Chinese authorities made the most important decision to end their punishing policy after unprecedented protests against zero-Covid.
Officials announced Wednesdaythe ending of forced centralised quarantine. This allows people with mild Covid, such as those suffering from Covid, to remain at home. There are also limits on lockdowns and fewer Covid test results checks, which will allow them to travel more freely around the country. After various cities had eased local restrictions, it was announced.
China must avoid many pitfalls as it charts a course from zero-Covid.
It is important to ensure that the inevitable rise in infections doesn’t lead to mass death.
James Crabtree (executive director, International Institute for Strategic Studies Singapore) stated that China’s biggest risk is to remove Covid restrictions and not have a large vaccinated population.
China will try to reopen in a targeted manner, protecting those still to be vaccinated. However, so far, at least other countries have not been capable of doing this and have seen that re-opening can lead to a surge of cases.”
This is particularly worrying for China, given its low Covid immunity among seniors and the fact it continues to rely upon less effective domestic vaccines.
South Korea and Singapore were open to foreign countries, and they had well-vaccinated people who received foreign jabs like Moderna, Pfizer and Astrazeneca. However, this did not stop an increase in infections.
According to Chinese authorities, only 69% of people over 60 have received a booster shot and 40% of those older than 80 have had one.
Given the distrust that vaccines continue to inspire, it will be difficult for them to get their vaccinations faster.
“Many older people have underlying illnesses. They think it is not safe to get vaccinated. However, it is actually safe,” Prof Liang Wannian of China’s Covid expert panel told BBC.
Chinese authorities presented plans for temporary and mobile vaccination clinics on Wednesday and urged local authorities not to forget to offer incentives to encourage the elderly to get vaccinated.
According to reports, they plan to increase ccbefore the Chinese New Year, when large numbers of people will be moving around the country.
China is at risk of seeing an increase in severe Covid cases due to its elderly population. This could lead to many deaths in hospitals if they become overwhelmed. This was exactly what occurred in Hong Kong earlier this year when the Omicron waves hit.
This may explain why mainland China now has home quarantine for mild cases and asymptomatic ones. The Global Times, a state media outlet, highlighted a similar move made by Singapore earlier this week as an example to follow, since it would allow for more resources and hospital beds for severe cases.
This goal might be hard to reach.
Singapore has a strong healthcare system that offers many options. People with mild Covid can move to home quarantine as the country has a large network of community clinics, telemedicine providers and other treatment options.
China’s healthcare infrastructure is still patchy, and it suffered from a slowdown in investment after the pandemic. Donald Low, a Hong Kong University of Science and Technology public policy expert, said that many people still rely on hospitals for basic treatment.
“Compared to hospital-based healthcare, China has a relatively small amount of community-based care. It is difficult to follow the Singapore model. China had two years to create that infrastructure. But they didn’t,” Prof Low said.
It is also difficult to determine the timing of relaxation.
Siddharth, a University of Hong Kong clinical virologist, stated that it is particularly concerning that China opens up in winter when the virus is more susceptible to spreading quickly.
Dr Sridhar warned that it must be slow in its reopening or it will experience an “exponentially worse situation” than in Hong Kong earlier in the year.
“Hong Kong has only 7.5 million inhabitants. Decent public healthcare infrastructure. You have deep pockets. This doesn’t hold true for all places in China.
An new Bloomberg analysis, based on data from the US and Europe during the Omicron epidemic, calculated that 5.8 million people would be admitted to intensive care if China had a similar full reopening. This would overwhelm China’s existing healthcare system, which has four ICU beds for every 100,000 people.
Dr Sridhar suggested that the Chinese government could use resources to redirect from containment to set up a door–to–door vaccination campaign, improve critical care infrastructure, such as ensuring oxygen supply, and train as many people in basic critical care as possible.
Experts believe it must also vastly improve its messaging regarding public healthcare to allay fears and provide clear instructions about what to do if someone tests positive for Covid.
Poor and confusing government directives caused hospitals to flood with patients during Hong Kong’s Omicron wave. People panicked even though they were allowed at home to isolate.
Prof Low stated that Chinese authorities could provide a roadmap for living with Covid like Singapore. He said that Covid must be discussed openly with the people to avoid it becoming an endemic problem and they need to accept this fact.
“People have a zero risk bias and the government must counter that by stating that we will always have the Covid Risk.”
Dr Sridhar said that caution is necessary. “It would be a big mistake to think Omicron is safe and that we are fine. It’s not. Now it’s time for us to open up.