With the gradual optimization of Covid prevention and control policies, China is experiencing a surge in infections, creating an increasing strain on health care provision. During a Covid-related visit in Beijing on Dec. 13, Sun Chunlan, vice premier of the State Council, stressed the need for strengthened overall coordination and a change in attitude. According to Sun, the government should shift the focus from the prevention and control of new infections to treating the infected, protecting people’s health, preventing severe cases, ensuring a stable transition of prevention and control, and effectively coordinating Covid prevention and control with economic and social development. She emphasized that guaranteeing access to health care and medicine must be the top priority. Sun’s statements are of great practical significance. Governments at all levels, communities and social organizations should apply the same level of commitment to guaranteeing health care service availability for the infected as they had for virus prevention and control.
After the policy optimization, several regions are, as expected, seeing surges in Covid-19 infections. This is inevitable, and no cause for fear or concern, provided that the relevant departments are fully prepared. The vast majority of infected persons are either asymptomatic or have mild symptoms, and do not need to be hospitalized, though they still should be accorded basic medication and other resources. On the other hand, given the country’s large population, there will be many falling critically ill and requiring timely health care services. In Beijing, the fever clinics of some hospitals are already overcrowded, and antipyretics and antigen detection kits in short supply. This alarming situation in the capital, one of the cities with the most ample health care resources in China, hints at what could happen in other places should they suffer a large-scale surge in infections. Even in areas where the Covid situation remains relatively stable, online and offline drug stores have been running out of inventory, reflecting growing panic among the people. Given the capacity of China’s pharmaceutical industry, these shortages should not be occurring. This status quo must be reversed as quickly as possible in order to ensure a smooth and orderly transition of prevention and control measures.
The imminent turnaround in the focus of Covid control constitutes a daunting task. The relative swiftness of the policy change calls for mechanisms providing a systematic and efficient response across society as a whole. Governments and medical institutions at all levels must determine serious risks factors and address health care department shortcomings in order to mitigate these. It is imperative to understand the risks entailed by inadequate preparation. Even countries with relatively abundant medical resources, such as European countries, the U.S., Japan, Korea and Singapore, have at times faced significant strain on their health care systems. A medical resource shortage in Hong Kong led to higher case fatality rates, especially for the unvaccinated elderly with underlying diseases. These lessons must be taken seriously.
Although medical institutions play a major role in health care provision, they should not be left to confront these pressures alone. The treatment of Covid-19 infections is a huge social task requiring active collaboration and systematic top-down deployment.
The top priority must be the provision of health care for severe infections, and ensuring that medical institutions at all levels are fully prepared to provide treatment. Recently, the State Council’s Joint Prevention and Control Mechanism issued a series of documents emphasizing the strengthening graded and classified medical treatment and referral, and expanding grassroots level medical resources. These plans include the Notice on Further Optimizing the Medical Treatment Process and Improving Current Medical Services, the Work Plan for Graded Diagnosis and Treatment of Covid-19 Based on the Integrated Healthcare System, and the Work Plan for Health Services for Key Populations Infected With Covid-19. Despite their timeliness, there is a long way to go before full implementation of these measures.
Meanwhile, it is uncertain how long hospitals, the “final line of defense,” can hold out. This will depend heavily on the efficacy of the “first line defense,” and the extent to which this can alleviate pressure. People are likely to head to medical institutions in droves, if they cannot procure medicines in drug stores and online platforms. Health care pressures on wards will increase sharply when unvaccinated elderly people develop severe symptoms. Any shortages in medical resources could severely impact the quality of health care services provided. It is a pity that China failed to take full advantage of the past three years to remedy the deficiencies of its health care system. But there is no point crying over spilled milk: the country should do its best to brace for the storm, fully leveraging fever clinics, community health centers and other medical institutions, in particular.
Plans should be made to provide special care for key populations. Two main groups of people merit special attention: Covid-19 patients living alone and seniors in rural areas. The former are in an enclosed environment with a lack of access to help, while the latter are usually “left behind” folks in rural villages because their relatives work in cities. The medicine supply in rural areas is worse than it is in cities, and health care systems risk being overwhelmed by any sudden surge in Covid-related incidents. Plans must be made well in advance for these key populations, lest unnoticed tragedies occur. For example, the country should allow grassroots organizations to play to their strengths, shift the focus from managing “risky” personnel to providing health care services, and improve related services including health surveys, drug delivery and psychological counseling.
At present, encouraging governments at all levels and autonomous organizations, such as communities, to shift the focus of their work, remains a major task. Many places have yet to move away from implementing strict prevention and control measures, their focus for the past three years. But even ample experience in implementing lockdowns is no preparation for providing medical treatment. While professional thresholds must be applied for health care provision, non-professionals can still offer support by performing auxiliary tasks. From the perspective of accountability, the reward and punishment mechanism for treatment should be aligned with those adopted previously for prevention and control efforts. Capacity building and incentive mechanisms will be crucial for completing the turnaround demanded by the central government. Both call for top-level design.
The shift to optimization of Covid prevention and control policies, and public support for it, shows that China is on the right path. And as official media has repeatedly emphasized, optimization is not equivalent to complete surrender. It is the duty of the government to protect the lives and health of the people. Whether or not China can ride out the new phase in dealing with Covid-19 while maintaining stability will be a test of the country’s ability to provide public goods such as health care. Covid-related health care will also help win over the hearts and minds of the Chinese population. It has been reported that the government of Changzhou, Jiangsu province, is distributing supplies, including antipyretics and antigen test kits, to the elderly, children and disadvantaged groups. This sets an excellent example for the rest of the country. China is the world’s second-largest economy and manufacturing powerhouse. This nation has what it takes to avoid shortages of medical resources. But refocusing manpower, finance and other resources on treating the infected remains a matter of utmost urgency.
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