Days after protesters took to the streets of China over Beijing's strict "zero-COVID" policy, experts say the government may soon face bigger COVID-19 containment challenges than those that came with three years of locking down entire cities.

On Thursday morning, China's State Health Administration reported a record number of locally transmitted infections: 43,218 cases. The surge in reported cases came just one day after the central government issued 10 "new measures," loosening almost every zero-COVID control.

The wide-ranging new measures permit people with mild or no symptoms and their close contacts to isolate at home instead of being forcibly shipped to government quarantine facilities.

Officials will no longer be allowed to designate entire residential districts as "high-risk" zones. Health codes and negative COVID tests are no longer mandatory to enter indoor venues, except for so-called "special places" such as nursing homes, hospitals, kindergartens and schools.

"China's unplanned exit strategy is a formula for causing mass hospitalizations and deaths, which are preventable," Lawrence Gostin, director of the World Health Organization Collaborating Center on National and Global Health Law, told VOA Mandarin in an email interview.

He said the three years under the zero-COVID policy has resulted in low natural immunity and inadequate administration of vaccine boosters. These factors, combined with the highly transmissible omicron variant of the virus, could lead to a spike in hospitalizations and deaths, especially among the elderly and those with chronic diseases.

"China should have been anticipating its gradual exit many months ago. A much more coherent strategy would be to gradually lift the exit strategy in a coordinated and planned way," Gostin said. "Overall, this is a major stain on President Xi's reputation for efficiency and professionalism."

The zero-COVID policy has been Chinese leader Xi Jinping's signature defense against COVID since the first widespread outbreak in January 2020 in Wuhan.

'Beyond reproach'

Before China eased its zero-COVID policy, it claimed to have had only 5,235 deaths in a country of 1.4 billion people since the first recorded case in humans in December 2019. By comparison, 1,083,000 died in the United States as of Wednesday, according to the Johns Hopkins University of Medicine Coronavirus Resource Center. There are 333.3 million people in the U.S. as of Wednesday, according to the U.S. Census Bureau Population Clock.

Zhao Lijian, Foreign Ministry spokesperson, told foreign journalists last December that China's pandemic control was beyond reproach. "The Chinese people have achieved a strategic victory in this fight against the COVID-19 epidemic," he said.

Dali Yang, a political science professor at the University of Chicago, told VOA Mandarin that "in the early days, [such propaganda] was justified, but in the past year, especially after the omicron variation came out, the situation has changed a lot. … And in this situation, the big challenge for China is how to guide the public to deal with it."

"Ideally, it would have been better to do some prospective experiments this spring," he said.

Yang explained that when the epidemic began ripping through Shanghai in April, city health department staffers wanted to explore precision methods for prevention and control, but Beijing's strict policy directives quashed that effort.

"We didn't learn from Shanghai's experience, and zero-COVID policy became more strict and turned into a political campaign," Yang said. "A public policy may be appropriate in a certain place at a certain time, but sometimes it should be adjusted when its effectiveness has significantly diminished."

Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, said the most important aspect of epidemic preparedness is that people gradually learn to calculate their acceptable risks. "This process was completely stunted with the authoritarian measures that did not permit any consideration of individual risk," he told VOA Mandarin in an email.

The relaxation of COVID-19 restrictions came after unprecedented protests erupted in dozens of Chinese cities, demanding an end to the three-year-long draconian zero-COVID policy. The groundswell was set off by an apartment fire that killed at least 10 people on November 24 in Urumqi, the capital city of the Xinjiang region.

Shoppers walk through a reopened shopping mall after authorities started easing some of the COVID-19 restrictions in Beijing, Dec. 6, 2022.

The public blamed the deaths on the lockdown policy that allowed officials to seal the escape exit, a common practice used to confine people within their homes.

The sudden easing of the zero-COVID policy confused not only the citizenry but also those charged with enforcing the new regulations. Contradictions abound.

For Mr. Yang, a resident of Beijing's Chaoyang District who asked to remain anonymous to avoid attracting official attention, the relaxed policies have made life more difficult.

"Last week, they said it's not mandatory to test for COVID every two days anymore, and many testing booths have disappeared. But supermarkets still request a negative result within 48 hours" entry, Yang told VOA Mandarin. "Last Thursday, I waited in line for almost two hours in below-freezing temperatures to get tested, and they didn't give me a result within 48 hours! So, I still didn't make it to the supermarket to buy groceries."

Yang said the situation was almost amusing. "I called the hotline to complain, but that did not help me solve the problem. This week, the policy has changed again. When you go to the supermarket, negative test results are no longer needed, but you still need to show them a green health code on your phone." Throughout the pandemic, authorities have tracked the health of individuals using a smartphone app. Using the app, those who are COVID-free get a green light; those whose health is in doubt, amber; and those infected, red.

After the central government began issuing its new rules, Chinese internet posted comments on Li Wenliang's account on Weibo, a Twitter-like platform. In a private group chat in late 2019, Li, an ophthalmologist in Wuhan, warned of the possible spread of COVID-19. Police reprimanded him for "spreading rumors." Since Li died of the virus in February 2020, people have expressed their pandemic-related grief on his Weibo account.

A Weibo user named "KSKS-H" posted: "Dr. Li, three years of pandemic is about to end. I wish you could see this."

Another user, "Yilikeleen," expressed a less hopeful outlook: "Dr. Li, it's all relaxed now, but I feel more scared." (SJ/VOA)