‘A very hard road ahead’ for China as COVID-19 cases spiral

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BASHO, China (AP) — Almost three years after it was first identified in China, the coronavirus has now spread across the vast country. Experts predict a difficult few months ahead for its 1.4 billion people.

China’s unwavering “zero COVID” approach, aimed at isolating all infected people, has spent years preparing for the disease.but a sudden restartIt was announced without warning on December 7 as a result of anti-lockdown protests.

Experts predict between one and two million people will die next year. Predicting death tolls has proven difficult throughout the pandemic as it is influenced by a variety of factors and presents a particularly complex case for China due to opaque information sharing.

It is not clear just how large the current outbreak is, as China has reduced testing and stopped reporting most mild cases. But the cities and towns around Baoding and Langfang in Hebei province were among the first to face an unidentified outbreak, and an Associated Press reporter said hospital intensive care units were overwhelmed with patients and ambulances were turned away. Across the country, widespread reports of staff missing work, running out of fever reducers and working overtime at crematoriums suggest the virus is spreading. increase.

China belongs to the small club that largely contained the virus domestically in 2020, but it was the last to end restrictions. Exit experiences vary. Singapore and New Zealand have achieved high vaccination coverage and strengthened health systems during restrictions and have reopened relatively smoothly. Hong Kong, where Omcron overcame defenses in a city where many older people are unvaccinated, was hit by her devastating COVID-19 wave in 2022. About 11,000 people died from the disease this year in a city of 7.4 million people, 95% of whom were over the age of 60. To the Ministry of Health, Hong Kong.data from the city Jin Dongyang, a virology expert at the University of Hong Kong, said the fatality rate was 15% for those over 80 who had not been vaccinated.


unvaccinated population

Vaccine coverage in China is higher than in Hong Kong at the time of the Omicron epidemic, but many people, especially the elderly, are susceptible.

The country has used exclusively domestically manufactured vaccines. It relies on technology that is older than mRNA vaccines used elsewhere and has shown the best protection against infection.

Research done in Hong KongBoth the mRNA vaccine and Sinovac’s CoronaVac were administered. The usual course of vaccine is two doses, with an optional booster later.

Most people vaccinated in China get either CoronaVac or a similar vaccine made by SinoPharm, but the country administers at least five other vaccines. , there is no comparable real data.

In China, 90% of the population is vaccinated, but only about 60% receive boosters. Older people are especially likely not to have had booster vaccines. According to China’s state-run Xinhua News Agency, more than 9 million of her over the age of 80 have not received her third vaccine.

Vaccine coverage has increased more than 10-fold since the beginning of the month, with more than 1 million doses being administered per day. But Dr. Gagandeep Khan, who studies viruses at India’s Christian Medical College in Vellore, said prioritizing the elderly will be key. Unlike other countries, China is prioritizing vaccination of more mobile young people to prevent the spread of the virus, said Ray Yip, founder of the US CDC’s China office. A campaign targeting those over 60 was launched in his December, but the results are unknown.

They “didn’t pay enough attention to ensure that everyone had full vaccine protection,” Yip said. The ability to do that may determine some of the results.”


overwhelmed hospital

Around Baoding and Langfang, hospitals are running out of intensive care beds and staff as the number of critically ill patients surges. Patients lay on the floor while others drove from hospital to hospital on Wednesday looking for beds for relatives.

According to the National Health Commission, there were 4 beds per 100,000 people on November 22, and 10 beds per 100,000 people on December 9, for a total of 138,000 beds. Within 3 weeks. But the numbers “may be wrong,” said Yu Changping, a respiratory doctor at Wuhan University People’s Hospital. “There’s no way the numbers have skyrocketed in such a short period of time,” he said.

At face value, an increase in intensive care unit beds does not mean the health system is prepared for a surge in cases. This is because, as is the case worldwide, the pressure is often on the availability of specialized doctors and nurses who can treat patients in need. Intensive care, Chen said. China’s critical care facilities have only 80,050 doctors and 220,000 nurses, and another 177,700, according to the National Health Commission, which may work in these wards. have a nurse.

“When you look at the beds in the intensive care unit, China… is in a severe shortage,” he said.

Yu said the number of COVID-19 patients has increased in recent weeks, with almost all doctors in the department infected. “We are under pressure because we are taking in a large number of patients in a short period of time,” he said.

China has also not released a clear triage plan. This is a system by which hospitals give priority to critically ill patients to ration their limited resources. Moreover, China’s healthcare system is heavily focused on large hospitals, which usually treat even mild cases, Chen said.

The potential shortage will depend on how quickly cases grow, and could still be overwhelming if people with mild symptoms don’t stay home to ration the resources of the very ill hospitals. Mr Chen said there is.

“It could easily crash the system,” he said.

To protect its medical system, Beijing has renovated temporary hospitals and central quarantine facilities, increasing the number of fever clinics from 94 to 1,263. But the majority of his ICU beds in China are in urban areas, so rural areas can suffer.

The use of digital tools and telemedicine could offer hospitals a breather. Urban area conducted by LEK Consulting in Shanghai.

China approved Pfizer’s drug Paxlovid for COVID-19 earlier this year and approved two domestic treatments. A cocktail of antiviral drugs used for AIDS made by genuine biotech repurposed for COVID-19 and virus-blocking antibodies made by BrieBio. However, it is unclear how widely available these drugs will be.


How bad does it get?

Scientists aren’t sure because mortality rates depend on factors such as vaccination rates, people’s behavior, and efforts to strengthen hospitals.

The Institute for Health Metrics and Evaluation at the University of Washington in Seattle predicts that the death toll could reach 1 million by the end of 2023 if the virus spreads unchecked. But Ali Mokhdad, a professor of health metrics science at the institute, said the government could likely cut this toll with new social distancing measures.

Another study from the University of Hong Kong also predicted nearly 1 million deaths in a scenario where the virus spreads across the country and authorities are unable to provide vaccine boosters or antiviral treatments. Bill Hanage, co-director of the Center for Communicable Disease Dynamics at the Harvard TH Chan School of Public Health, said at a news conference on Dec. 14 that he estimated the death toll to be 2 million.

“China is going to have a very difficult road in the coming months,” Hanage said. “But without vaccination, things will be much worse.”

Will the surge in China spill over to the rest of the world? Neighboring India asks state governments to stay vigilant, and don’t let the genome sequencing effort falter. Jeremy Louvain, of the University of Massachusetts Chang School of Medicine, said a spike in infections increases the likelihood of more dangerous mutations developing. We see “no particular reason to worry” about the alarming variant already boiling in China.

“The more we can control the infection rate in China, the better,” Ruban added.


Ghosal reported from New Delhi and W reported from Taipei, Taiwan. Associated Press journalist Carla K. Johnson (Seattle) and video her producer Olivia Cheung (Beijing) contributed to this report.


The Associated Press’ Health Sciences Division is supported by the Scientific and Educational Media Group at the Howard Hughes Medical Institute. AP is solely responsible for all content.

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