It was almost noon and the crematorium at Baobaoshan Revolutionary Cemetery in the west of Beijing was busy with mourners carrying boxes containing the ashes of their loved ones. In the Chinese funeral tradition, bodies are cremated on the day of death or on the third, fifth or seventh day afterwards and the ashes should ideally be collected before sunrise.
Since the middle of December, Baobaoshan crematorium has been operating on a 24-hour basis and mourners can no longer book a time-slot for cremations but must take their turn on the next available day. The wave of coronavirus infections that hit Beijing last month has subsided but older people with underlying conditions are still dying, if in smaller numbers.
The Chinese authorities have rejected criticism of the way the zero-Covid policy was abandoned after three years, denying that the move was abrupt and asserting that the healthcare system was prepared. And Beijing has reacted sharply to the decision by many western countries to require inbound travellers from China to take a PCR test before they fly, something all visitors to China must do.
But the authorities this week acknowledged that the Chinese new year on January 22nd, when millions of people travel to see relations, will accelerate the spread of coronavirus and advised people how to respond to it.
Officials expect travellers to make more than two billion trips by road, rail, air and water over the next 40 days, twice as many as were recorded around Chinese New Year in 2022
“Understand the epidemic correctly. Pay attention to your health status at all times and consult the village clinic and township health centre if you have symptoms of infection. Stay informed about the relevant regulations of local epidemic prevention and control, maintain a good mentality, and do not panic, don’t worry, don’t believe in rumours, don’t spread rumours, and don’t blindly use medication,” the state council said in a statement.
Officials expect travellers to make more than two billion trips by road, rail, air and water over the next 40 days, twice as many as were recorded around Chinese new year in 2022. This migration will hasten the spread of the virus from major cities such as Beijing and Shanghai to second- and third-tier cities and rural areas.
A nursing assistant in one of Beijing’s biggest hospitals described the challenge of dealing with the peak of the outbreak in the capital, which is likely to be replicated across China over the next few weeks.
“From the middle of December, there were a lot of patients with severe and critical illness, corridors and emergency rooms full of people, no beds or wheelchairs available and queues outside the fever clinics. Many of us became infected, so healthcare workers were very scarce, and the whole hospital was in a mess,” she told The Irish Times.
“Nobody expected it to be so infectious. Wearing an N95 mask and disinfecting all the time did not stop it.”
A nurse at a community hospital said that at the height of the outbreak, the pressure on major hospitals had a knock-on impact all the way down to local clinics like hers.
“Generally common, frequently occurring minor diseases are treated in community hospitals, while serious diseases are transferred to large hospitals. Treatment of chronic diseases after diagnosis in large hospitals and rehabilitation after surgery can be transferred back to community hospitals,” she said.
“Basically, we recommend that severely ill patients go to the big teaching hospitals because they have better medical resources. At that time in mid-December, there were more than 10 cases every day, and we could not make the transfers because the big teaching hospitals were overcrowded.”
Intensive care beds are scarce in rural China and the authorities admit that opening more intensive care units is a long-term project that cannot address the immediate challenge
Doctors and nurses at every level in the healthcare system in Beijing say that the number of people seriously ill or dying has almost returned to normal. But hospitals in smaller cities are more poorly resourced than those in the capital and many people in rural areas struggle to access healthcare.
The state council, China’s equivalent to the cabinet, has published a plan to beef up the resources available to deal with a wave of infections in rural areas. It calls for a guaranteed supply of medicines to rural areas, accelerating the production of drugs to treat coronavirus symptoms and unblocking supply-chain problems.
Intensive care beds are scarce in rural China and the authorities admit that opening more intensive care units is a long-term project that cannot address the immediate challenge. The focus will instead be on reconfiguring existing resources to ensure that oxygen-supply systems and other equipment is adequate and deployed to the best effect.
Among the biggest problems is the fact that although more than nine out of 10 people in China are vaccinated, the uptake of vaccines is lowest among older people. Earlier campaigns to persuade the over-65s to get vaccinated have had limited success but there is a big effort now to reach the elderly before the virus does.
Both the United States and the European Union have offered to supply China with the mRNA vaccines such as those made by Pfizer. But China is confident that its own vaccines, although less effective at preventing infection, offer good protection from serious illness.
“We have enough vaccines to make sure that people eligible have access to vaccines,” foreign ministry spokeswoman Mao Ning said on Friday.
“We will continue to work with the international community, including the US, to better deal with the challenge of Covid and protect people’s life and health.”