Latest policy massively relaxes COVID restrictions: summary & full translation

China takes further ten-measure "optimizations" on COVID prevention & control, with an eye on potential disruption to the labor force, society, & hospitals.

China, on Wednesday, Dec. 7, further “optimized” its COVID prevention and control by massively cutting requirements for centralized quarantine and all but abolishing mandatory PCR testing and electronic “health codes,” among other steps.

Pekingnology offers a summary followed by the full translation of the new Ten Measures and an official Q&A accompanying it.

1. China, on November 11, published the landmark 20 optimization measures on COVID prevention and control. Since then, the lightning speed of an apparent return to normal has, by all accounts, exceeded perhaps even the wildest expectation.

   Full Text & Analysis: China's 20 measures to optimize COVID controls

As Pekingnology documented on Dec. 2, there was an apparent shift to a new phase of COVID prevention and control, with a top official publicly acknowledging the “weakening of the pathogenicity of Omicron” and “China's epidemic prevention and control face a new situation and new tasks.” Influential media outlets have also begun saying that Omicron is not very serious and there is little evidence of a “long COVID.”

China signals a new phase of COVID control

2. Wednesday’s Ten Measures takes the relaxation even further by all but abolishing mandatory PCR testing and the electronic “health codes.”

   除养老院、福利院、医疗机构、托幼机构、中小学等特殊场所外，不要求提供核酸检测阴性证明，不查验健康码。重要机关、大型企业及一些特定场所可由属地自行确定防控措施。不再对跨地区流动人员查验核酸检测阴性证明和健康码，不再开展落地检。

   Except in particular places like nursing homes, orphanages, medical institutions, child-care institutions, and primary and secondary schools, proof of negative nucleic acid test results are not demanded, and people’s health codes are not checked.

   Their affiliated local authorities can determine epidemiological prevention and control measures for critical institutions, large enterprises, and certain specific places.

   Checks on cross-regional traveling personnel’s negative nucleic acid test results and health codes are discontinued. Nucleic acid tests upon arrival are discontinued.

Zichen Wang @ZichenWanghere

the policy also abolished 落地检 testing upon arrival (for example if you go to shanghai from beijing, it was required you get tested in Shanghai upon arriving, and if you test positive well...), taking a big step to make inter-city travel less burdensome.

Shanghai Daily @shanghaidaily

People traveling across #China won’t need to provide #PCR test results or even health codes. No PCR tests will be required for people upon arrival in a certain place.

The Washington Post @washingtonpost

China announced on Wednesday that frequent coronavirus tests and health codes would no longer be required for daily life or to travel within the country — a significant relaxation of previously unyielding restrictions.

wapo.stChina eases covid testing and health-pass rules in wake of protestsChina relaxed measures in a 10-point plan that also said that people with less severe infections could quarantine at home rather than in centralized facilities.

This is pretty important to note

Zichen Wang @ZichenWanghere

If the health code becomes irrelevant, as it looks like it will be, then the fear - shared by many here - that the entire protocols, with the health code at the center, for prevention & controlling COVID will be retained or even expanded for social control won't come true.

3. Home quarantine now becomes the default option

具备居家隔离条件的无症状感染者和轻型病例一般采取居家隔离，也可自愿选择集中隔离收治……具备居家隔离条件的密切接触者采取5天居家隔离，也可自愿选择集中隔离，第5天核酸检测阴性后解除隔离。

Home quarantine should be usually taken for infected people with no or mild symptoms if there qre conditions for home quarantine, while centralized quarantine and treatment can also be chosen voluntarily by the people…Close contacts with home quarantine conditions should take five days of home quarantine or voluntarily choose centralized quarantine, with quarantine measures being lifted after the nucleic acid test has yielded negative results on the fifth day of the quarantine.

4. There are also mandatory re-opening of schools without COVID transmission, more reduction of the scope and frequency of PCR testing, and a blanket ban of restrictions or spension on the movement of people, work, production, or business, etc.

5. The massive relaxation inevitably leads to more cases and, in my personal opinion, what is mostly concerning is whether the medical system will be overwhelmed or whether there will be disruptions to life and business. Beijing appears aware of the risk, or at least that is mentioned in the official Q&A.

   We have a large population including a big number of vulnerable people. We have unbalanced regional development and insufficient medical and health resources.  Currently, the scale of the epidemic in some areas is large, and the prevention and control situation is serious and complex. Although the pathogenicity of the Omicron variant is significantly weakened, the transmission capacity is significantly increased. If a large number of people who guarantee the normal operation of society and basic medical services are infected in a short period of time,  it will cause a shortage of workforce, which may bring disruptions to the operation of society and basic medical services.

But, for now, the Shanghai Disney reopens!

Shanghai Daily @shanghaidaily

#Shanghai #Disneyland will resume operations from Thursday, marking the Shanghai Disney Resort's return to full operations. It will operated from 8:30am to 10pm on the reopening day. shine.cn/news/metro/221…

Full translation of the Ten Measures, officially

《关于进一步优化落实新冠肺炎疫情防控措施的通知》

Notice on further optimizing and implmenting the prevention and control measures of COVID-19

国务院应对新型冠状病毒肺炎疫情联防联控机制综合组

General Affairs Section of the State Council Joint Prevention and Control Mechanism on COVID-19

Dec. 7, 2022

Recently, all departments and local authorities have thoroughly followed the CPC Central Committee’s and the State Council’s decisions and arrangements, adhered to the ninth version of the Plan for Diagnosis and Treatment of 2019 Novel Coronavirus Pneumonia, implemented the “twenty optimization measures,” and continued to rectify the problem of “incremental intensification,” and yielded positive results. According to the current epidemic and virus mutation situation, to control the virus more scientifically and precisely, as well as to solve outstanding problems in the prevention and control practices more effectively, announcements to further optimize the implementation of the epidemic prevention and control measures related matters are notified as follows:

First, conduct scientific and accurate division of risk areas.

High-risk areas should be delineated by building, the designation shall not be arbitrarily expanded to the apartment complex, community, street (township), etc. No temporary lockdowns of any form should be taken.

Second, further optimization of nucleic acid testing.

No district-wide full-scale nucleic acid testing should be taken. More reduction of the scope and frequency of nucleic acid testing. Antigen testing can be carried out according to the needs of epidemic prevention and control. Nucleic acid testing for personnel with high-risk occupations and residence areas is carried out under relevant regulations, with other personnel shall take nucleic acid tests based on their voluntary will. Except in particular places like nursing homes, orphanages, medical institutions, child-care institutions, and primary and secondary schools, proof of negative nucleic acid test results should not be demanded, and people’s health code should not be checked. Their affiliated local authorities can determine epidemiological prevention and control measures for critical institutions, large enterprises, and certain specific places. Checks on cross-regional traveling personnel’s negative nucleic acid test results and health codes are discontinued. Nucleic acid tests upon arrival (of another place) are discontinued.

Third, optimization and adjustment of quarantine.

Infected personnel should be scientifically classified and treated. Home quarantine should be usually taken for infected people with no or mild symptoms if there qre conditions for home quarantine, while centralized quarantine and treatment can also be chosen voluntarily by the people. Health monitoring should be strengthened during home quarantine, and quarantine measures should be lifted after nucleic acid tests have yielded results with CT Values ≥ 35 on the sixth and seventh day of the quarantine period, with infected personnel with aggravated symptoms be timely transferred to designated hospitals for further treatment. Close contacts with home quarantine conditions should take five days of home quarantine or voluntarily choose centralized quarantine, with quarantine measures being lifted after the nucleic acid test has yielded negative results on the fifth day of the quarantine.

Fourth, implement "fast lockdown, fast open-up" for high-risk areas.

High-risk areas with no new infected people for five consecutive days should be promptly unsealed.

Fifth, safeguard the people's basic needs for medicine.

Pharmacies should operate normally without arbitrary closures. There shall be no restriction on people’s purchase of OTC antipyretic, cough, antiviral and cold treatment medicines either online or offline channels.

Sixth, accelerate the promotion of COVID vaccination for the elderly.

All local authorities should ensure all people eligible for vaccination have access to it and make special arrangements to focus on improving the vaccination rate of people aged 60-79 and boost the vaccination rate of people aged 80 and above. Vaccination services should be optimized by setting up “green channels,” temporary vaccination sites, and mobile vaccination vans for the elderly. Training on determining contraindications to vaccination should be carried out at each level, and medical personnel should be instructed to scientifically determine contraindications to vaccination. Publicity of popular science should be detailed to call on the whole society to participate in encouraging the elderly to receive the vaccination, and local authorities can adopt incentives to motivate the elderly to get vaccinated.

Seventh, enhance the mapping- and classification-based management of key populations' health situations.

The role of the "basedline" of primary medical and health institutions and the "gatekeeper" of family doctors should be further enacted to identify elderly people with cardiovascular and cerebrovascular diseases, chronic obstructive pulmonary disease, diabetes, chronic kidney disease, tumors, immune function deficiency and other diseases in the district and their vaccination status against COVID-19, promoting the implementation of grading- and classification-based management.

Eighth, safeguard the society's normal functioning and essential medical services.

Non-high-risk areas should not restrict the movement of people or suspend work, production, or business. Personnel in medical services, public security, transportation and logistics, supermarkets, supply of goods, plumbing, electricity, gas, heating, and other sectors in maintaining the normal operation of basic medical services and social function should be put under the "safelist" management. Relevant personnel shall adopt personal protection, vaccination, and health monitoring, to ensure that routine medical services, basic supplies, electricity, water, gas, and heating supply to maintain normal production and work order.  Urgent problems raised by the public shall be solved in a timely manner, and the basic needs of the public during the control of the epidemic shall be effectively met.

Ninth, strengthen safety in epidemic situations.

The blocking of fire lanes and doors for apartment units and complexes under any form is strictly prohibited, and outward passages for medical and emergency purposes should be kept clear. Mechanisms to connect communities with specialized medical institutions should be established to assist the elderly living alone, minors, pregnant women, people with disabilities, and patients with chronic diseases in seeking medical services. Care and psychological guidance for quarantined personnel, patients, and front-line staff should be improved.

Tenth, optmize epidemic prevention and control work in schools.

Schools in all regions should firmly adhere to scientific and precise prevention and control requirements. Schools not affected by the epidemic should carry out normal offline teaching activities, and supermarkets, cafeterias, sports venues, and libraries on campus should open normally. Schools affected by the epidemic should precisely delineate risk areas and still ensure regular teaching, living and other orders outside the risk areas.

各地各有关部门要进一步提高政治站位，把思想和行动统一到党中央决策部署上来，坚持第九版防控方案、落实二十条优化措施、执行本通知要求，坚决纠正简单化、“一刀切”、层层加码等做法，反对和克服形式主义、官僚主义，抓严抓实抓细各项防控措施，最大程度保护人民生命安全和身体健康，最大限度减少疫情对经济社会发展的影响。

All relevant departments should further raise their political standing, unify their thoughts and actions to the decision and deployment of the CPC Central Committee, adhere to the ninth version of the Plan for Diagnosis and Treatment of 2019 Novel Coronavirus Pneumonia, implement the “twenty optimization measures,” follow the requirements in this announcement, resolutely correct simplification, "one-size-fits-all," "incremental intensification" and other practices, oppose and overcome formalism, bureaucracy, thoroughly execute the details of all prevention and control measures to maximize the protection of people's lives and health and minimize the impact of the epidemic on economic and social development.

《关于进一步优化落实新冠肺炎疫情防控措施的通知》解读问答

Interpretation of the “Notice on further optimizing and implmenting the prevention and control measures of COVID-19”

1. What is the background of the notice? What is the main content?

Since the spread of  COVID-19, the Central Committee of the Communist Party of China (CPC), and the State Council always put the safety and health of the people first. According to the changes of the virus and the epidemic situation, we adhere to the principle of ensuring stability and seeking progress within stability, take small steps without pausing. We optimize and improve the prevention and control measures based on the time and situation. After the announcement of the “twenty optimization measures,” we closely tracked the effects of the implementation. 

Combined with helpful experience in the process and in response to outstanding problems, we organized research and proposed ten targeted measures to further optimize the quarantine measures, nucleic acid testing requirements, and other measures for infected people and close contacts. The notice also further required "fast lockdown, fast open-up" in high-risk areas, vaccination, prevention and control in schools, epidemic-related safety, public access to medical care and medication, and basic livelihood protection and normal social operation. The measures continuously improve the scientific and precise prevention and control, maximize the protection of people's lives and health, and minimize the impact of the COVID-19 on people’s normal production and social development.

2. how do the notice detailedly define the risk area? What are the considerations?

The Notice requires scientific and precise delineation of risk areas. Localities should define high-risk areas by building, unit, floor, and particular apartment and they should not arbitrarily expand delienation to housing complex, communities, and streets (townships), and so on. To further reduce the number of people who stay in quarantine, localities should accurately determine risk areas through epidemiological investigations/contact tracing.  At the same time, it is required not to take any forms of temporary lockdown, and not to arbitrary impose “quiteness.”  In the process of dealing with COVID-19, all local govts should quickly quarantine close conducts, and are enabled to designate high-risk areas when there is no risk of community transmission.

3. What further optimization of nucleic acid testing requirement has been specified in the Notice? What are the considerations? 

Nucleic acid testing should focus on areas and personnel with a high risk of infection and not be conducted citywide by administrative areas so that localities should further reduce the scope and frequency of nucleic acid testing. Antigen testing may be carried out according to the needs of epidemic prevention work. In accordance with the relevant provisions of the “twenty optimal measures,” nucleic acid testing should be carried out for personnel in direct contact with inbound personnel, goods, and the environment, staff of centralized isolation sites, medical personnel of designated medical institutions, and fever outpatient clinics of general medical institutions, and employees of shopping malls and supermarkets, express delivery, take-away and other high-risk positions. That’s because they are in densely-populated environment, or frequent contact with people, or with high mobility. Other people can take the test out of their volition. 

Nursing homes, orphanages, childcare institutions, and primary and secondary schools are places that are concentrated with the elderly, young children, and other special groups of people. Once the source of infection is introduced, outbreak in clusters and serious illness are more likely. Thus, it is necessary to provide a negative test result to prevent the that when entering nursing homes, orphanages, childcare institutions, and primary and secondary schools. 

In medical institutions, the population have complicated medical conditions, the flow of the people is large, and the space is confined. Once the source of infection is introduced, it is easy to cause the spread of COVID-19 and nosocomial infections, affecting the normal operation of medical institutions and the public's normal access to medical care.

Thus, a negative test result is required to enter a medical institution, but medical institutions are not allowed to pass the buck and refuse to treat patients with acute and critical illnesses without a testing report. Critical institutions, large enterprises, and some specific places may determine their own preventions and control measures to ensure the normal operation of society and maintain normal production and living order.

After the emergence of an epidemic, localities should assess the size of the epidemic risk in different regions based on the epidemic situation and epidemiological investigations, determine the scope and frequency of nucleic acid testing in a grading- and classification-based manner, and improve the quality and efficiency of nucleic acid screening.

4.  For what reasons has the Notice adjusted quarantining infected persons and close contacts?

The pathogenicity of the Omicron variant of the virus is significantly weakened, and after clinical observation, most of the infected people are asymptomatic or with mild symptoms, where no special treatment is needed. Asymptomatic and mild cases with home quarantine conditions can stay at home quarantine with strengthened health monitoring. If their condition worsen, they should be promptly transferred to designated hospitals for treatment. Close contact with certain conditions should stay under home quarantine for 5 days, strengthen good health monitoring, and complete the nucleic acid testing according to regulations. 

The adjustment of the quarantine of infected people and close contacts fully reflects that the prevention and control of COVID-19 in China always adhere to the principle of people first and life first. Also, according to the  characteristics of the virus mutation and the development of the epidemic situation, dynamic optimizations are here for improved prevention and control measures in light of the evolving situation.

5.  For what considerations the Notice requires “fast lockdown, fast open-up” for high-risk areas?

According to the 9th edition of diagnostic and treatment protocols for COVID-19 and the 20 optimization measures, after the discovery of infected cases, localities should as soon as possible delineate the high-risk areas, screen, and control people at risk of infection, and timely interrupt the community transmission to achieve “fast lockdown, fast open-up.” If there are no new infected cases in the high-risk area for 5 consecutive days, localities should lift the lockdown in a timely manner to avoid prolonged control and to reduce the inconvenience caused by the epidemic to the public. 

After ending the lockdown, if a new infected case who is a close contact, and if an assessment finds no risk in community transmission outside the home of the quarantine, the ending the lockdown in the high-risk area shall not be impacted.

6. What initiatives do the Notice protect the public's basic access to medicine?

Localities should protect the normal operation of pharmacies and not arbitrarily shut down pharmacies. Also, localities ought to prepare for the supply and reserve of common medicines, especially the sort of medicines for patients with underlying diseases. Localities should smoothen multiple channels of medicine purchase and distribution, not restrict the public from buying OTC medicines for antipyretic, cough, antiviral, cold, and flu, and eliminate the restrictions or nucleic acid testing requirements when buying these over-the-counter medicines. Localities are asked to take a variety of initiatives to protect the public access to basic medicines, especially the elderly, patients with underlying diseases, and other special groups.

（The Seventh Q&A is on the need to vaccinate old people and hereby omitted.)

(The Eighth Q&A is on surveying the vulnerable groups and hereby omitted.)

9. What are the considerations of the Notice to ensure the normal operation of society and basic medical services? What are the requirements and issues that need to be noted in the implementation?

We have a large population including a big number of vulnerable people. We have unbalanced regional development and insufficient medical and health resources.  Currently, the scale of the epidemic in some areas is large, and the prevention and control situation is serious and complex. Although the pathogenicity of the Omicron variant is significantly weakened, the transmission capacity is significantly increased. If a large number of people who guarantee the normal operation of society and basic medical services are infected in a short period of time,  it will cause a shortage of workforce, which may bring disruptions to the operation of society and basic medical services.

In order to efficiently coordinate the epidemic prevention and control and economic and social development, and to protect the normal operation of society and basic medical services during the epidemic, the Notice requires that non-high-risk areas shall not restrict the resident movement and shall not suspend work, production, or business. It points out that medical personnel, public security, transportation and logistics, supermarkets, security, plumbing, electricity, gas, heating, and other personnel to protect basic medical services and the normal operation of the society shall be included in the "white list ".

Also, the relevant personnel should pay attention to personal protection, vaccination, and health monitoring, reduce contact outside quarantined areas, travel only between home and work site, and can go to work with a negative nucleic acid test result.  When a positive case is detected, close contacts will be accurately determined, and workplaces will not be temporarily controlled. Their colleagues in the same workplace shall not be quarantined on a large scale, to ensure normal medical services and basic living materials including electricity, water, gas, and heating supplies. Localities should try to maintain normal production and work and promptly solve the urgent problems raised by the public to effectively meet the basic living needs of the public during the epidemic.

10. What are the provisions of the Notice to strengthen safety in the epidemic?

In order to strengthen risk prevention in epidemic control and to protect the lives and properties of the public, the Notice requires that it is strictly forbidden to block fire escapes, apartment building gates, and community gates in any way. Ensure the smooth flow of channels for people to go out for medical treatment and emergency evacuation. While quaantine people at risk of COVID, it’s necessary to strengthen door-to-door services to make sure their life and normal medical protection. Also, localities should promote the establishment of a docking mechanism between the community and specialized medical institutions to facilitate medical care for the elderly living alone, minors, pregnant women, people with disabilities, and patients with chronic diseases. Also, localities should strengthen the care and psychological guidance for people in quarantine, patients, and front-line staff by providing psychological assistance hotlines and carrying out psychological support services, and so on.

11. What are the further optimizations that have been made in the Notice for school epidemic prevention and control? What are the considerations?

Schools are densely populated key places. Protecting the health of teachers and students to the greatest extent possible and maintaining the normal order of education and teaching are important tasks of the current school epidemic prevention and control. According to the current epidemic situation and the actual situation in schools, in order to guide schools to be more scientific and precise in prevention and control, the Notice clearly requires special places such as childcare institutions and primary and secondary schools to check for negative nucleic acid test results and health codes. At the same time, all schools around China should firmly implement the requirements of scientific and precise prevention and control. Schools without an epidemic should carry out normal offline teaching activities, and supermarkets, canteens, sports venues, and libraries in the schools should open normally. Schools with an epidemic should scientifically and precisely delineate the risk areas, and outside the risk areas, schools should still ensure normal teaching and living. To ensure the health of teachers and students and campus safety, all relevant departments should attach great importance to the prevention and control of epidemics in schools, improve the school-site coordination mechanism, and further optimize prevention and control measures in accordance with the characteristics of schools at all levels.