Reflecting on relaxing zero-COVID and moving forward with positivity: A population-based quantitative and qualitative study

Abstract

Objectives

The event that China lifted its zero-COVID policy in December 2022 promoted this study to investigate people's responses in terms of health, mood, life satisfaction, and policy satisfaction following the policy relaxation.

Methods

We conducted a cross-sectional online survey one month after relaxing zero-COVID policy among Chinese general population using qualitative and quantitative approaches. Participants rated their health, mood, life satisfaction, and policy satisfaction on a horizontal visual analogue scale ranging from 1 to 100. In addition, we included open-ended questions to gain deeper insights into their responses.

Results

Out of 4456 participants, approximately 70 % reported satisfaction following the policy change. Those with recent COVID-19 infection (N = 3308) rated lower scores in health, mood, life satisfaction, and policy satisfaction than those without recent infection. A multiple linear regression model revealed that the absence of recent COVID-19 infection, higher life satisfaction, and greater policy satisfaction were associated with better mood. Interestingly, participants who experienced increases in life and policy satisfaction also had better moods. Qualitative analysis revealed an improved mood of participants, reflecting a desire to return to normal life despite a preference for a gradual and well-prepared transition policy.

Conclusions

This study highlighted positive changes following the relaxation of zero-COVID policy. Strategies aiming at post-COVID-19 recovery should prioritize individuals who have contracted the virus while promoting life and policy satisfaction amongst the general population.

Public Interest Summary

China's decision to lift its dynamic zero-COVID policy on December 7, 2022, marked a significant shift in COVID-19 control measures, ushering in immediate stressors and challenges. Our study, employing both quantitative and qualitative methods, sought to understand how the general population in China responded to this transition. We found that participants reported above-average levels of self-assessment health, mood, life satisfaction, and policy satisfaction following the relaxation of the zero-COVID policy. Notably, those with recent COVID-19 infection reported lower satisfaction levels than those without recent infection. Moreover, the absence of recent COVID-19 infection, higher life satisfaction, and greater policy satisfaction were associated with better mood outcomes. In addition, we observed a positive synergistic effect between life satisfaction and policy satisfaction on mood. Despite a preference for a gradual and well-prepared transition policy, participants showed improved mood, reflecting an inclination towards a return to normalcy. Our study captured this pivotal moment of policy change, revealing positive changes to move forward amid complex responses.