Coronavirus infections were rampant in China long before the government’s decision to abandon its strict “zero-COVID” policy, a World Health Organization director said on Wednesday, responding to suggestions that the sudden reversal led to an increase in cases.

The comments by WHO emergencies director Mike Ryan come alongside warnings about the need to ramp up vaccinations in the world’s second-biggest economy.

At a news conference, Ryan said the virus was spreading “intensely” in the country long before the restrictions were lifted.

“There is a narrative at the time that China lifted the restrictions and all of a sudden the disease is out of control,” he said.

“The disease was spreading intensely because I think control measures by themselves were not stopping the disease. And I think China strategically decided that was no longer the best option.”

Beijing began to move away from its signature “zero-COVID” policy this month after protests against economically damaging restrictions advocated by President Xi Jinping.

The relaxation has led to long lines outside clinics, in a worrying sign that a wave of infections is mounting, even as official counts of new cases have trended lower.

In its most recent COVID report for the week to November 27, the WHO said China had reported an increase in hospitalizations for four consecutive weeks.

“So the challenge that China and other countries still have is: are the people who need to be vaccinated, vaccinated properly, with the correct vaccines and the correct number of doses and when was the last time those people received the vaccines?” Ryan said.

Euphoria in China over changes to the policy allowing people to live with the virus has quickly faded amid growing concerns about rising infections as the population lacks “herd immunity” and has low vaccination rates among seniors.

WHO chief epidemiologist Maria Van Kerkhove said the UN agency was providing technical advice to China and Ryan said channels were open.

Among the first major deals announced in which a Western drugmaker will supply China with COVID therapies, China Meheco Group Co Ltd said Wednesday it would import and distribute Pfizer’s Paxlovid treatment products.

Earlier at the news conference, WHO chief Tedros Adhanom Ghebreyesus said he was “hopeful” that the pandemic, which has killed more than 6.6 million people since it emerged in Wuhan three years ago, no longer considered a global emergency sometime next year.

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