From zero-COVID to global alignment: transnational pressures and China’s pandemic communication transformation

BACKGROUND: Public health crises are governed not only through policies but also through talk. Government press conferences are ritualized arenas where authorities construct meaning, claim competence, and manage domestic and international legitimacy. China's abrupt transition from "zero‑COVID" to a strategy of coexistence provides a critical case for examining how transnational pressures-from the World Health Organization, diplomatic partners, markets, and global media-shape official communication over time. MAIN BODY: This study analyzes 154 central government press‑conference transcripts (February 2020-February 2023) using a mixed‑methods design that combines topic modeling with qualitative frame analysis and process tracing of international pressure events. We segment the period into four phases-International Scrutiny, Global Cooperation, International Isolation, and Global Alignment-and identify seven recurring frames spanning health‑system capacity, epidemiological standards, vaccine diplomacy, economic-health trade‑offs, supply‑chain interdependence, and policy adaptation. Event‑timing analysis shows a consistent lag of roughly 7-21 days between major international cues and subsequent adjustments in domestic frames, with the economic-health and policy‑adaptation frames most responsive. A micro‑level discourse analysis demonstrates "semantic governance": lexical substitutions ("optimization," "new phase") and contextual recoding that converted a substantive policy reversal into a narrative of adaptive improvement. We argue that authorities achieved discursive alignment with evolving global norms without immediate policy convergence, illustrating how sovereignty sensitivities are managed communicatively. The findings also reveal equity‑relevant mechanisms: semantic smoothing that stabilizes compliance can under‑specify risks for vulnerable groups during transition windows, and generic references to "key populations" can displace time‑bound commitments to protection and access. Building on these insights, we propose two practical tools for global health governance: (1) an equity checkpoint for each policy pivot (plain‑language risk summaries, service guarantees, and a short equity note), and (2) a discursive alignment dashboard that tracks lead-lag to international guidance, domain‑specific alignment, and semantic markers of convergence or divergence. CONCLUSIONS: Pandemic communication in China followed a cyclical frame‑reinforcement pattern rather than a linear arc, and relied on semantic governance to manage rapid policy change under transnational pressure. Recognizing and monitoring these communicative mechanisms can strengthen global health governance and reduce equity risks during future protracted emergencies.