Chinese authorities are making the most significant move to end the harsh policy of zero-Covid after massive protests.

officials declaredthe end to forced centralised quarries. This will allow people with mild Covid to be isolated at home. They also have limits on lockdowns, fewer Covid test results checking and more freedom to travel across the country. This announcement was made after several cities started to ease local restrictions.

China has to navigate many obstacles ahead of it, even as it chart a course out from zero-Covid.

It is crucial to avoid mass deaths from the inevitable increase in infections.

James Crabtree is the executive director of International Institute for Strategic Studies Singapore. He stated, “China’s greatest risk now is removing Covid restraints without having a broadly vaccined population.”

China hopes to reopen in targeted ways, protecting those who have yet to get vaccinated. But so far, other countries have not been allowed to do this. They have also seen that reopening causes a flood of cases.

This is especially concerning for China because of its low Covid immunity in the elderly and the fact that it continues relying on less effective vaccines domestically.

South Korea, Singapore, and Moderna opened their doors to the world. They had well-vaccinated populations that received foreign jabs, such as Astrazeneca, Moderna, and Pfizer. But they could not prevent an increase in infections.

Chinese authorities have revealed that only 69% and 40%, respectively, of the over-60s have received booster shots.

Given their continued distrust of vaccines, it will continue to be a challenge to accelerate their vaccinations.

“Many people over 60 have underlying conditions. They believe it will not be safe to have vaccinated. It is, in fact,” Prof Liang Wannian from China’s Covid expert panels, stated to the BBC.

Chinese authorities announced plans to establish mobile and temporary vaccination clinics and encouraged local authorities to use incentives to motivate the elderly to vaccinate.

They plan to boost immunity for most seniors by January 31, before Chinese New Year when large numbers will move about the country.

China’s elderly population is still at risk and China may see a surge in Covid cases. If hospitals become overwhelmed, this could result in many deaths. This exactly was the situation in Hong Kong during the Omicron wave earlier this year.

It could be the reason mainland China has moved to home quarantine now for mild and asymptomatic patients. A similar move by Singapore was highlighted earlier in the week by the Global Times state media outlet. It would make it easier to provide resources and beds for more serious cases.

However, this goal can be challenging to attain.

Singapore has an excellent healthcare system, with many options. Singaporeans could easily shift to home quarantine, as people with mild Covid could access treatment through the large number of community clinics or telemedicine providers.

China has a patchy healthcare system, which was hit hard by a slowdown of investment in the aftermath of the pandemic. Donald Low, a Hong Kong University of Science and Technology expert on public policy, stated that people still depend on hospitals for basic care in many areas.

“In China, community-based health care is much more common than hospital-based care. It’s difficult to follow the Singaporean model. China had only two years to construct that infrastructure. They didn’t,” stated Prof Low.

A challenge is also the timing of the relaxation.

Siddharth Shridhar, a University of Hong Kong clinical virusologist, stated that it was particularly worrying that China opened up during winter, when the virus can spread faster.

It will need to slow down in its reopening. Or else, it will face an “exponentially more difficult” situation than the one in Hong Kong earlier this month, warned Dr Sridhar.

“Hong Kong only has 7.5 millions people. Decent public healthcare infrastructure. It is not easy to get a job. It’s not applicable to all areas in China.

Based on the Omicron virus outbreak data, a Bloomberg analysis calculated that China would see 5.8 million people admitted into intensive care. This would totally overwhelm China’s healthcare system which currently has less than four ICU beds per 100 people.

Dr Sridhar said that the Chinese government could shift resources away from containment and set up a campaign to immunize people, increase critical care infrastructure like ensuring oxygen supplies and train as many people as they can in basic critical health care.

Experts suggest that it needs to improve its communication with the public about public health to allay fears. It also needs to give clear instructions to people who test positive for Covid.

Poor and vague government directives during Hong Kong’s Omicron wave led to hospitals being flooded with cases. Many panicked, even though it was allowed for them to remain at home.

Prof Low suggested that Chinese authorities could create a roadmap to deal with Covid in the same way as Singapore. He also said that the Chinese authorities must be open with their people about Covid’s inevitable endemicity and how they can live with it.

“People have a zero rate of risk bias. The government must counteract this by saying that there will always be the Covid risk.”

Dr Sridhar stated that caution is still necessary. “A mistake we could make right now is to assume Omicron’s harmless, we are okay. We are doing that, it’s now time to open our eyes.

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