China lacked a ‘zero COVID’ exit plan. Its people are paying the price.

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HONG KONG/SHANGHAI, Dec 23 (Reuters) – The 30-year-old doctor, Nora, works at a public hospital in Shanghai, where tensions have mounted since China eased its strict zero-coronavirus policy on Dec. 7. there is

Patients wrestle with doctors to obtain missing medicines, such as cough medicine and pain relievers. Doctors are overloaded. Infected staff continue to work due to understaffing.

“Policies to control the novel coronavirus were suddenly eased,” Nora said. “Hospitals should have been notified in advance to be well prepared.”

After years of tough measures to eradicate the coronavirus, China’s public health system collapses as President Xi Jinping suddenly abandons zero COVID in the face of protests and a growing outbreak. is in a hurry to avoid

Shortages of medicines and test kits, as well as logistical disruptions, have overturned daily life. Four hospital workers told Reuters that Zero’s poor planning to end COVID had forced him to manage a chaotic reopening.

Kenji Shibuya, a former senior adviser to the World Health Organization, said: “I think China thought that its policies would be successful and that a gradual transition to the epidemic stage would be possible, but clearly that was not the case. did.

More than a dozen global health experts, epidemiologists, residents and political analysts interviewed by Reuters say the elderly have not been vaccinated, their exit strategies have not been communicated to the public, and that there has been an excessive push to eliminate the virus. The focus has been identified as a source of burden for the Chinese government. medical infrastructure.

The country has spent the past three years spending a lot of money on quarantine and testing facilities rather than beefing up hospitals and clinics and training medical staff, these people said.

“There is no transition time for the health system to prepare for this,” said Zuofeng Zhang, professor of epidemiology at the University of California, Los Angeles. China will do better with this policy change if it can spend more.”

China’s National Health Commission did not respond to a request for comment on the resilience of the health system and the supply of medical staff. Whether there was a contingency plan to deal with the surge in hospitalizations. Whether strict coronavirus measures were hindering improvements in medical capacity.

While defending Beijing’s approach, state media reworked the message to emphasize the benign nature of the Omicron subspecies. In a review of China’s COVID-19 response, the state-run Xinhua News Agency said on Dec. 9 that Xi “did the right thing” by taking “decisive action to curb the spread of the virus.”

official data

As the outbreak escalates, official data on severe cases and mortality is unlikely to reflect the situation, experts say, including Mike Ryan, WHO director of emergencies. and crematoriums are struggling to meet demand.

The National Health Commission has reported only a handful of COVID-related deaths since reopening, and China’s official pandemic total is 5,241, very low by global standards.

Meanwhile, efforts to vaccinate the elderly, launched three weeks ago, have yet to bear fruit. According to government data, vaccination coverage across China is over 90%, but among adults who received boosters, he dropped to 57.9%, and among those over the age of 80, he dropped to 42.3%. declining.

China refuses to deploy a Western-made mRNA vaccine, which studies show is more effective than its own vaccine. China’s healthcare system could be at risk, dozens of experts say.

“As seen in Hong Kong, unvaccinated elderly are particularly at risk of death, and perhaps China’s medical capacity will soon be overwhelmed by the demand for case numbers,” said Japan’s COVID Task Force. said Hiroshi Nishiura, a member of

Frustration over China’s frequent lockdowns and harsh pandemic control reached a tipping point in November when protests erupted nationwide. Within days, Beijing announced a sudden relaxation of its zero COVID rule.

Since then, small-scale protests have erupted in medical schools, demanding better protection and medicines for some front-line workers. The December 14 death of her 23-year-old medical student in Chengdu has fueled public anger over the strain on China’s health care system.

“We are at the bottom of the hospital food chain,” said a 26-year-old medical student from northern China. You may even be asked to reuse the

investment delay

China’s quest for zero COVID exacerbated pressure on hospitals and medical staff due to its centralized health system, forcing people to be hospitalized even with mild symptoms. The government just started allowing him to self-quarantine on December 7th.

China’s Center for Disease Control and Prevention has continued to warn that the massive outbreak will have a devastating impact on the health system, but the insistence on eradicating the virus has strained medical resources. rice field.

Some experts, like Hong Xiao, a researcher at the Fred Hutchinson Cancer Research Center in Seattle, say COVID-Zero will prove costly and dangerous for public health, draining funding and medical staff. It said it has diverted to the front lines of the pandemic and is preventing patients with other conditions from getting treatment.

Other researchers say the current threat to China’s healthcare system is exaggerated.

Chen Zimin, a researcher at China’s Foshan University, said there was a good chance China’s health system could cope now that China has ended quarantining asymptomatic and mild cases.

“I think China can now sufficiently mitigate the looming COVID-19 tsunami,” he said. “Certainly, the health system is under a lot of pressure these days, but I think the government can manage it.”

Reuters Graphics

Still, China’s investment in medical resources such as hospital beds and the growth rate of its medical staff slowed during the pandemic, official data show. Overall health spending rose modestly from 2019 to 2021, but fell slightly as a share of GDP for the first time in over six years, falling from 7.1% in 2020 to 6.6% in 2019. Last year it was 6.5%.

It’s unclear how much money has been spent building quarantine facilities or providing testing, but analyst estimates collected by Reuters in May put China’s COVID-related spending at about $52 billion this year. is.

Faced with a surge in infections, authorities are trying to keep up. Local government bids for the purchase of ventilators and patient monitors have surged, according to a Reuters review. , up from 283 in the previous quarter and 200 in the previous period.

The government has changed its message, urging people to stay home unless they are seriously ill, but after three years of government propaganda about the dangers of the virus, patients are flooding hospitals and clinics.

Reuters Graphics

In Tianmen, a small city near Wuhan, infected patients camped outside clinics to receive intravenous fluids, according to a resident who shared images with Reuters.

Footage obtained by Reuters on Dec. 14 showed a patient sitting in a car to receive an IV through the car window in Hanchuan, Hubei province.

In some cities, the lack of clear guidance on what will happen if someone gets infected adds to the confusion.

An attending physician at a public hospital in Beijing said all surgeries were canceled unless the patient was likely to die the next day.

“Up to 80% of doctors at Beijing’s top hospitals have the virus but are forced to continue working,” he told Reuters on condition of anonymity because he was not authorized to speak to the media.

According to the World Health Organization, China has about 2 doctors per 1,000 people, compared with 4.3 in Germany and 5.8 in the UK. According to data from the World Population Review, there are 3.6 intensive care unit beds per 100,000 population, compared to 34.7 in the United States, 29.2 in Germany and 12.5 in Italy.

Position of China’s medical infrastructure compared to other countries Position of China’s medical infrastructure compared to other countries

no roadmap

China had to pursue a rigorous zero-COVID approach this year, given what the massive outbreak may have brought to major events. Ahead of the Beijing Winter Olympics in February, the government stepped up its pandemic measures and state media warned of the dangers of the virus.

Ahead of the Communist Party Congress in October, as Xi sought to consolidate his rule as he entered his third term, officials stressed that he would never deviate from coronavirus-free despite the economic costs. , warned of the risks of reopening.

“Ease of epidemic prevention and control will lead to a large number of people being infected in a short period of time, a large number of severe cases and deaths, and a shortage of medical resources,” said the People’s Daily, a party official. The newspaper said in its Oct. 12 commentary that it called for sticking to zero COVID.

As President Xi tightened his grip on power and continued to focus on eradicating the virus at all costs, the leadership has become less clear about how China will move beyond meaningless restrictions. I didn’t publish the photo.

As infections began to surge in recent weeks, it became clear that the virus had surpassed COVID-zero defenses.

But Xi’s sudden U-turn meant that many businesses didn’t have sick leave policies or protective equipment in place, leaving many ordinary Chinese people unaccustomed to treating COVID at home. People flooded pharmacies for cold and flu medicine.

Some cities have said workers with mild symptoms can continue to go to work, with local media reporting further confusion. A hospital in Shanghai told staff this week to prepare for a “tragic battle”.

At least 10 medical experts interviewed by Reuters said they expected infections to peak in the next month or two around the Lunar New Year holidays, which begin on January 21.

Keith Neal, professor emeritus of infectious disease epidemiology at the University of Nottingham, said a wave of deaths similar to the one Hong Kong experienced earlier this year was “a good marker of what might happen” in mainland China. rice field.

“The key challenge is the large number of severe infections and deaths that occur in largely susceptible populations due to lack of infection and vaccination,” he said.

The US-based Institute for Health Metrics and Evaluation, part of the University of Washington, said last week that more than 1 million deaths are expected by 2023 as a result of China’s sudden lifting of COVID restrictions.

At her Shanghai hospital, Nora said new infections were on the rise, but the hospital has not disclosed the data publicly.

“Hospitals don’t have a perfect plan for dealing with all issues, and policies change daily,” she said.

Additional reporting by Siyi Liu, Eduardo Baptista and Albee Zhang from Beijing, Brenda Goh from Shanghai, Julie Zhu and Selena Li from Hong Kong, Stella Qiu from Sydney, Rocky Swift from Tokyo, Hyunsu Yim from Seoul, and Xinghui Kok from Singapore. Edited by David Crowshaw.

Our standards: Thomson Reuters Trust Principles.

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