China's optimization of COVID-19 policies

Editor's note: China has actively optimized and refined its COVID-19 response as the pathogenicity of the Omicron virus weakens, the vaccination rate rises and the country accumulates experience in containing the virus. Following the adjustment, China's COVID-19 prevention and control efforts will focus on protecting health and preventing severe cases. Three experts share their views on the issue.

Future of online diagnosis, care promising

Medical experts interact with a patient through an online platform at a hospital in Cangzhou, Hebei province. FU XINCHUN/FOR CHINA DAILY
The Chinese government issued a series of supportive policies to promote the development of telemedicine much before the outbreak of the COVID-19 pandemic. The General Office of the State Council, China's Cabinet, issued the "Guiding Opinions on the Promotion and Standardization of Application and Development of Big Data for the Healthcare Industry" in June 2016 and the "Opinions of the General Office of the State Council on Promotion and Development of the Internet Plus Healthcare" in April 2018, which facilitated the establishment of the service provision system, support guarantee system, and helped make internet-aided diagnosis and treatment safer.

There was a rapid increase in the demand for internet-aided diagnosis and treatment after the COVID-19 pandemic broke out in early 2020, prompting the National Health Commission to encourage people to pay follow-up visits to online hospitals for the treatment of some common and chronic diseases, as well as to purchase medicines to curb the spread of the novel coronavirus.

At the end of 2022, the number of COVID-19 infections rocketed in China, putting huge pressure on offline medical institutions. So the NHC asked hospitals to prescribe online medical care for patients receiving treatment at home.

Internet-aided diagnosis and treatment have played a positive role in the fight against the pandemic. To start with, they have met the medical needs of many people and prevented cross-infection. During the pandemic, the online outpatient platforms provided exemplary service for the elderly, children and patients with high risk of cross-infection who could not consult a doctor in person due to the strict prevention and control measures. They also helped free offline hospitals' diagnosis and treatment resources, which were used to treat seriously ill patients.

Major hospitals have opened online COVID-19 clinics where patients can consult doctors, purchase medicines, and receive rehabilitation training. Thanks to the online medical services, many doctors who cannot be physically present at a hospital can provide online medical services.

From Dec 12 to 31, online hospitals in Guangdong province served a total of 1,246,800 person-times, attending on average 62,400 patients a day. This is equal to eight medium and large tertiary hospitals attending to 8,000 person-times a day in outpatient and emergency departments.

During the pandemic, many hospitals expanded online medical services, from online follow-up visits to non-contact medicine delivery.

However, internet-aided medical diagnosis and treatment have been caught in a bottleneck. First, the definitions of the core concepts such as common diseases and follow-up visits for chronic diseases are not clear enough, so it is not possible to standardize doctors' practice and ensure the accuracy of online diagnosis and the efficacy of internet-aided treatment.

The threshold for opening more online hospitals (public tertiary hospitals and above) is relatively high, because it requires huge investments and requires doctors (attending physicians, consultants and surgeons) to put many extra hours at their job.

Therefore, it is difficult for grassroots medical institutions to operate online hospitals on their own. While the large number of patients with mild symptoms that junior doctors can deal with is most suitable for online treatment, the State should introduce supporting policies to encourage doctors working at the grassroots level to join the service team of online hospitals.

Second, there are restrictions on patients' "first visit" to an online hospital. The NHC has set a redline for online hospitals that "do not carry out Internet diagnosis and treatment activities for first-visit outpatients", which greatly limits the value of internet-aided diagnosis and treatment. In December, however, Guangdong province took the lead in allowing the first online diagnosis of COVID-19, which was a major breakthrough.

Third, the online medical bill settlement system using medical insurance remains a problem. Take Beijing for example. Although the internet-aided diagnosis and treatment covered by medical insurance in Beijing was included in the medical insurance reimbursement system in April 2020, patients can only settle bills for medical services online. To pay the bills for treatment and medicines, they have to visit the medical institutions in person.

And fourth, the pricing of internet-aided diagnosis and treatment services is problematic, too, because they break the time and space barriers, allowing medical institutions to maximize their resource advantages. The majority of medical workers have to work beyond working hours, even outside their hospital, and a large number of senior doctors divide their time between offline and online hospitals.

Also, the diagnosis and treatment services are priced unreasonably, and don't fully reflect the work of medical workers, which is not conducive to the expansion and improvement of internet-aided medical services. So appropriate measures should be taken to unleash the full potential of online hospitals.

(Liu Yuanli is a professor at the Chinese Academy of Medical Sciences and Peking Union Medical College. Ma Jing is a professor at the Institute for Hospital Management of Tsinghua University.)

 

Fight against virus should not slacken, it's not gone away

Chinese tourists arrive at the Ngurah Rai International Airport in Bali, Indonesia, Jan 22, 2023. [Photo/VCG]
In traditional Chinese culture, the rabbit is regarded as the luckiest of the Chinese zodiac signs. It represents peace, longevity, prosperity, which all reasonable and sensible people look forward to.

Chinese folklore considers the rabbit, the fourth in the 12-year cycle of Chinese zodiac signs, a particularly gentle, kind, tender and particularly alert creature. All this appears to predict 2023 to be a year of hope.

I spent a part of the Spring Festival holiday in Bangkok, my first overseas trip in over three years. The trip was made possible because of the Chinese central government's decision late last year to ease its "dynamic clearing" COVID-19 prevention and control policy, doing away with the mandatory quarantine and other restrictions. The governments of the Hong Kong and Macao special administrative regions (SARs) quickly followed suit. The result is an extraordinarily speedy recovery of the tourism industry in China.

I noticed during my weeklong stay in Bangkok that the Thai people were very happy to welcome back large numbers of Chinese tourists (from the Chinese mainland, Hong Kong, Taiwan and Macao), because tourism revenue is a big contributor to Thailand's GDP.

This shows that Chinese overseas tourists are a godsend to the rest of the world, Southeast Asia in particular. Some retailers and restaurateurs in Bangkok told me that they love Chinese holidaymakers for the simple reason that they are big shoppers and big eaters.

In Macao, hope helped us go through three difficult years of COVID-19 relatively unscathed, although the pandemic's impacts on the local economy were quite dire, notwithstanding the government's string of financial support for both citizens and businesses.

Thanks to the Macao government's strict anti-pandemic curbs, the SAR was globally known as an oasis in the COVID-19 desert for nearly three years. As the Omicron variant of the novel coronavirus is much more infectious but less lethal than the Alpha, Beta, Gamma and Delta variants, the central, Hong Kong and Macao governments took the right decision, based on scientific findings, to relax their respective pandemic curbs.

I agree with Macao-based Foreign Ministry Commissioner Liu Xianfa who recently wrote in an article that "the continuous optimisation and adjustment of China's epidemic prevention and control policies will also provide a more stable and reliable turbine to the recovery of the world economy and help the world to end the epidemic as soon as possible".

The spectacular recovery of the tourism industry in Bangkok and Macao during the Chinese New Year has proved Liu right.

However, the fight against COVID-19 must continue unabated, because the battle to effectively control the spread of the novel coronavirus will remain among medical sciences' major challenges.

This reminds me of a Chinese proverb, "holding a tree and waiting for a rabbit" (shou zhu dai tu), which can also be translated as "keeping watch at the tree awaiting a rabbit".

The proverb is about a farmer who one day saw a scared rabbit running past him before fatally crashing into a tree on his field. The farmer was happy as he had got a free dinner without having to work for it. Enjoying his rabbit stew later that day, he wondered why he should bother plowing his land as he had a tree in his field where rabbits happened to bite the dust. So he stopped toiling on his land and merely sat by the tree waiting for another rabbit to crash into it. Much to his surprise, it never happened again. He fell into poverty and became the butt of jokes for the villagers.

It's sheer imprudence to rely on luck and fail to put in the necessary effort.
Science-based tenacity and resolve are required to vanquish COVID-19. But all this will probably take many more months, or even years.

As President Xi Jinping said in a video message to medical workers and an elderly patient in a hospital in Harbin, "We have now entered a new phase of COVID-19 response. Tough challenges remain, but the light of hope is right in front of us. Perseverance means victory."

That's why the authorities must continue to take steps to eradicate COVID-19. That's also the best way of ensuring Macao's full economic recovery. Tourists must feel safe during or after their visit to the SAR. While resuming normal business activities, Macao must remain on high alert against COVID-19. Protecting people's lives also means protecting business interests, especially Macao's all-important tourism sector.

We hope virologists and epidemiologists intensify their research to stamp out COVID-19. We also hope there will soon be a pill that can protect us against the virus.

Thanks to the adjustment of COVID-19 prevention and control measures by the authorities, we could enjoy our first quarantine-free Chinese New Year vacation abroad in three years. But we also ought to remain aware that the novel coronavirus is still lurking around the corner. So let's not keep watch at the tree awaiting a rabbit to crash but work hard and remain both optimistic and realistic by staying as alert as a rabbit to protect ourselves and all those around us — and science is there to help us in this lifesaving endeavor.

(The writer Harald Brüning is the director of the Macau Post Daily.)