A week into China’s easing, uncertainty over virus direction

While there are no official indications yet of the massive surge of critically ill patients some feared, social media posts, business closures and other anecdotal evidence suggest huge numbers of people are being infected. In Beijing and elsewhere, there was a rush on cold medication and testing kits. Some hospital staff are staying home, while others are back to work after being infected.

After years of trying to track the virus down to every last infection, the government now says that’s essentially impossible — but it’s not clear what that means for reporting the most serious cases.

While major cities such as Beijing, Shanghai and Shenzhen have invested heavily in health care, second- and third-tier cities and communities in the vast rural hinterland have far fewer resources to deal with a major outbreak.

For a variety of economic and cultural reasons, Chinese tend to be more reliant than citizens of other countries on hospitals, even for illnesses that are not severe. The government has asked to those with mild symptoms to recuperate at home, but if they don’t, that could lead to strains, Yale professor of public health Xi Chen said.

“If people do not have such culture to stay at home, to keep those resources for sicker people, then that could easily crash the system,” Chen said.

So far, Beijing has more than tripled the number of fever clinics to over 300, and those visited by Associated Press journalists were generally calm and orderly, with few indications of overcrowding. A children’s hospital had 50 or 60 people waiting in line Wednesday afternoon, but three others had shorter queues. At one clinic in southern Beijing, a few elderly patients were put on IV drips, and one was inhaling pressurized oxygen.

Though the health care system in big cities appears to be holding up so far, Chen cautions that it’s too soon to tell when cases will peak. The January Lunar New Year — when millions of people travel to visit family — is expected to present another challenge, Chen said.

“I’m concerned it could be a super-spreader event,” he said.

Winter is also a tough time to loosen restrictions, Chen said, as the virus circulates more easily.

Other concerns include boosting China’s elderly vaccination rate and bolstering the country’s intensive care capacity. Though most of China’s population is vaccinated, millions of older adults haven’t had a booster shot of the country’s domestically made vaccines. Studies show Chinese vaccines are effective in preventing hospitalization and death, but require at least three doses in order to be fully effective.

China says around 30% of people 60 or older have yet to get three shots. Part of the hesitancy derives from original government directives that discouraged those above 59 from getting vaccinated, but there are also longstanding concerns about the safety of Chinese vaccines.

On Wednesday, the government said it would offer a fourth shot to those in vulnerable groups.

Downtown Beijing was largely empty Thursday and those businesses and restaurants that remained open or had not cut back radically on operating hours saw few customers. The empty streets reflected both the fact that many who are sick are staying home but also that others don’t want venture out to avoid getting infected.

Experts have increasingly said China’s “zero-COVID” policy of lockdowns, quarantines and mandatory testing was unsustainable, especially in the face of the more infectious omicron variant that resulted in increasingly harsh restrictions.

Those measures were blamed for hindering the economy and created massive societal stress. The easing began after Beijing and several other cities saw protests over the restrictions that grew into calls for President Xi Jinping and the Communist Party to step down — a level of public dissent not seen in decades.

Though the Dec. 7 relaxation of measures has allowed more avenues for the coronavirus’s spread across the country, the full effects are not yet clear.

In the economy, the news has been mixed. The National Bureau of Statistics on Thursday said China’s value-added industrial output rose a modest 2.2% year-on-year, while the urban unemployment rate rose slightly to 5.7% in November, from 5.5% the month before. China does not survey unemployment outside of major cities.

Xi’s government is still officially committed to stopping virus transmission. But the latest moves suggest the Communist Party will tolerate more cases without quarantines or shutting down travel or businesses.

Mi Feng, spokesperson for National Health Commission, reiterated that shift in tone on Thursday.

“At present, the focus of epidemic prevention and control has shifted from prevention and control of infection to medical treatment,” Mi said at a briefing.

The task of gauging China’s preparedness is made all the harder by the lack of reliable statistics and projections.

The only numbers the National Health Commission is currently reporting are confirmed cases detected in public testing facilities where symptoms are displayed.

The government stopped announcing asymptomatic case totals earlier this week, saying an accurate count was impossible. The results of home tests also won’t be captured.

China’s official death toll remains low, with just 5,235 deaths — compared with 1.1 million in the United States. However, public health experts caution that such statistics can’t be directly compared.

Chinese health authorities count only those who died directly from COVID-19, excluding those whose underlying conditions were worsened by the virus. In many other countries, guidelines stipulate that any death where COVID-19 is a factor or contributor is counted as a COVID-related death.

Experts say this has been the longstanding practice in China, but questions have been raised at times about whether officials have sought to minimize the figures.

Associated Press news assistant Caroline Chen and researcher Yu Bing in Beijing, and writer Huizhong Wu in Taipei, Taiwan, contributed to this report.