Friday 29 Mar 2024
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(Jan 20): The sudden dismantling of China’s Covid Zero restrictions in December means hundreds of millions of people are headed home for the Lunar New Year holiday for the first time since 2019. The crush of travel risks supercharging the world’s biggest Covid outbreak, spreading it to every corner of the country.

Travellers, from migrant workers to college students to educated urban elites, risk carrying the highly infectious Omicron strain with them to Covid-naive swathes of rural China that have managed to evade the pandemic — until now.

Known as the world’s biggest human migration, the holiday traditionally involves packed planes, trains, buses and ferries departing big cities along China’s prosperous eastern coast for remote hinterlands as workers reunite with their families ahead of the new lunar year, which begins on Sunday. This year, they may be bringing Covid-19 with them, and exposing their loved ones to it for the first time.

Some 2.1 billion trips are expected to take place during the 40-day Spring Festival period, double the number of treks from last year.

“There is a lot of jubilation around going home to celebrate the Chinese New Year, but that could also bring about tragedy for a lot of families,” said Zuo-Feng Zhang, chair of the department of epidemiology at the Fielding School of Public Health at University of California, Los Angeles.

Chinese President Xi Jinping singled out Covid’s rural spread in a nationwide video address he held before the holiday, saying he’s especially concerned about efforts to battle Covid in the countryside. Health experts are worried the virus could ravage the vulnerable in villages with sparse health care infrastructure, creating worse outcomes than the outbreaks that have already strained hospitals, overwhelmed crematoriums and crippled the nation’s megacities.

Rural China is particularly susceptible to harm from Covid, Zhang said. Nearly one in four residents are aged 60 or older, compared to 19% of the total population, a group that’s comparatively less vaccinated and more likely to develop complications. Many people are unfamiliar with the virus, with no exposure or natural immunity to the infection.

Meanwhile, medical resources in remote areas are scarce. There are only 1.62 doctors and nurses combined for every 1,000 people in rural China, compared to 2.9 doctors and 3.3 nurses nationally. Access to intensive care with experienced doctors and equipment like ventilators to help gravely ill patients survive is often miles away.

Megacities hit

The predicative health analytics firm Airfinity Ltd raised its estimate for China’s coming Covid deaths to peak at 36,000 a day, an increase of 11,000 every 24 hours from a previous forecast, after taking into account travel for the upcoming holiday. The London-based pandemic-tracking firm initially anticipated two Covid surges, one before and one after the Chinese New Year celebration. Now it says unfettered New Year travel will likely merge them into one massive wave.

The result is likely “a significant burden on China’s healthcare system for the next fortnight”, said Airfinity’s analytic director Matt Linley. “Many treatable patients could die due to overcrowded hospitals and lack of care.”

The virus has quickly raced through China’s megacities and highly settled regions. Henan, one of the country’s most populous provinces, said nearly 90% of its residents have been infected. Top-tier cities, from the nation’s capital Beijing and financial centre Shanghai to the southern trade hub Guangzhou, have all said their outbreaks have peaked.

The sudden avalanche of disease, with some researchers projecting that more than than 900 million of the country’s 1.4 billion people have been infected, led to persistent shortages of everything from basic drugs to reduce fever to potent antivirals like Pfizer Inc’s Paxlovid.

The true toll of the outbreak in rural areas may be hard to decipher. Government censors, concerned that overwhelmed villages and death reports from the heartland could undermine New Year celebrations, are getting more active.

The Cyberspace Administration of China, the country’s internet watchdog, recently vowed to double down on what it called Covid-related rumours ranging from fabricating estimates of the virus’s spread to experiences of getting sick that may mislead the public and cause public panic.

Health authorities, meanwhile, issued a slew of directives urging local governments to improve hospital preparation and help them work with rural clinics to handle patients with severe infections. The agriculture ministry is sending one oxygen concentrator and two pulse oximeters to village clinics across the country.

It remains to be seen if the help will be sufficient or come in time.

“The plans dedicated to Covid control and prevention in rural areas are well devised, but how to implement them is a big problem,” said Zeng Guang, the former chief scientist at the Chinese Center for Disease Control and Prevention, at a recent seminar.

UCLA’s Zhang said the lack of information about infections makes it hard to predict the scope of severe disease and deaths ahead. Still, the epidemiologist originally from eastern China is worried about the lingering damage, well after the joy from the reunions has faded and travellers have returned to their jobs in distant factories and cities.

“This New Year travel could bring about inevitably catastrophic consequences for many families,” he said.

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