China, already struggling with a dramatic surge in coronavirus infections after abandoning its “zero covid” policy, is bracing for another spike in cases during the upcoming Lunar New Year period.
Traffic authorities forecast some 2.1 billion trips nationwide in the 40 days around Lunar New Year, the first major holiday since the pandemic began during which domestic travel will be possible with minimal restrictions. What has been called the world’s largest annual migration is likely to expand the ongoing outbreak and endanger the many elderly and undervaccinated people in China’s rural areas, experts said, since hundreds of millions of people will travel to see family, many for the first time in three years.
Beijing has abandoned mass testing and no reliable nationwide tally of infections is available, but a National Health Commission official told state media Sunday that some 8 percent of China’s cases had moderate to severe symptoms and that demand for intensive care would peak over Lunar New Year, which begins Jan. 22. The central province of Henan estimated that roughly 89 million residents had been infected as of Monday and said that its hospitals were overwhelmed.
Investigations by The Washington Post paint a picture of hospital infrastructure under immense pressure, as fatalities soar. Authorities remain worried, with several local governments announcing that while they believe cases have peaked for now, a second wave is coming. Some cities reminded residents to wear masks and urged them to keep group activities small.
Liang Wannian, an epidemiologist who is a top adviser to Beijing’s covid response team, admitted that the government was “not well prepared” for the reopening and that many elderly patients had died in the current outbreak.
“It came too soon and caused massive infections in a short time, especially among senior citizens who needed to be hospitalized,” Liang told state broadcaster CCTV on Monday. He urged local officials to prioritize the timely treatment of elderly people in rural areas, who he said were at heightened risk from social activities around Lunar New Year.
While China’s urban medical infrastructure has significantly improved in recent years, state media has reported that many rural clinics suffer from a lack of doctors, with some being forced to ration painkillers earlier this month.
Some authorities said that they believe the worst is over, though they are offering scant evidence. Officials in Chongqing, a landlocked metropolis of some 10 million people, said at a briefing Jan. 3 that the peak “should have passed,” citing two weeks of declining visits to clinics from patients suffering fevers.
“The number of severe covid cases has hit a plateau and will continue for a while,” Gao Yuan, director of the intensive care unit at Renji Hospital in Shanghai, told local media Tuesday.
Health officials have tried to reassure the public by citing the relatively low fatality rate resulting from infection by the omicron variant. Officially, just over 5,200 people have died of covid in China since the beginning of the pandemic, though the World Health Organization has said Beijing is probably undercounting infections and deaths.
The lack of transparency in the face of a covid surge has prompted unease abroad. Countries such as the United States, Japan and South Korea have imposed entry restrictions on travelers from China, citing fears about the emergence of new variants. Independent experts say the measures, which include predeparture testing, are probably ineffective, though Seoul reported that more than a fifth of short-term visitors from China who landed in South Korea between Jan. 2 and Jan. 6 tested positive for the coronavirus.
Chinese state media branded the restrictions “ridiculous” and Beijing retaliated by suspending the issuance of short-term visas for Japanese and South Korean citizens. On Wednesday, it also suspended certain transit privileges for people from those countries. The impact from those moves is likely to be limited, since China has not lifted curbs on leisure travel for foreigners.
There were some signs of hope, at least in the medium term. Beijing has not authorized the mass use of Western-made messenger RNA vaccines, which studies have shown are significantly more effective than Chinese homegrown shots at preventing severe illness. But Chinese pharmaceutical firm CanSino Biologics said last week that it was moving an mRNA shot targeting omicron into “trial production” phase after positive data from a mid-stage trial involving 433 people.
Medicine was also becoming more available, at least in major urban areas. When China lifted covid restrictions in December, panicking residents rushed to stockpile medications and test kits. Cold medicine was particularly hard to come by, with supplies in Hong Kong and South Korea also stretched as Chinese nationals shipped pills home.
Officials addressed the shortage by granting expedited approval to more than two dozen generic versions of fever medication and painkillers. Residents in some major Chinese cities wrote on social media that they were finally able to purchase such medication from local pharmacies in January, after weeks of empty shelves.
But Beijing on Sunday also said that it had failed to agree with Pfizer on a price for the Paxlovid oral antiviral, which studies have shown to be extremely effective in reducing the risk of severe illness for seniors and other at-risk groups. That would mean that state medical insurance stops paying for the medication by late March, significantly reducing the ability of many Chinese to access the drug.
There is a thriving gray market for the medication, according to state media, which reported that scalpers in Beijing were selling it for up to $7,400 per box. Pfizer supplies the medication to China under a soon-to-expire agreement for about $340 per pack.