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Residents take nucleic acid test of COVID-19 in Guangzhou, South China’s Guangdong Province. ¬†--Photo VCG

Precision urged as cities roll out optimised COVID response

(Global) -- China’s top health authority has dispatched working groups to supervise local authorities in implementing the ninth edition of China’s COVID-19 control protocols and the 20 optimised measures to curb the spread of outbreaks more resolutely while the country may face an extremely challenging winter, some health experts predicted, as the country reported Sunday almost 40,000 daily infections, including 35,858 asymptomatic cases detected on Saturday.
The National Health Commission and its national administration of disease control and prevention has jointly dispatched working groups to rectify some problems that have emerged when the 20 optimised measures for combating COVID-19 are being implemented. The implementation of the measures require the effective coordination and information sharing among epidemiological  investigation, transferring positive patients and testing groups and taking the first 24 hours as a primary opportunity to contain the outbreaks, Wang Liping, a research fellow at the Chinese Centre for Disease Control and Prevention (CDC), was quoted as saying during the weekend.
However, when implementing epidemic control measures, two polarised yet erroneous tendencies have emerged - either a complete lockdown or a “lying flat,” meaning no pandemic precautions at all. The joint prevention and control mechanism team of the State Council has promoted strict and determined correction of a “one-size-fits-all” approach and excessive policy steps, Wang said.
Some cities and provinces have issued orders to prevent “one-size-fits-all” approaches of any kind, prohibiting local regulators from imposing extra restrictions on some low-risk areas. For example, Zhengzhou, capital of Central China’s Henan Province, said on Saturday that a “stay-at-home” order does not mean local residents cannot go out at all. Residents are allowed to go out for medical treatment, emergencies, escape and rescue.
Hefei, capital of East China’s Anhui Province, issued a “not-to-do” list of 16 items including not to seal and weld doors for those quarantined at home. If it is necessary to take control measures, these must be accurately defined and should not arbitrarily expand sealed-off areas or prolong the control period, and fire escapes must not be occupied or blocked.
In Beijing’s Chaoyang district - the hardest-hit district in the capital amid the ongoing outbreak, restrictions were lifted in 75 high-risk areas as of Sunday 8 am to reduce the impact on residents’ livelihoods to the maximum level, the local health authority said. Also, it said that in principle, temporary epidemic control management should not exceed 24 hours. Those measures are in line with the 20 optimised measures.
Avoid ‘one-size-fits-all’ approach
Coming up with 20 optimised measures for combating COVID-19 is the optimisation and improvement of the ninth edition of China’s COVID-19 control protocols, and the original intention is to save medical resources, Zhuang Shilihe, a Guangzhou-based expert, told the Global Times on Sunday.
“Those measures are very timely for Guangzhou, as the city has been struggling to fight the outbreak and its medical resources have almost reached the limit,” Zhuang said.¬† “But now the pressure on many medical resources has been relieved.”
However, in implementing those measures, some local authorities have taken a “one-size-fits-all” approach and excessive policy steps, increasing the burden on local medical resources and residents, and some places have not fully followed the new measures, which has also amplified the impact on economic and public services to livelihoods, some experts said.
To “further explain the 20 measures” for optimising the epidemic response, China recently outlined four technical documents with detailed regulations governing nucleic acid testing, classification of risk areas, home quarantine and home health monitoring.
According to documents with detailed regulation on nucleic acid testing, classification of risk areas, home quarantine and home health monitoring, local authorities should not roll out mass nucleic acid testing if there is no outbreak. Instead, they should closely focus on key populations. 
How to precisely implement the epidemic control measures is also testing local authorities’ management and governance, as when the virus becomes much more contagious, it becomes much more difficult to implement the control work, a Beijing-based expert told the Global Times on Sunday.
“On one hand, local authorities hope to contain the outbreak as soon as possible, on the other hand, they are dealing with limited resources and a more complex situation, which may force them to take excessive measures,” said the expert who asked not to be named.
Still, some places have been following the 20 optimised measures to meet the needs of people in risky areas in line with epidemic control work. These areas have seen an orderly lifting of the restrictions on some areas.
Urumqi, capital of Northwest China’s Xinjiang Uygur Autonomous Region, said it would gradually resume public transport services including railway, civil aviation, buses and taxis from Monday.
Some other cities in Xinjiang are lifting COVID-19 restrictions. Korla and Shihezi announced that normal public order would resume from Sunday.
Beijing and some cities in Henan and North China’s Inner Mongolia Autonomous Region are experimenting with self testing of nucleic acid. Sampling is done at home by individuals, with health officials responsible for guidance and sample collection.
The new method is considered as fast and convenient, which also avoids time wasting and the risk of cross-infection.

(Latest Update November 29, 2022)

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