A few months ago, the strict “zero Covid” policy still applied in China. After ongoing protests, the measures have since been suspended. Now the health system is overloaded, the number of deaths is increasing dramatically – and the government is watching idly.

After almost three years of self-isolation, China has introduced the first easing measures. The domestic travel restrictions, mass tests and radical lockdowns as part of the “zero Covid” strategy had already been lifted at the beginning of December. On January 8th, the country will open its borders again. If you want to enter from abroad, you no longer have to be in quarantine. Air traffic to China is also to be expanded. Business people and students can enter with a visa. Tourists are still exempt from the regulation. In addition, Chinese nationals will be allowed to travel abroad without giving a reason.

A look at Japan and India shows how much the corona situation in China has worsened: Both countries now require Chinese travelers to take a Covid test. Within a few months, China has developed from a “zero Covid” bastion into what is probably the largest corona hotspot in the world.

So far, the number of new infections in China has been difficult to estimate. Although the central government may have developed a model for the spread of the virus, its information for the public is useless. With only a few thousand new cases per day, she reported a number that is far from reality. More plausible estimates exist in some regional governments. Officials in Zhejiang, a wealthy eastern province of around 65 million people, recorded nearly a million new infections a day as of December 25.

The inexperience of a large part of the population with Covid and the undersupply of the older generation with vaccines pose further challenges for the country. While Omicron causes only relatively mild symptoms in most cases, many people in China are now nevertheless exposed to a serious course of the disease. The country’s patchy healthcare system is already under severe pressure. An eyewitness from Beijing tells of a hospital where elderly patients lie with oxygen tanks in crowded corridors and waiting rooms.

Video footage circulating on the internet shows similar conditions across the country. According to official information, there are around ten intensive care beds per 100,000 inhabitants nationwide, which falls far short of actual needs. There is also a shortage of medical staff. As a health official recently warned, some regions are approaching a “critical point” in the supply of intensive care beds.

The need for drugs to treat Covid is great. Many pharmacies have run out of fever and painkillers. In particular, Paxlovid, an antiviral to prevent severe disease progression, is in high demand. A circumstance that is also reflected in the price development; Many hospitals have reportedly run out of the drug, sometimes requiring unapproved versions of Paxlovid to be sourced from abroad. Meanwhile, popular messaging app WeChat has launched a feature designed to mediate between those who need fever medication or similar supplies and those who can provide them.

The government has reported 13 Covid deaths for the month of December so far – the actual number is undoubtedly higher. China only records those deaths related to Covid that are due to respiratory failure or pneumonia. However, the virus often leads to death by damaging other organs. In the UK, for example, a Covid death is anyone who has recently tested positive for the virus.

The Chinese crematoria are bustling with activity. A crematorium in Beijing, which had become the focal point of numerous reporters, is now under police protection. Earlier this month, London-based data company Airfinity estimated that more than 5,000 people in China could die of Covid every day. The Economist’s model assumes a worst-case scenario that predicts 1.5 million Chinese deaths in the coming months.

In China, too, vaccination is the best way to prevent mortality. With three vaccinations, a Chinese vaccine offers a sufficiently high level of protection against severe disease progression and death. Still, by the end of November, only 40 percent of those over 80 had received all three vaccinations. In some cases it has been so long since the vaccination that their protection is gradually diminishing. The wave of infections in early December prompted China to intensify its efforts. On December 21, the average number of doses administered reached over three million per day, having previously been under one million. Since then, the campaign seems to have lost momentum – more effective vaccines from abroad remain banned.

China could have dealt with the situation better by stockpiling medicines, administering vaccines more quickly, and establishing treatment guidelines. What remains is an attempt by the authorities to whitewash. A renaming of the disease caused by the virus from “novel coronavirus pneumonia” to the milder-sounding “novel coronavirus infection” has already been decided. At a press conference on December 27, Vice Director of the State Health Commission Li Bin said that China is “waging a battle that we have prepared for. There’s no way we’re just going to stand by and do nothing.”

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How bad the situation really is can be seen from the behavior of Chinese head of state Xi Jinping. When the virus seemed under control, Xi was hailed as the “commander in chief” in the “people’s war” against Covid. He often emphasized the need to consistently implement the zero-Covid strategy. Since the cases have skyrocketed, it has become quiet around him – his statements about the outbreak of the disease are limited to hints. He said on December 26 that the country was “now facing new circumstances and challenges in epidemic prevention and control.” More understatement is hardly possible.

When the wave of infections picked up speed in early December, the streets of Beijing and other major cities were empty. Meanwhile, life is gradually returning. However, the epidemic is far from over. With the upcoming Lunar New Year, millions of people will travel to their hometowns – taking the virus to rural areas with unstable health systems. It is not unlikely that there could be several waves of infection. The situation in China is serious – but the true acid test is yet to come.

This article first appeared in The Economist under the title “Covid-19 is tearing through China” and was translated by Cornelia Zink.

*The post “Up to 1.5 million dead! Beijing crematoria under police protection” is published by The Economist. Contact the person responsible here.