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COVID-19

After years with little covid, videos show China is now getting hit hard

By Christian Shepherd,Samuel Oakford,Stefanie Le and Vic Chiang Washington Post

Emergency departments are overflowing, with patients sleeping in hallways until they can be evaluated or taken to a hospital room. In at least one hospital, half of doctors and nurses were absent because they had tested positive for covid.

These and other alarming scenes in Chinese medical facilities have been captured in videos and photographs posted to social media during the past two weeks. They offer a glimpse of the toll a huge coronavirus wave is wreaking - and undercut Beijing’s claim that the government is in control.

The full extent of the outbreak is unclear. The government’s sudden easing of coronavirus restrictions in early December came as infections were already surging across the country. Officials soon stopped reporting asymptomatic cases, leaving the public to rely on social media to understand what was happening.

To better assess the impact of the current wave - which projections suggest could claim more than 1 million lives in 2023 - The Washington Post tracked hundreds of posts on popular Chinese platforms, including Weibo and Douyin, and reviewed material that was re-posted on Twitter and other sites. The Post’s preliminary analysis found evidence of overwhelmed health-care facilities in major cities, particularly along the country’s heavily populated east coast.

Given China’s strict censorship, the content is only a snapshot of what’s happening nationwide. But it shows that many communities are struggling to cope with the massive surge of patients infected with covid.

Most at risk: The elderly

A video taken at Tianjin Medical University Hospital and posted on Douyin - a Chinese video platform owned by TikTok parent company ByteDance - reveals the current strain on medical facilities. Patients, many of them elderly, are seen resting on gurneys or cots in crowded lobbies or near elevators and other public areas. Family members appear to hover nearby - proximity certain to help spread the virus.

“It’s clear that [in] those major cities, the health-care system is overwhelmed because of the rapid increase of the cases, especially [among] the elderly,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations, who reviewed the footage for The Post. Only about 40 percent of people ages 80 and older in China have received a coronavirus booster shot.

This viral wave hit northern cities fastest and hardest. Beijing’s health authorities said on Dec. 11 that 22,000 people daily were visiting fever clinics, 16 times more than the previous week.

A video posted to Douyin on Wednesday shows many elderly patients seeking care at Beijing Tsinghua Changgung Hospital. “The emergency room is extremely crowded,” wrote a woman who said she had brought her mother for care a day earlier. “Wherever I went, wherever I looked, there were younger senior citizens accompanying those even older,” the woman noted. “Everyone must please take care of the elderly around you.”

The country’s most populous city is suffering a similar outbreak. On Wednesday, Shanghai Neuromedical Center posted - then quickly deleted - a WeChat article estimating that 7 million residents were already infected and that half of the city’s 25 million people would be infected by the end of this week.

Shanghai’s draconian lockdown in March and April traumatized locals and shocked the rest of the country. The municipal government, determined to avoid a replay of acutely sick people stuck at home without medical care, is directing patients to 2,600 designated fever clinics across the city.

State media reported Friday that the emergency department of the Zhongshan Hospital, one of the most prominent in China, was handling about 1,000 patients a day, up from 700 to 800 at the same time last year.

Inside the ER, video taken Wednesday by a journalist for The Post showed patients crammed in hallway after hallway - on gurneys, cots and even folding chairs probably brought from home. Relatives crouched by their sides, leaving barely enough room for others to walk.

Videos and social media posts also suggest some children’s facilities are unusually busy, especially with parents bringing in young babies despite officials’ assurances that infants are at lower risk than other vulnerable groups. A popular video blogger’s announcement on Dec. 20 that his 2-year-old daughter died of encephalitis caused by a coronavirus fever was discussed widely online, although authorities never confirmed any connection publicly.

Illness among the young could be exacerbated by other respiratory viruses, including the combination of flu and RSV that has hit children in the United States hard, noted Justin Lessler, a professor of epidemiology at the University of North Carolina.

“There are few, if any, places in the world where the health system would not be severely taxed by a large epidemic of severe respiratory infections in children,” said Lessler, who also reviewed footage that was part of The Post’s analysis.

Video posted by one father in the southern city of Guangzhou shows exhausted family members waiting with little ones in the hallways of Guangzhou Women and Children Medical Center. The man explained that he had been there 10 hours.

Hospitals with too few doctors and nurses

The National Health Commission recently advised hospitals to rehire retired health-care workers to help deal with exploding number of covid cases - in part, filling in for doctors and nurses who have themselves become infected.

In Guangzhou, nearly 1,000 staff were called back to front-line positions, according to local reports. Doctors and nurses are being redeployed from smaller cities to Beijing, where officials have converted sports stadiums previously used as centralized quarantine centers to serve as temporary emergency wards.

In Nanjing, about 190 miles west of Shanghai, Nanjing Drum Tower Hospital reported that half of its doctors and even more nurses were on sick leave because of covid. Visitors posted videos of an empty entrance foyer with signs saying that most counters were temporarily closed.

In eastern China, the Wenzhou Medical University 2nd Affiliated Hospital said in a statement that one of its pharmacists had fainted from fatigue while on the job at 4 a.m. The Post verified three videos showing people packed into the hospital’s common areas.

Triaging medical resources will be a challenge in a country that for decades has tried, with limited success, to keep medicines, equipment and health-care professionals from being concentrated only in large hospitals in major cities. Though well-known facilities are in theory best equipped to handle critical cases, they often end up overrun and their staff exhausted.

In Shenzhen, China’s third-most-populous city, many people are desperate to see a doctor. One video posted to Douyin on Dec. 19 showed a line stretching around the block at Longhua People’s Hospital. Wait times have extended to more than half a day, according to videos and pictures from the scene confirmed by patients and verified by The Post.

When Zhou Zedong, 28, arrived there late the next night, he was warned about a 20-hour wait. Shortly before midnight, he went home with plans to come back the next morning - only to discover upon his return that he’d missed his number being called and would have to start the process again.

“It makes me angry,” said Zhou, who diverted to a traditional Chinese medicine clinic and asked family members to send medicines that were sold out at many pharmacies in Shenzhen. “It’s not the level of medical care that a first-tier city should have.”

Suddenly, a country of ‘zero negative’

The government’s contradictory messaging has intensified public unease. For nearly three years, authorities justified harsh lockdowns as necessary to save every life possible. Anger over the “zero covid” policies erupted publicly in November with a week of defiant protests in at least a dozen cities.

Then, almost overnight, everything changed. Required testing and centralized quarantine were jettisoned. And just as health experts had predicted, a country with very limited immunity succumbed quickly to the virus. Some Chinese joke that the government’s new policy is “zero negative” because everyone is infected.

Jonathan Chen, 21, a medical school student, visited the University of Hong Kong’s Shenzhen Hospital on Tuesday after testing positive and spiking a fever. He waited for eight hours to see a doctor and now wonders whether “zero covid” should have been phased out gradually.

“I used to hope the government would open up as soon possible,” Chen said. He’s no longer sure that was the smartest move.