China’s Covid-19 prevention and control strategy is undergoing a major revamp. On Dec. 7, the Joint Prevention and Control Mechanism of the State Council issued the “Notice on Further Optimizing and Implementing Covid-19 Prevention and Control Measures.” It says that providing proof of a negative nucleic acid test or presenting a health code is no longer required, except at special locations such as nursing homes, welfare homes, medical establishments, childcare institutions and primary and secondary schools. Proof of negative nucleic acid tests and health codes will no longer be checked for cross-regional migrants, nor will testing be carried out at the destination. In addition, asymptomatic infected persons and mild cases capable of isolating at home will now generally be subject to home quarantine, with centralized quarantine and treatment offered voluntarily as an alternative. Better known as the “10 New Measures,” the latest round of easing represents a landmark initiative following 20 measures announced in November. The Chinese government made this major decision based on both science and public opinion, and to better coordinate Covid control with economic development. But with the implementation of the “10 New Measures,” the country faces immediate pressure to strengthen capacity building, which will be key to a smooth, orderly policy transition.
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The need for capacity building has already attracted the attention of relevant departments. At a press conference of the Joint Prevention and Control Mechanism of the State Council held on Dec. 7, several officials touched upon the issue and a consensus was reached. The areas in need of strengthening included grassroots professional prevention and control capacity; R&D, production and storage of vaccines and drugs; vaccination, especially for the elderly; preparing health care resources to minimize the impact on normal medical services; monitoring virus variation, disease severity and medical resource usage; and enhancing public consensus and public awareness concerning Covid-19. The epidemic and public sentiment are sure to test the adequacy of capacity building. With deficient capacity, optimization policies may deteriorate into capitulation, going from one extreme to another. Governments at all levels will not find their work easier under this new optimization principle. Rather, they must be prepared for a more daunting task, and hurry to overcome their weaknesses.
Experts anticipate one or even several infection peaks in the near future. Handled poorly, these could place the health of the people in serious jeopardy. At present, China is confronting two major challenges: preventing medical resource shortages, and stabilizing economic growth while optimizing epidemic prevention and control. Both issues present high demands in terms of capacity building.
It is unavoidable that infection numbers will surge for some time after the implementation of optimized measures. The most urgent problem is ensuring that the enormous health care needs, especially for patients with fever, can be met. Recently, fever clinics at many hospitals have become overcrowded, while some hospitals have shut down their fever clinics altogether. Infections may also increase among frontline medical personnel. In combination, these complexities will place medical institutions under the greatest pressure they have faced during the past three years. Policies such as shutting down hospitals upon detecting a single case, or imposing one-size-fits-all access criteria, are ill-suited to the critical challenges ahead.
The central government has made it clear that medical institutions at risk of infection cannot arbitrarily shut down. In particular, important diagnosis and treatment departments such as fever clinics, emergency departments, operating rooms, dialysis departments and intensive care units must remain accessible. However, to ensure that the local governments discard their rigid ideas and implement these policies, strong supervision and more fundamental solutions are needed. The government must empower medical institutions, strengthen their hand in managing risk and loosen restrictive policies. Medical institutions all over the country have also started exploring solutions. For example, some hospitals have set up separate diagnosis and treatment areas for patients with positive nucleic acid test results, required fever clinics and emergency departments to provide health care services in the absence of exceptional circumstances, expanded fever clinics, and added consulting rooms. These measures are worthy of recognition.
The public’s perception of the virus will directly determine the effectiveness of future epidemic prevention and control. Though Covid-19 has already been around for three years, perceptions of the virus are little changed since the beginning of the outbreak, with many remaining fearful of the supposedly deadly disease. The current “Covid-19 panic,” whether created intentionally or subconsciously, is also closely linked to shortages of fever and cough medicines at certain hospitals. Perceptions solidified over time are difficult to change. This makes it commendable that the many decent officials, scholars and people in the media maintain the spirit of seeking the truth. The Chinese people, now more than ever, sorely need the popularization of rigorous scientific knowledge. As such, the country is in equal need of upright professionals who are brave enough to speak the truth. These professionals must step forward in this time of need. Active guidance from government departments, social organizations and the media also remains indispensable for enhancing the public’s ability to cope with the situation.
In addition, the optimization of prevention and control measures must be aligned with the needs of economic and social development. If optimization measures are replaced by mere capitulation in areas where capacity is inadequate, economic and social development may suffer a renewed blow, derailing recovery. The recently concluded meeting of the Communist Party Central Committee’s Politburo puts greater emphasis on steady growth. More detailed arrangements are expected during the forthcoming Central Economic Work Conference. But steady growth will not be possible unless Covid-19 is under effective control. At present, it is noteworthy that different regions are responding to the virus differently. While some areas are extending a warm welcome to migrants coming home for the Spring Festival, other regions continue to implement excessive anti-covid measures. Even after the central government’s issuance of both the “20 Measures” and “10 New Measures,” many areas remain hesitant to make changes, some even backsliding. This amounts to a kind of “negative capacity building.”
Preparedness ensures success; unpreparedness guarantees failure. The pathogenicity of variants of the virus has weakened over the past three years, and China has made remarkable achievements in terms of virus prevention and control, as vaccination has been popularized and experience accumulated. All this has created necessary conditions for economic and social development to get back on track. However, in many areas, reflection also remains worthwhile. For example, although hierarchical, classified diagnosis and treatment has long been advocated, but progress in its implementation has not been satisfactory. According to one high-level Health Commission official, had China pressed ahead with health care reform prior to the epidemic, its Covid-19 prevention and control strategies could have been completely different. Yesterday’s errors cannot be corrected, but tomorrow can still be won or lost. At this moment when China’s epidemic prevention and control is confronted with a new situation and new tasks, summarizing past experience and reflecting upon any shortcomings cannot only help to smoothly overcome the impact of the epidemic, but also serve to promote institutional reform and improve national governance. That would constitute capacity building at its deepest level.
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