China took a major step toward abandoning its long-held "zero-COVID" approach Wednesday, easing a range of restrictions that it has persisted with long after the rest of the world moved on to living with the virus.

By jettisoning key tenets of the virus elimination strategy, including a requirement for infected people to quarantine in centralized camps, China’s switch in COVID-19 policy is suddenly moving faster than expected. The rapid acceleration reflects mounting pressure on Chinese President Xi Jinping to chart a path out of the crisis and quell public discontent.

The National Health Commission set out 10 new measures, less than a month after it started the reopening process with 20 guidelines for officials to minimize disruption. Despite a buildup in expectations in recent weeks, markets appeared to be taken aback by how far-reaching Wednesday’s moves were. An initial rally fizzled as some investors worried about a spike in infections and chaos that might ensue from the sweeping changes.

Top health officials sought to project confidence at a briefing in Beijing after the announcement, insisting that China’s zero-COVID adherence had limited loss of life, and that conditions were now appropriate to move on.

Liang Wannian, who led China’s initial pandemic response, said the country was adjusting policies in a "pro-active, not reactive” way.

The latest steps include accelerating vaccination among the elderly and stopping local officials from designating large areas such as entire housing compounds as high risk, leading to lockdown-like curbs. A green health code on contact-tracing smartphone apps is no longer needed for domestic travel or to enter most venues.

A nationwide expansion of the home isolation rule, pioneered in Beijing after quarantine facilities ran out of space, could shift public perception of the virus from a serious health threat to a more commonplace illness. The government had championed its zero-COVID approach throughout the pandemic, with its policy of widespread testing and lockdowns to wipe out infections. But it left China isolated and caused misery and economic hardship.

The three-year adherence to zero-COVID has hit economic activity, pushing down consumer and business confidence and leaving people stuck in a cycle of outbreaks and lockdowns. Tragic incidents blamed on COVID-19 controls, including a deadly fire in Xinjiang, intensified public anger.

With an eye on recovery, senior officials are debating an economic growth target of around 5% in 2023.

The Politburo said it will use "targeted and forceful” monetary policy as it aims for "overall improvement” in the economy next year, according to a Wednesday readout of its most recent meeting. The phrase "Dynamic zero-COVID,” which it has used previously, didn’t appear.

The new measures mean that asymptomatic and mild cases will be able to isolate at home, provided their residences meet certain conditions, which authorities didn’t specify. People can still go to centralized quarantine facilities if they prefer. Close contacts can either isolate at home or at government facilities, and they can finish quarantine five days after a negative PCR test.

Authorities also pledged to bolster vaccination rates among the elderly. For those 80 or above, the rate for booster shots is less than 50% and about 60% for full doses, raising concern that fatalities could surge and health care services come under even greater pressure as the virus inevitably spreads.

Expectations that China would loosen its COVID-19 regime spurred the strongest monthly rally in Hong Kong-listed Chinese stocks in nearly two decades in November. Shares initially climbed after the news Wednesday, including the country’s three main airlines, Air China, China Eastern Airlines and China Southern Airlines, which all surged more than 10% in Hong Kong.

The CSI 300 Index later erased its gain and a key gauge of Hong Kong-listed Chinese stocks also reversed course to slide 1.6%.

State media had painted COVID-19 as fearsome and Western countries’ acceptance of it as a moral failing. But as other places moved past the pandemic, a growing number of people started questioning why they were stuck with China’s approach, raising pressure on the authorities. Protests eventually spilled into streets in cities around the country, with some demonstrators calling for Xi to step down — incredibly rare scenes of public unrest in the world’s most populous nation.

The easing comes as COVID-19 spreads rapidly in China — cases nationwide surged to highs of nearly 40,000 a day at the end of November before declining. While loosened rules will drive the numbers higher again as cold weather intensifies, the government appears to consider the trade-off a necessary one, though it remains to be seen how evenly the changes will be applied nationwide.

Grassroots medical institutions have been urged to help meet health-care demands so hospitals aren’t overwhelmed.

The 20 measures issued last month, including cutting quarantine times and discouraging arbitrary mass testing, were met with a muddled and chaotic rollout. A reversion to strict curbs in some cities fueled public discontent, with residents brandishing the new guidelines to stop neighborhood authorities from locking them down.