* Strong measures remain cost-effective, China expert says

* "Zero-COVID" stance putting burden on global economy - IMF

* China cautious amid worries about its healthcare system

By David Stanway

SHANGHAI, Jan 27 (Reuters) - China's "zero-COVID" stance hasput it at odds with the rest of the world and is exacting amounting economic toll, but an exit strategy remains elusive asauthorities worry about the ability of the healthcare system tocope and adapt to new strains.

Chinese medical experts believed last year that highervaccination rates would eventually allow China to relax toughrules on movement and testing as infection rates slow elsewhere.

The emergence https://graphics.reuters.com/world-coronavirus-tracker-and-maps/vaccination-rollout-and-access of the highly transmissible Omicron variant dashed those hopes.

While some analysts have branded China's approach as"unsustainable", many local health experts - and some fromoverseas - say the country has no choice but to continue givenits less developed health system.

Some even argue China's economy could even emerge strongerthan ever if it keeps Omicron at bay.

"For a large country with a population of 1.4 billion, itmust be said that the cost effectiveness of our country'sprevention and control has been extremely high," said LiangWannian, head of the expert epidemic prevention group at China'sNational Health Commission, at a Saturday briefing.

Kristalina Georgieva, managing director of the InternationalMonetary Fund, called on China last week to "reassess" itsapproach, saying it had now become a "burden" on both theChinese and global economies.

But China is concerned the cost of lowering its defencescould prove even higher, especially with a healthcare systemthat has lagged its broader development.

"With a large population and high density the government isrightly concerned about impacts for the spread of the virus,"said Jaya Dantas, professor of international health at theCurtin School of Population Health in Perth, Australia.

China had 4.7 million registered nurses at the end of 2020,or 3.35 per 1,000 people, official data showed. The UnitedStates has around 3 million - around 9 per 1,000.

China is also wary of the risk of new variants, especiallyas it refuses to import foreign vaccines. Studies suggestChina's vaccines are less effective against Omicron and it hasnot yet rolled out its own mRNA version.

Wu Zunyou, chief epidemiologist at the Chinese Center ForDisease Control and Prevention, warned the "insidious" Omicroncould still lead to a rise in the absolute number of deaths evenif it was proven to be less deadly, and China must remainpatient.

"China's medical capacity and standards are not as good asBritain or the United States, but the results of China'scoronavirus prevention and control are far, far superior," hesaid in a weekend interview with the Beijing News.


China has stepped up its health warnings, urging citizens toignore claims that Omicron is no more serious than the 'flu andto stay vigilant.

On Wednesday, the Global Times, published by the officialPeople's Daily, also lashed out at overseas media for "mocking"China's policies, saying they saved lives.

Foreign criticism was "based on unfounded or prematureoptimism regarding the end of the pandemic", it added.

Experts in China and overseas have also cast doubt on thehope that Omicron represents the final stage of the pandemic.

"SARS-CoV-2 will not magically turn into a malaria-likeendemic infection where levels stay constant for long periods,"said Raina MacIntyre, head of the Biosecurity Research Programmeat the University of New South Wales' Kirby Institute.

"It will keep causing epidemic waves, driven by waningvaccine immunity, new variants that escape vaccine protection,unvaccinated pockets, births and migration," she told Reuters.


China's economy is expected to slow as a result of COVIDrelated supply disruptions, while lockdowns to douse domesticoutbreaks weigh on travel and consumption.

Hong Kong's "zero-COVID" approach has put theChinese-controlled city out of step https://www.reuters.com/markets/europe/hong-kongs-financial-sector-faces-talent-crunch-expats-head-exit-2022-01-23 with other global finance centres and is battering its economy.

Still, China's economy has remained resilient, with GDPgrowth at 8.1% last year, far exceeding expectations.

MacIntyre of the Kirby Institute said it wasn't a "binarychoice" between opening up and remaining isolated, adding therewas "no need to surrender to the virus, as Australia is doing atthe moment."

China could still emerge from the crisis in the strongestposition, especially if COVID leads to widespread cognitiveimpairment, organ damage and other long-term conditions in othercountries, she said.

"If China keeps the virus largely under control, theirpopulation will be fit and healthy into the future, while theUnited States and Europe will be groaning under an unprecedentedburden of chronic disease."

<^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^Interactive graphic: https://graphics.reuters.com/world-coronavirus-tracker-and-maps/vaccination-rollout-and-access/ FACTBOX-Worldwide coronavirus cases/deaths urn:newsml:reuters.com:*:nL4N2AY3AS FACTBOX-Latest on global spread of coronavirus urn:newsml:reuters.com:*:nL4N2KI0XB

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^> (Reporting by David Stanway; Editing by Lincoln Feast) ((david.stanway@thomsonreuters.com; +86 21 2083 0066;))