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CNN
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China’s zero-Covid policy, which has stalled the world’s second-largest economy and sparked an unprecedented wave of protests, announced Wednesday a drastic fix to draconian measures that ultimately failed to cure the virus. Therefore, it is currently dismantled.
While maintaining some restrictions, the new guidelines largely do away with health QR codes that were mandatory to enter most public places and roll back mass testing. Close contacts of Covid-19 cases can also skip centralized quarantine.
Recently, many cities have begun lifting some of the stringent restrictions that have dictated and severely restricted daily life in China for nearly three years.
But while the changes represent a major shift and have brought relief to many who were increasingly frustrated by high costs and COVID-19 demands, another reality is also clear. look now
experts say Much is still unknown about how the coming weeks and months will unfold, with China looking to boost vaccination coverage among the elderly, surge in hospitals and improve intensive care capacity, and antiviral drugs. Inadequate preparations such as stockpiles of
The Omicron variant is milder than previous strains, and although China’s overall vaccination coverage is high, even a small number of severe cases in vulnerable and poorly vaccinated groups like the elderly have been reported nationwide. If the 1.4 billion infections surge, it could overwhelm hospitals, experts say.
“This is an imminent crisis. The timing is really bad… China now has to relax many of its measures over the winter (which coincides with flu season). No, the US School of Public Health notes that public dissatisfaction likely triggered China’s accelerated transition.
guidelines This comes three years after Covid-19 cases were first detected in central China’s Wuhan, and after protests were held across China against its Covid-zero policy late last month.
China used to control cases by requiring testing and clear health codes for entry into most public places and domestic travel, except for a few places such as medical facilities and schools. , these codes will no longer be checked. Mass testing will be rolled back for everyone, except for those in high-risk areas and those in high-risk positions. People who test positive for Covid-19 but have mild or asymptomatic cases who meet certain criteria should stay at home rather than being forced to go to centralized quarantine centers like close contacts. can be quarantined.
Locations classified as “high risk” by authorities can still be locked down, but these lockdowns must be more limited and precise, according to new guidelines circulated by Chinese state media.
The shift marks a rapid turnaround following mounting public discontent, economic costs and record case numbers in recent weeks. They come after senior government officials first suggested last week that the country may move away from its Covid-free policy into which it has devoted significant resources for so long, they asked at a press conference.
“China has pursued this policy for a very long time, but is now between a rock and a hard place,” said William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center in the United States. “They no longer have good options in either direction. Is not.”
As restrictions ease and the virus spreads across the country, China, like it has seen elsewhere in the world, “will have to go through a painful period in terms of sickness, serious illness, deaths and stress on the health care system. We have to,” he added, early in the pandemic.
Since the emergence of a global vaccination campaign and Omicron variant, health experts have questioned China’s zero Covid compliance, using mass testing and surveillance, lockdowns and quarantines. It points to the sustainability of strategies that tried to stop a highly contagious virus by using .
But as some restrictions are lifted, experts say it looks like a haphazard transition after years of focusing on meticulously controlling the virus. , said change could come before China could make the preparations it deemed necessary by health officials.
“An uncontrolled epidemic – one that only peaks when the virus starts to infect too few people – poses serious challenges to health systems, not just in terms of managing a small fraction of severe Covid cases. Ben Cowling, professor of epidemiology at the University of Hong Kong, said:
But even if restrictions are eased, it’s “hard to predict” how quickly the infection will spread across China, Cowling said.
“And I don’t rule out the possibility that stricter measures will be reintroduced to combat the rising number of cases,” he said.
Experts agree that allowing the virus to spread nationwide is a big change for a country that has officially reported 5,235 Covid-19 deaths so far in early 2020. Until recently, state media heavily touted the dangers of the virus.
According to a model published in Nature Medicine in May by researchers at Shanghai’s Fudan University, if Covid-19 restrictions are lifted and China’s approved antiviral drugs are no longer available, then within six months It is estimated that more than 1.5 million Chinese could die in
But if nearly all older people were vaccinated and antiviral drugs were widely used, mortality could drop to the level of seasonal flu, the authors say.
Last month, China released a list of measures to strengthen its health system against Covid-19. This included directives such as increased vaccination of the elderly, stockpiling antiviral treatments and medical equipment, and expanding critical care capacity. achieved before it occurs.
“(Is China ready?) No, given the surging capacity in three years and the stockpile of effective antivirals. If we talk about triage procedures – they are not strictly enforced – And when it comes to talking about immunization rates for older people, especially those over 80, it’s a general no.” at the Council on Foreign Relations in New York.
Chinese officials are likely to closely assess outcomes such as mortality to determine future policy measures, he added.
According to the Organization for Economic Co-operation and Development, the United States has at least 25 critical care beds per 100,000 people. In contrast, there are fewer than four beds in China, the same number, health officials said last month.
The system also offers limited primary care, said Cheng of Yale University, and may take even moderately ill people to the hospital rather than calling their family doctor. There is an increasing burden on
Meanwhile, weak health infrastructure in rural areas could exacerbate the crisis, especially as testing declines and urban youth return to their rural hometowns to visit elderly family members for next month’s Lunar New Year. there is, he said.
Although China’s overall vaccination coverage is high, the elderly are less protected than in other parts of the world: they are most likely to die from Covid-19 and are the most prioritized for vaccination. Some countries have already started giving 4th or 5th doses to at-risk groups.
According to China’s National Health Commission, China’s calculations show that more than 86% of the population over the age of 60 is fully vaccinated, with a low booster rate and a More than 45 million of them have not yet received a booster dose. About 25 million older people are not vaccinated, according to a comparison of official demographics and immunization data on 28 November.
According to state media, about two-thirds of the most at-risk group over the age of 80 had been fully vaccinated according to Chinese standards, but had not received a booster dose as of 11 November. Only 40% received
But while China calls the third dose of its widely used inactivated vaccine a booster shot, the World Health Organization’s Vaccine Advisory Group last year said older people receiving these vaccines could not get enough of them. It recommends 3 doses in the first course to ensure protection.
Inactivated vaccines used in China have been found to induce lower levels of antibody responses compared to other vaccines used abroad, and many countries using this dose combines it with a more protective mRNA vaccine that China has not approved for use.
Cowling said evidence from the Hong Kong outbreak shows that the Chinese inactivated vaccine used in Hong Kong worked well to prevent severe disease, but the World Health Organization recommends He said it was important for older people to receive three doses in the first course, so that a fourth dose should be given on top of that to keep immunity high, he said. added.
On November 28, top health officials announced a new plan to increase vaccination coverage among the elderly, but such measures will take time and other preparations for the surge.
Minimizing the worst consequences of the Covid-free transition will depend on its preparation, Cowling said. From that perspective, he said, “It doesn’t seem like a good time to ease policy.”
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