Objective To understand and analyze the experiences and challenges of Beijing city in preventing and controlling the COVID-19 epidemic, providing references for improving the prevention and control practices and policy-making of infectious disease pandemics in megacities in the future.

Methods From October 2023 to February 2024, 21 staff members from Beijing's health administrative departments, professional disease prevention and control institutions, medical and health institutions, professional public health institutions, and community health service centers were invited for key informant interviews. Thematic framework analysis was used to process and analyze the interview data.

Results Through the analysis of 21 qualitative data sets, two major themes emerged: experiences and challenges in the prevention and control of the COVID-19 epidemic in Beijing, covering 11 primary indicators and 39 secondary indicators. Specific aspects include the construction of a multi-level joint command and management system, improvement of the top-level design for public health emergencies, optimization of the medical and health service system, clarification of the four-party responsibility mechanism for infectious disease prevention and control, creation of a "specialist-led, specialist-community integrated" model, and improvement of the information transmission and communication mechanism. However, there were also challenges, such as the need to strengthen the connection between policy and system changes, the relatively lagging development of informatization, and deficiencies in epidemiological investigation, tracing, and close contact management.

Conclusions The epidemic prevention and control in Beijing is of great significance. Relevant institutions or departments should pay attention to the effective connection between new and old iterations of policies and systems, improve the normalized infectious disease surveillance and early warning system, strengthen the construction of epidemiological investigation teams and the mechanism for switching between normal and emergency situations, and enhance the level of informatization.