Residents in North China's Tianjin Municipality undergo nucleic acid testing in an orderly manner. Tianjin reported 12 confirmed cases on March 9, 2022. Photo: VCG

China has seen spikes in domestically transmitted COVID-19 infections in recent days, of which about 50 percent are asymptomatic cases, affecting at least 16 provincial-level regions, the latest daily report showed on Thursday. 

Some Chinese public health experts called the latest rebound  "the most severe onslaught" since the early epidemic in Wuhan, and after two years of fighting the epidemic with rigorous measures, different sectors have shown a certain level of fatigue toward the dynamic zero COVID strategy, which could affect the outcome of the implementation of the current policy. 

But experts warned that it's still crucial for China to stick to the zero tolerance policy, which has proved to be effective in preventing severe cases and deaths, helping maintain the normal livelihoods and economic development at a low cost. While more countries discuss changing strategies for either living with the virus or abandoning strict lockdown measures, as the world has been battling the virus relentlessly for two years, China needs to carry out its current strategy at its own pace, seizing the opportunity for accelerating the public's immunity through vaccinations and taking more time to observe the impact of mutations before cautiously preparing for policy adjustment. 

Two years ago, WHO Director-General Tedros Adhanom Ghebreyesus announced that, after assessing the outbreak, COVID-19 could be characterized as a pandemic, according to a statement on the WHO website on March 11, 2020. 

Two years later, UN chief Antonio Guterres sent out a message saying it's a serious mistake to think the crisis is over, as about three billion people are still waiting for their first shot of the COVID-19 vaccine. However, some countries and regions have been opening up and opting to live with the virus. One such example is Denmark, which declared last September that precautions were over and lifted the restrictions in February. Most recently, states in the US including California and Connecticut have been ending mask mandates, according to media reports. 

However, it's still too early for China to discuss reopening, some epidemiologists warned, given that the overall public immunity level induced by vaccines is still needed to be increased as well as uncertainties caused by the virus mutations, which also weaken the effectiveness of the current vaccines. There's still a window of opportunity for the country to continue increasing the public's immunity by accelerating mass vaccination while the mutated virus becoming less lethal, and when two dimensions are getting closer, it could be an occasion for talking about reopening, or adjusting the strategy, some experts said. 

New situation, new challenges 

China's National Health Commission on Thursday reported 837 domestically transmitted COVID-19 cases registered on Wednesday, of which 435 are asymptomatic cases. In some places, asymptomatic cases accounted for over 90 percent of total confirmed cases, which is a major characteristic of the current outbreaks in multiple places, signaling a worrying trend of hidden transmission chains, some experts said. 

It was also the third consecutive day that the Chinese mainland reported daily new infections of over 500, and for the fourth consecutive day, the total number of asymptomatic cases exceeded confirmed cases, recent public data showed. 

As the Omicron variant is highly transmissible, China has been enhancing the population's immunity, which could help prevent many from getting infected. However, as the virus continues to mutate, it results in mild or no symptoms, which explains why there are more asymptomatic cases amid current outbreaks, some experts explained. 

"One of the reasons why there are so many asymptomatic infected people is because of mass immunization and the enhanced immunity of the population," Lu Hongzhou, head of the Third People's Hospital of Shenzhen, told the Global Times on Thursday.

With the current situation in the Hong Kong Special Administrative Region, some elderly people have died after being infected with COVID-19, showing that "we can't ignore the danger of the virus and can't regard Omicron as a 'big flu'," Lu said.

The problem is that those people who have been infected with a mutated variant such as Delta can get infected again with Omicron; more than a million people are still infected every day globally, so it's hard to say that the pandemic will end soon, he said.

The rising number of asymptomatic infections has become an obvious characteristic of the current resurgence of the outbreaks in multiple places across the country, making the virus transmission more complex and hidden, some experts said, noting that it also adds to the difficulties involved in anti-epidemic and origins-tracing work. 

The outbreaks have occurred in schools, households and communities. In Northeast China's Jilin, for example, three Fangcang makeshift hospitals were used for the first time since the epidemic began, and a cluster outbreak occurred in a local school in the city of Jilin where 30 buses sent students for quarantine on Thursday. In Qingdao, East China's Shandong, Laixi district reported a total of 544 cases in five days, but the origin of the cluster outbreak remained unclear. 

"A major issue now is after two years of fighting COVID-19 relentlessly, various sectors showed a certain level of fatigue, leading to relaxed anti-epidemic measures in some places," a senior expert close to the Chinese CDC told the Global Times on Thursday on condition of anonymity.

"Such fatigue and relaxation definitely weighs on the outcome of continuing the current policy, and what we need to do now is strengthen our past successful experiences by screening out infections and putting them into quarantine as early as possible," he said. 

China's future plans 

With the world battling COVID-19 for more than two years, many people are eager to know when they can get back to normality, with some looking at China's future plans and asking whether it's time to change its dynamic zero COVID strategy and reopen its borders. Some Western media such as the AP also appeared to notice a change in measures adopted by some areas compared to the strict city lockdowns of the past, as the country constantly seeks to refine its epidemic measures, striking a balance between anti-epidemic work and economic development. 

Chen Xi, associate professor of School of Public Health at Yale University, told the Global Times on Thursday that China's epidemic prevention policy should not be fully relaxed at the moment. For the entire Chinese population, especially the elderly and other key groups, vaccine immunization appears to be the main approach in fighting COVID-19, he said. 

It is still rather difficult to predict what will happen after China fully ends restrictions in its battle against the virus, although data from the UK shows that the fatality rate of the Omicron variant has largely dropped after people receive the booster shot, even to below the level of the flu, Chen noted. 

"However, if it happens during flu season, it may add to the death rate and become a risk we can't ignore, given China's large population," he said. 

Senior Chinese officials and experts recently explained that China's dynamic zero-COVID approach does not seek to achieve zero infections but aims to contain outbreaks as soon as possible, which is still the correct policy for the country at this time. 

"As China continues strengthening public immunity through vaccination, the mutated variant becomes more transmissible but less lethal. When these two dimensions get closer together, it will be time to prepare for a gradual reopening," Chen said.