China will reopen its borders and abandon quarantine after it downgrades its management of Covid-19 on January 8. The decision is the country’s last step in abandoning three years of zero-Covid policy and pivoting to living with the virus. Covid-19 has been categorized as a class B disease, but managed as a top category A infectious disease since 2020, putting it on par with bubonic plague and cholera. When the declaration was made to do so, authorities said it would be administered according to the Frontier Health and Quarantine Law. Under Chinese laws, authorities must impose the toughest restrictions such as quarantine and isolation of the infected and their close contacts, and citywide lockdowns to contain those diseases. At the border, the infected must be isolated and those who might be infected quarantined, depending on the incubation period. But Covid-19 will be downgraded to category B management from January 8, meaning Covid-19 only requires “necessary treatment and measures to curb the spread”. Strict control measures including compulsory quarantine for travelers coming to China will also be removed after the downgrade, since it is no longer a compulsory requirement in the category B management. While Covid-19 has always been a category B infectious disease in China – a class that also includes HIV, viral hepatitis and H7N9 bird flu – authorities have managed it as category A, empowering local governments to impose strong measures such as lockdowns, isolation and quarantine. It also allowed them to enlist law enforcement to aid with disease controls.
China had been preparing for the change, with PCR testing no longer mandatory and Vice Premier Sun Chunlan, who has been in charge of the Covid-19 response, urging lower level authorities to focus on treatment instead of preventing infections. Authorities will also no longer refer to Covid-19 as a form of pneumonia. The National Health Commission (NHC) said Covid-19 would be known officially as a “novel coronavirus infection” instead of a “novel coronavirus pneumonia”. “The name change is subtle but important,” a hospital administrator said. “I think it is official recognition of the clear changes in the symptoms of infection with the Omicron variant, which is less deadly. It does not always trigger pneumonia-like symptoms.”
The NHC also announced it stopped publishing the number of daily Covid-19 cases on December 25 and handed over this task to the Chinese Center for Disease Control and Prevention (CDC), which has not announced how frequently it would update the number of cases. Zhao Wei, Professor at the School of Public Health of the Southern Medical University, said it is unnecessary to release epidemic information every day and resources should now be devoted to clinical treatment of severe cases and trying to reducing mortality. The Global Times added that Covid-19 case data from the NHC cannot reflect the country's real epidemic situation since China has scrapped mass nucleic acid testing. China's NHC began to release daily case numbers on January 21, 2020 when epidemic experts concluded the virus could spread between humans and it was decided to classify Covid-19 as a Class B infectious disease but managed as a category A disease.
The new daily tally in Zhejiang province has surpassed one million, local authorities said on December 25 and it was expected to reach two million daily by New Year. On December 26, the Global Times reported that in Zhejiang 13,583 Covid-19 patients were receiving treatment at hospitals, including one critically ill patient in stable condition and 242 severely or critically ill patients suffering underlying diseases. Qingdao in Shandong province on December 23 said it was seeing a daily tally of between 490,000 and 530,000 cases. Dongguan in Guangdong province reported around Christmas that the number of infections was increasing at the scale of 250,000 to 300,000 a day. Anhui and Hunan provinces said the first wave is likely to peak in January.
Antigen testing kit manufacturers have been increasing output as demand surges along with the rapid increase of Covid-19 infections across the country. By December 24, China had approved 44 antigen test kits, and the regulator was still reviewing applications from other companies. Manufacturers which had already obtained certificates are operating around the clock to ensure supply. China's daily output of antigen test kits has hit around 60 million units, Huang Guo, Deputy Director of the National Medical Products Administration (NMPA), said at a press conference. Local governments also accelerated the opening of grassroots fever clinics.
China has approved two Covid-19 antiviral drugs this year – Pfizer’s Paxlovid and China-made Azvudine, an HIV drug from Chinese firm Genuine Biotech. But their limited supply and steep price have driven many Chinese to opt for cheaper but illegally imported generic drugs from India. Four kinds of generic anti-Covid drugs from India are being sold illegally in the Chinese market – under the brand names Primovir, Paxista, Molnunat and Molnatris. While Paxlovid is priced at CNY2,980 per box, a box of Indian-made drugs can be bought for CNY530 to CNY1,600, according to online portal Tencent News. Primovir and Paxista are generic versions of Paxlovid, while Molnunat and Molnatris are generics of Merck’s molnupiravir. However, the Indian generics have not been approved by the Chinese government and selling them is a punishable offense. Public health experts and doctors in China have warned of the potential risks and urged people not to buy medicines from illegal channels, including unlicensed salespersons on messaging app WeChat.
China’s Covid-19 vaccination campaign has picked up speed in the past week. The country administered 3.1 million doses on December 20 and 3.6 million the following day, up from the daily average of less than 1.5 million in the previous two weeks, NHC data show. China’s vaccination rates have increased as the country ramps up efforts to expand immunization of the elderly and other vulnerable people. These groups are lagging behind in being vaccinated due to a lack of understanding of the virus’ threat and concerns over adverse reactions, experts have warned. In Beijing the target is for more than 90% of residents aged 80 and above to receive at least one dose of a Covid-19 vaccine by the end of January. On December 4, Beijing health authorities said 643,000 people over 80 had received their first shots – about 57% of the age group.
This overview is based on reports by the China Daily, Shanghai Daily, Global Times and South China Morning Post.
