Covid Surges in China, Reaching an Estimated 37 Million Cases Per Day

The country abruptly relaxed its zero-Covid policy earlier this month

A covid swab test
China has eased its Covid testing with the relaxation of zero-Covid policies. Lintao Zhang / Staff via Getty Images

Covid cases are spiking in China following the government’s decision earlier this month to abruptly relax its strict Covid mitigation policies.

As many as 248 million people in the country became infected with Covid during the first 20 days of December, according to minutes from an internal meeting of China’s National Health Commission, Bloomberg News reported Friday. This means that 37 million people per day may be coming down with the virus.

Modelers predict the country will see close to one million deaths in the coming months if it continues along its current path, per a preprint paper, which has not been peer-reviewed, published this month in medRxiv

“However way we look at it, it’s very likely that the next few months are going to be quite challenging for China,” Christopher Murray, director of the Institute for Health Metrics and Evaluation, a global health research institute at the University of Washington, said in a video earlier this month. “The populations at greatest risk in the world are those that have avoided a lot of transmission and have gaps in vaccination. And that’s exactly the case for China.”

China’s strategy for battling the virus over the past few years has been to keep cases as close to zero as possible by imposing strict lockdowns, travel restrictions, workplace shutdowns and daily testing, even as much of the rest of the world has returned to normal life. The policy, known as zero-Covid, has kept the country’s deaths low, at about 5,200 (compared to 1.1 million in the United States), though questions have been raised over the country’s official data.

Mass protests have surged against the restrictions, with protestors saying they have slowed economic growth and pushed millions into poverty, writes Suzanne Sataline for Smithsonian magazine. Earlier this month, the country began to dismantle its zero-Covid policy. 

But China’s population is vulnerable. A “substantial fraction” of people over the age of 80 have not been vaccinated, Murray says in the video. As of November 28, 65.8 percent of those over 80 had their initial shots, but of that group, only 40 percent had received a booster as of November 11. Of China’s entire population, only 56 percent have received three vaccine doses.

Per the preprint, lifting restrictions at the same time in all provinces could lead the country to surpass hospital surge capacity by 1.5 to 2.5 times.

China has nine COVID vaccines developed in the country that are approved for use, but none have been updated to target the Omicron variant, reports Reuters’ Thomas Peter and Alessandro Diviggiano. The Chinese shots are not mRNA vaccines like Pfizer’s and Moderna’s, but rather are made from an inactive form of the SARS-CoV-2 virus.

The country has also changed how it counts Covid, with only a few official deaths reported since lifting its restrictions. Only deaths that were directly caused by respiratory failure are counted, officials have said. On Monday, officials reported two deaths, the first since early December. On Tuesday, the country reported five more.

Yet, crematoriums and funeral homes are struggling to keep up with the demand, reports the Agence France-Presse (AFP). A staff member of a funeral business in the city of Shenyang tells the publication that bodies were left unburied for up to five days, because crematoriums are “absolutely packed.” 

“It’s three or four times busier than in previous years. We are cremating over 40 bodies per day when before it was only a dozen or so,” a staffer in Guangzhou tells the AFP. When asked whether the deaths were Covid-related, a crematorium worker in Chongqing told the publication: “We are not sure … you need to ask the leaders in charge.”

The rise in cases has led to a run on fever medications and painkillers. The price of ibuprofen has quadrupled in one eastern Chinese city, forcing it to sell pills individually, report David Pierson, Isabelle Qian, Olivia Wang and Tiffany May for the New York Times

Researchers say steps can be taken to reduce deaths, including ramping up vaccinations, reimposing some travel restrictions and widespread masking, writes Nature News’ Smriti Mallapaty. If 85 percent of the population receives a fourth dose different from the previous shots and if antiviral drug use is increased, deaths could be reduced by up to 35 percent, the preprint suggests.  

“It is never too late to flatten the curve,” Xi Chen, an economist at Yale University in New Haven, Connecticut, who studies China’s public health system, tells Nature News.

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