses a mid-range level and phases out most travel restrictions by early 2021. Internal movement restrictions show a similar divergence, with U.S. values dropping close to zero by 2021 Q1 as domestic reopening accelerated, whereas China’s remain elevated due to recurrent lockdowns and digital mobility controls. Stay-at-home requirements are also short-lived and front-loaded in the U.S. but prolonged and cyclical in China. Meanwhile, contact tracing stays consistently high in China even as other measures begin to loosen, reflecting ongoing surveillance and testing infrastructure that continues shaping mobility. 

Taken together, the disaggregated policy domains show that China’s tourism stagnation stemmed not just from generally high stringency but from the persistence of border closures and movement restrictions, the very policies that most directly constrain travel flows; by contrast, the U.S.’s earlier reopening across these domains enabled a faster recovery in both domestic and inbound tourism.