China has stopped releasing a daily count of asymptomatic coronavirus cases and has apparently tightened the criteria for what counts as a covid-related death after criticism that the earlier method was failing to capture a wave of infections that came with the sudden pivot from a “zero covid” policy.

The Chinese Center for Disease Control and Prevention announced Wednesday that it had scrapped the daily reports because there was no way to track the full extent of asymptomatic infections after the shift last week to voluntary testing. Individuals who test positive should continue to report their results to local health-care workers in their locality, it said.

The government has also updated rules for classifying and reporting deaths, according to statements from a local government in Heilongjiang province and a hospital in Inner Mongolia. Both cited a notice issued by the epidemic response team of the State Council, China’s cabinet, although they did not provide any details.

Covid spreads and medical staff sicken after China relaxes restrictions

The State Council Information Office did not immediately respond to a request for comment, but a widely circulating screenshot purportedly of the document suggested that only individuals deemed to have died primarily from the coronavirus would be included in the official count going forward.

If accurate, the decision to exclude deaths where patients have an existing condition would mark a significant departure from how hospitals operated previously. During the outbreak in Shanghai last April, for instance, 36 deaths were linked to covid despite preexisting illnesses being ruled as the primary cause in each case.

Including such cases in the count was the standard procedure in China as recently as late November and mimics the approach in Britain, the United States and other countries where if covid is seen as a contributing factor, then it is listed on a death certificate.

China’s new approach resembles that of Russia, which was criticized in 2020 for excluding from its covid death toll any fatalities that involved other conditions.

Discussion of missing deaths spread online after the official toll in China on Wednesday was zero, despite local media reports that a famous former footballer, Wang Ruoji, had died Tuesday and he had had covid and an underlying condition.

For over two years, China has pursued a nationwide effort to track down every covid-19 infection and place infected individuals into centralized quarantine. The mass testing, regular lockdowns and extensive digital monitoring required for this process were closely and strictly managed by authorities.

After the early chaos and delayed response of Wuhan city and Hubei province at the start of the coronavirus outbreak, local officials across the country were tasked with being as vigilant as possible in discovering and reporting cases. Failures to do so could mean losing a job or even jail time.

The top leadership continued to promise “unswerving” adherence to the approach until as recently as October, piling pressure on local governments to smother outbreaks. Faced with more transmissible coronavirus variants, major cities implemented ever harsher lockdowns. Late last month, discontent with excessive controls on everyday life erupted into the largest display of civil disobedience in decades.

In the wake of protests, China’s cabinet on Dec. 7 unexpectedly announced it was scrapping centralized PCR testing requirements and ending regular checks of digital health codes. Home quarantine for asymptomatic and nonsevere infections was allowed for the first time.

The announcement removed central government pressure for low-level officials to be as transparent with test results and transferred responsibility for monitoring health to individual families. Overnight, self-administered rapid test kits, previously barely used, became the primary means of tracking cases, even though no system of reporting results existed.

During an inspection tour of a hospital, pharmacy and neighborhood clinic Tuesday in Beijing, Sun Chunlan, the vice premier leading the pandemic response, called for a “mind-set adjustment” as the focus shifted from containment to medical interventions.

“The work target is to protect health and prevent serious symptoms and ensure that the transition period in prevention measures is smooth and orderly,” she said.

The unexpected dismantling of many key pillars of the zero covid policy has been jarring for many in China. After months of warnings about the continued danger of contracting the virus, official messaging abruptly changed to downplaying the risks of hospitalization.

Projections from leading Chinese virologists suggest that 60 percent of the population could be infected over the winter. Hospitals in areas of the country that barely had any cases during the zero covid era are scrambling to prepare for an influx of patients, even as many staff are unable to work due to contracting the disease.

The government has pushed back against criticism that it failed to prepare for the coming wave. Health-care authorities on Friday released a new estimate of intensive care unit capacity that suggested the country now had nearly 10 beds per 100,000 people, an abrupt doubling of the previous estimate of 4.5.

A vaccination drive has also picked up momentum in recent days with 1.25 million shots being administered Monday. The primary focus of the campaign is the elderly population. Authorities on Wednesday announced that those over 60 with underlying conditions and low immunity could now get a second booster shot.

As of Tuesday, only 42 percent of people over 80 had received a first booster.


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