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China’s covid crisis hits Lunar New Year: Deaths could reach 36,000 a day

As hundreds of millions of people travel home, China’s rural areas are particularly vulnerable.

Now, zero-covid is over, lockdowns are a thing of the past and those Shanghai crowds are just a small fraction of the hundreds of millions of people traveling to celebrate the holiday. But as people embark on their New Year’s journeys, along with the traditional red envelopes of cash, cases of fruit and bottles of baijiu, they are bringing an unwelcome guest: covid.

Over the past few weeks, Chinese social media platforms have been filled with stories about people in rural areas getting sick and dying from covid. Grid surveyed the situation in rural parts of Shaanxi, Guizhou, Qinghai, and Sichuan provinces, through people who have returned for the holiday or have family in these places. All said that most of their relatives have already gotten sick.

“I have a really big extended family, maybe around 50 people,” said Amy, whose family lives in a rural area of Tongren, in western Qinghai province. “There are only I think two or three of my cousins that didn’t get it. Other than them, everybody got it. Everybody.”

The healthcare gap that left rural areas vulnerable

Ideally, the years of relative calm during the zero-covid period, when urban lockdowns largely kept covid from the countryside, would have allowed rural areas to prepare for the inevitable wave. But experts say that time wasn’t well utilized. As of November, vaccine rates among the elderly remained lower than the rest of China, and it didn’t help matters that the few covid cases that came to rural clinics had been regularly directed to higher-level hospitals. “As a result, they haven’t gotten much experience dealing with the virus,” Sylvia said.

But these measures seem to have been a case of too little, too late. As Sylvia said, “The rural health system -- my impression is that it was just vastly unprepared for a covid wave.”

How the wave has hit

Reports from rural areas indicate that these regions have suffered significant losses under the crush of the covid wave.

When people come down with covid in rural China, their first stop is usually the local doctor. “They just go to small clinics, and everybody just sits in one room and then gets an injection,” said Amy, referring to the IV saline drip her sick family members sought out in Qinghai. “That is the only thing they’re doing.” (Amy is using a pseudonym due to the sensitivity of the topic in China).

In town after town, the picture looks bleak.

“My mom is saying there were so many funerals in the village in the past few weeks because it’s hitting so many older people,” Amy told Grid. “One of my aunts, she’s 92 or 93. She also passed away a few weeks ago.” She died at home, Amy added; the nearest well-equipped hospital is a two-hour drive away.

Huang says that by not seeking care, elderly patients have likely eased the burden on hospitals.

“Sadly and paradoxically, it is such a fatalist approach that makes the health system ‘resilient’ in coping with the Covid-19 tsunami in rural China,” he wrote.

Another wave?

In the coming days, all those hundreds of millions of people across China will gather to make dumplings, feast and visit distant relatives. The question lingers: How much worse will the rural wave get?

Estimates vary. Government health officials have said the worst of the surge is behind the country. And Shengjie Lai, an infectious disease expert at the University of Southampton, told Grid that because of the extent of the spread over the past two months, the current Lunar New Year migration will have only a limited impact on the wave.

To put that figure in context — 36,000 would be roughly seven times the total number of deaths China reported in the first two years of the pandemic, for the entire country.

Fears of fresh rural outbreaks have caused some people to alter their travel plans. One source who traveled to Zunyi, a city in Guizhou province, for the New Year told Grid he won’t venture out of the city. “Some relatives who live in a rural area invited me to have a New Year’s meal with them, but I decided not to go because I am afraid of infecting them,” he said. “Coming from Shanghai, I’m a lot more worried about covid than they are.”

Another woman Grid spoke with is taking the scenic route — a three-day drive from Beijing to Shaanxi province to avoid exposing her elderly in-laws in rural Shaanxi to new variants that might be picked up on a crowded train or plane.

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