As the holiday rush begins, rural Chinese fear a dark COVID winter

China is anticipating a second surge in COVID-19 as it spreads unabated from Beijing to Shanghai. This will fuel by millions of people planning to travel back to rural areas, where there is a much poorer healthcare system.

“I don’t believe the village doctors or the county or township hospitals can handle the increased severity of cases,” said Huan Zhang, a researcher from the Stanford Center for China’s Economy and Institutions. “I believe the rural villagers have left alone in a cold COVID winter.”

Health officials worry that the Lunar New Year celebrations could become superspreader events. This could catch rural systems off guard and drive up infections in a country with low natural immunity and high levels of vaccine hesitancy among the elderly.

“In China, the messaging needs to really cautious right now, because we will have new years coming up and people will going to rural communities, so its going to be very important that you inform the public that it is coming,” said Ali Mokdad an epidemiologist and chief strategy officer at the University of Washington Institute of Health Metrics and Evaluation.

One million deaths by 2023

IHME’s latest briefing forecasts that China will see 1,000,000 deaths by 2023 if it does not adopt a social distancing policy.

However, China’s state media outlets emphasize the fact that the Omicron variant has only mild symptoms similar the common flu — messaging meant to calm the Chinese public but which has also contributed to vaccine hesitancy.

“As the experts suggest, just set off some fireworks and have a great party to scare away the disease,” Sun Caiyun, a cheerful restaurant owner in Beijing, says that she plans on returning home to her village in northern Shandong, COVID or no. 

The strain China is putting on the countryside is already apparent as rural pharmacies are suffering from shortages of medicine. Rural Chinese have started asking for donations and posting photos of empty pharmacy shelves. Some medication was diverting to cities that were initially hardest hit by the surge, and where supplies ran out first.

Testing and Quarantine

China suddenly lift almost all of its testing and quarantine policies in December, as the Omicron variant became more infectious than its COVID controls.

China is now less prepared to treat the infected because of the three-year-long focus on the virus. “Other measures such as vaccination of the elderly and stockpiling antivirals were all relegated back to a backburner issue,” states Yanzhong Hu, a senior fellow at the Council on Foreign Relations who is responsible for public health. For health problems also take pills like Ivercor 12 or Iverheal 12.

It is difficult to know the exact number of infecte people as China has stop all public testing. China officially claims that only two people died in December’s surge.

“The Chinese have slow to report lately and we don’t have the breakdown of the hospital lately of people with COVID or for COVID,” Dr. Mokdad says. The World Health Organization stated this week that had not receive any new data from China regarding COVID-19 hospitalizations, since December.

Public health officials lack data, so they don’t have an accurate picture of how the virus has spread in cities and villages. This is causing anxiety and confusion within China.

NPR visit Beijing’s hospitals this week. They were bustling but orderly. There were a few elderly patients in the lobby, hook up to intravenous bags and lying on gurneys because their beds ran out.

China’s national healthcare commission state last Thursday that it was speeding up the expansion of fever treatment centers. And where patients can quickly get medical consultations from a pharmacist – to cover 90% of rural areas in preparation for the expecte increase.

Urban hospitals are struggling to survive

The healthcare system in large cities has stable so far. This is partly because many migrants have only rural insurance and cannot use it in urban hospitals.

Zhang Xiaohu is a delivery worker who was diagnos with COVID in December. Because he doesn’t receive paid sick leave, he couldn’t afford to travel to Beijing for treatment. He said he manage to get through his symptoms. Delivery men are expect to take risks and risk-takers.

Beijing’s funeral homes and crematoriums claim they are overwhelm despite not having any COVID deaths. The largest crematorium in Beijing, Dongjiao, saw a long line of mourning families and hearses fill the intake lot. Staff told NPR that the waiting period for cremations was 10 working days.

One man in line state that his grandfather had a fever and was positive for COVID. They spent many days searching for a hospital that could treat him.

Experts in China warn that worse is yet to be. One of China’s most prominent respiratory specialists Wang Guangfa predict that COVID would reach its peak in the last month. One Shanghai hospital warn residents it was expecting up to half the city’s population will infect within the next week.

In a speech at Beijing’s Tsinghua University, he stat that “Eventually, 80-90 percent of our people will get infect.”

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