A tourist feeds black-headed gulls by the bank of Dianchi Lake in Kunming, southwest China's Yunnan Province, Jan. 1, 2023. People take part in various leisure activities to spend the New Year holiday. (Xinhua/Cao Mengyao)

  Editor's Note: After three years' hard efforts to keep COVID-19 at bay, China has optimized its virus response and come up with a major shift in its epidemic policy by downgrading COVID management and announcing the reopening of international borders from January 8, 2023. Global Times talked with frontline medical workers, experts and ordinary Chinese people, refuting some Western media narratives that China's sudden U-turn in policy had left many unprepared. The changing virus variant, accelerated mass vaccination and enhanced medical resources all laid out the foundation for COVID response adjustment. 


When Chinese people woke up on Tuesday morning, many shared their excitement on social media for the long-awaited relaxation of the epidemic control measures as the Chinese top health authority announced late on Monday it would downgrade COVID-19 management and reopen the country's borders, to be effective on January 8, 2023. After three years fight against the pandemic, some considered the ending of COVID-19 quarantines and reopening borders as the best New Year gift, which will also be a major turning point in the country's fight against the virus. 

For Chinese officials, medical workers, experts and the public, it has been a tough battle over the past three years. During this period, professionals have never stopped exploring more effective ways to contain virus spread and actively optimize epidemic control measures, as well as striking a balance between protecting public health and lives and ensuring social and economic development. China gained valuable windows of opportunity through three-year efforts, including the continuous decline in the virulence of coronavirus variants, more effective medicine, better medical treatment and expanded mass vaccination, providing the confidence and strength to exit the COVID control phase. 

Refuting claims of some Western media that such an adjustment is a sudden policy U-turn, leaving hospitals scrambling to cope with an unprecedented surge of infections while China lacked a COVID exit plan with people paying the price, some medical workers, experts and ordinary Chinese people the Global Times contacted said that they have been constantly preparing for such major shift in COVID-19 response as the country could not be isolated from the world and locked down for good, and especially as the virus variants continued to mutated, people need to make changes in line with the changing situation.  

New situation 

The National Health Commission (NHC) announced late Monday night that the management of COVID-19 will be downgraded from Class A to Class B from January 8, and according to related regulation, there will be no more quarantine for people entering the country, and there will be no isolation of COVID-19 cases and designation of high-risk areas.

The country will gradually resume entry and exit of passenger transport through water and land ports as well as outbound tourism in an orderly manner in light of the international pandemic situation and support capacity of all sectors. International passengers coming into the country should still take a nucleic acid test 48 hours before departure.

Mi Feng, spokesperson of the NHC, said on Tuesday that China has entered a new stage in epidemic prevention and control work, shifting its focus from preventing infections toward preventing severe cases. 

Downgrading the management of COVID-19 from Class A to Class B is an adjustment of the prevention and control strategy made on the basis of comprehensive evaluation of the virus mutation, the epidemic situation and China's prevention and control work, Mi told a press conference. It also aims to continuously improve the epidemic control work, making it more scientific, accurate and effective, he said. 

The State Council joint prevention and control mechanism against COVID-19 also issued five affiliated documents on Tuesday to detail epidemic surveillance, testing, prevention in key groups, institutions and places and personal protection and training work. For severe cases and death caused by COVID-19, medical institutions at all levels should carry out diagnosis and make revisions every 24 hours according to the change of condition and report the death rate and cause within 24 hours after death. 

Downgrading the management of COVID-19 is a prepared battle not a forced reopening, the NHC's deputy director Li Bin told the press conference on Tuesday. Closely monitoring the characteristics of the virus, studying changes in the epidemic situation and accelerating vaccination and supply of medicines while enforcing the medical treatment and emergency handling all created the condition for the new classification of the disease, Li said. 

The wild type of coronavirus has much stronger virulence than flu, which explains why there was relatively higher death rate at the early stage of the COVID outbreak in Wuhan, Wang Guangfa, a respiratory expert from Peking University First Hospital, told the Global Times on Tuesday. 

At that time, there was no deep understanding about the epidemic and little progress in antiviral drug and vaccines, so China had to manage it like a category A disease by controlling the source of infection, cutting transmission routes and protecting vulnerable groups. In the absence of a vaccine, it was difficult to take any effective measures besides controlling the source of infection and cutting off the transmission route, Wang said. 

It turns out that these measures did have good results, and the wave was under full control in the Chinese mainland, he said. 

However, as Omicron spreads much faster than flu while there has been much more progress in vaccination and antiviral drugs, if we insisted on managing the COVID as a category A disease and taking a zero-COVID approach, the costs would be significantly rising while yielding little effect, Wang said. 

Wu Zunyou, China CDC's chief infectious disease expert, told a recent forum in Beijing that the proportion of both severe and critically ill cases fell from 16.47 percent in 2020 to 3.32 percent in 2021, and as of December 5, the rate of this year was 0.18 percent, which showed that the proportion of severe and critical cases is decreasing year by year and the fatality rate is also gradually decreasing.

Also, from the level of population immunization, more than 3.4 billion doses of vaccines have been administered nationwide, with the number of people fully vaccinated accounting for over 90 percent of the total population, according to the NHC. 

Liang Wannian, head of the expert panel overseeing the national Covid-19 response, was quoted as saying in media reports on Tuesday that some Chinese cities have passed or are passing the first wave of peak infections without frightening widespread levels of death. 

Such adjustment is also a scientific optimization in line with the reality rather than completely "lying flat," and prevention and control measures will be adjusted in terms of isolation of infections and close contacts, lockdowns of infected areas and epidemic measures for traffic, Liang noted. "Over the past three years, we have been actively preparing for dealing with those risks to ensure a smooth transition," he said.  

Changing mindset 

For medical workers who have been fighting at the frontline against the epidemic over the past three years, the adjustment of COVID measures is considered as timely and necessary, which will help them shift the focus from mass screening and testing toward treating critical cases. 

"We are not unprepared," Peng Zhiyong, director of the intensive care unit of Zhongnan Hospital of Wuhan University in Wuhan, Central China's Hubei Province, who had fought the early outbreak in 2020, told the Global Times on Tuesday. 

For the past years, we have been enhancing the construction of designated hospitals for treating COVID patients and improving the team of medical workers in ICUs, he said. 

Currently, the total number of critical care medicine beds in China is 138,100, close to the level of 10 per 100,000 people, the total number of doctors in critical care medicine is 80,500, and the number of nurses is 220,000, according to data released by the State Council joint prevention and control mechanism against COVID-19 on December 9. 

Also, makeshift hospitals around the country have also been upgraded and will be transformed into sub-designated hospitals with certain treatment functions. 

To help people be better prepared for the possible waves of infections on the heels of the COVID policy adjustment, some cities such as Haikou, in South China's Hainan, Changsha in Central China's Hunan and Dalian in Northeast China' Liaoning have been distributing healthcare packages to local residents. 

Beijing plans to distribute Pfizer's COVID-19 treatment drug Paxlovid to community health centers in a bid to help treatment of key populations as the city's peak caseload approaches. Local health authorities in the capital also announced on Tuesday they will provide blood oxygen sensors to the elderly and other high-risk groups so they can monitor their health status at home. 

"I have felt Chinese people are fighting together with the government and governmental departments, they are addressing the upsurge and spread of the epidemic," Liang, the leading expert, said. 

More Chinese people showed confidence and solidarity in overcoming COVID infections in recent weeks, as some posted their experiences on social media, inspiring others to stay strong amid the first wave of infections. 

Three years on, many no longer fear the disease by understanding it from a scientific and rational way, and some also encouraged others by sharing their personal experiences of getting infected and telling others that "Omicron is not horrible."

"Downgrading COVID management is based on a comprehensive analysis and it's also a step forward toward the exiting the pandemic," Liang said.