Until recently, China, the world’s most populous country, was also the world’s last Covid outbreak. But in a few weeks, it will be hit by a wave that a top health official predicts could infect hundreds of millions of people.
This week, Beijing took its biggest step forward to living with Covid, minus the unpopular and costly “Covid-free” mass lockdown and isolation policy it hopes to eliminate. infection status. The sudden pivot has raised the specter of a terrible strain on a healthcare system that is already overwhelmed even in normal times. The situation could worsen in another month, as people travel across the country to visit family during the Lunar New Year holiday.
Feng Zijian, an adviser in China’s Covid task force, said this week that the outbreak could infect 60% of the country’s 1.4 billion population – or more than 840 million. People. For most Chinese, this will be their first encounter with Covid.
Like many countries, China is currently facing highly infectious, but so far milder variants of Omicron than previous iterations. Unlike the rest of the world, China has had almost three years to prepare for this surge. But it has spent much of that time focusing on lockdowns rather than vaccinations and preparing people to live with Covid, a prospect many experts have warned is inevitable.
Jin Dong-Yan, a virologist at the University of Hong Kong, said: “A tsunami of cases is coming regardless of whether they stick to Covid’s zero or not.
The question is how many cases will become serious and require more serious medical attention. Even the current picture is not clear. According to official data released by the National Health Commission, there were 159 severe Covid-19 infections nationwide as of Friday, an increase of about 60 from the beginning of the month.
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“That number is still very low because, in fact, there should have been more confirmed cases that are currently under-reported,” said Jin. Another difficulty: the definition of a “severe” case can vary from city to city, he added.
What is clear is that the government is preparing for the big wave. Officials on Friday announced plans to double the capacity of intensive care beds and increase the number of doctors and nurses working for those departments. Also in the works: upgrading formerly built temporary facilities to isolate people believed to have been in close contact, turning them into secondary hospitals. Officials also added that those working at the community level will categorize residents by level of risk — assigning color codes to indicate risk based on immunization status, age and other health conditions. , changing the way surveillance tracked residents based on contact and infection traces.
China wants to allocate hospital beds for the most severe cases, but officials now need to convince the majority of those infected to stay home, despite telling them for years to fear Covid. A grading system has been established to send Covid patients to community health centers, but most people are not used to seeing doctors outside of hospitals. The government is relying on an army of volunteers to make phone calls and deliver cold medicines and Covid testing kits to sick people at home, but there are early signs of a shortage of manpower and shortages. necessary supplies.
To some extent, the complications China is facing in opening up are not unique. Other countries that have moved from strict pandemic control to adapting to the virus have experienced some degree of shock as people unfamiliar with the virus flood hospitals for help. But in places like Singapore and New Zealand, that change is more controlled. Officials only lifted restrictions after letting the public know what would happen and when, allowing hospital systems more time to prepare for the coming outbreak and people more time for vaccination.
“Singapore has adopted a cautious approach with gradual reopening,” said Paul Anantharajah Tambyah, an infectious disease physician and president of the Asia Pacific Society of Clinical Microbiology and Infections. . He added that mild and moderate cases are treated outside the hospital system. “That has helped the media a lot and is more easily accepted by the general public than a drastic change to the ‘business as usual’ approach.”
China is now just trying to ramp up its vaccination campaign that was mostly stalled in the spring as resources were diverted to building and implementing a national mass testing system. According to the World Health Organization, more than 600 million vaccinated people have yet to receive a booster shot, a necessary prerequisite for preventing serious cases in people vaccinated with China, which has been proven to be effective. is weaker. Among people 80 years of age and older, only 40% had a booster shot.
After the easing was announced on Wednesday, officials rushed to write new guidelines on everything from home isolation to rapid antigen testing and freeing up resources for an upcoming batch of cases.
Dale Fisher, a professor of medicine and head of the National Committee for Infection Control and Prevention of Singapore’s Ministry of Health, said that Chinese health officials will need to ensure that additional hospital beds are available. ready, ventilators available and medical staff redeployed.
China has moved quickly in recent days, more than doubling its intensive care bed capacity to 10 beds per 100,000 people, up from less than four beds just a month ago.
The National Health Commission on Friday also said it would move 106,000 doctors and 177,700 nurses to intensive care units. According to the most recent official figures reported for 2020, China has three registered nurses for every 1,000 people and two practicing doctors for every 1,000 people.
Some of the changes created confusion as authorities acted quickly to respond to the new measures. In cities like Beijing and Shanghai, authorities removed many testing kiosks almost immediately after Wednesday’s new guidelines called for restrictions on testing requirements. But on Friday, the National Health Commission said that testing sites should not be dismantled on their own and should be made available to people who need to go to nursing homes and medical facilities, where there are still request a negative test result.
As cases increased in Beijing, many people lined up at hospitals to receive fever-reducing medicines and home testing kits. Some city residents report that hospitals are turning away people with symptoms, telling them their cases must first be reported by local neighborhood officials.
Wakeman Wang, a resident of Beijing, said he had hoped to bring his 7-year-old son to the doctor after he choked on a salmon bone earlier this week. But because his son had tested positive for Covid, his local neighborhood worker – tasked with overseeing pandemic policies at the community level – asked him to take care of her son at home.
Mr. Wang said his wife tried to call several local family doctors, who were quickly assembled to help deal with public health issues, but to no avail.
“I feel hopeless and guilty,” he said. “When my child is in danger, I cannot solve the problem and I cannot guarantee his safety.”
Scarlet Zhang, a resident of Fengtai, a district in the southwest of the city, said she tried to go to the hospital after testing positive for a fever of 100 degrees Fahrenheit.
She said she had repeatedly tried to call an ambulance but the city’s emergency number, the equivalent of 911 in the United States, was always busy. She said the pharmacy near her house had run out of antipyretics.
“I had a fever until the third day, I couldn’t get expert advice and I don’t know what to do now,” she said.
Given the previous hard line on the severity of the virus, Chinese officials now face a major challenge in alleviating public fears, Fisher said.
“It’s really hard to get the message across when you’ve been saying for two to three years that this is deadly, and now you’re saying, ‘If you’re sick, stay home and isolate yourself’. ,” he added.