China is preparing for another wave of Covid to hit its more vulnerable countryside in early 2023, as the current wave of infections overwhelms hospitals and intensive care units in many cities.
The lunar new year, China’s most important holiday, falls in late January. It offers a chance of reunion after years of separation under the harsh internal travel restrictions and lockdowns of the previous zero-Covid policy.
But as hundreds of millions of workers head home, many are expected to take the disease with them, to areas that have fewer hospitals and clinics, fewer medical professionals, less equipment and medicine, and less money to pay for care.
“In the face of a virus like Omicron, all people should be equal, but the fact is that as far as the virus is concerned, urban and rural areas are not equal,” said one post on the Chinese social media platform WeChat, from a user in a small town in central Henan province. “Not only are resources and opportunities unequal but there is also a wide gap in the understanding of how to handle public health.”
The next wave of infections is likely to hit rural areas in late winter, the British health analytics company Airfinity predicts, and could affect even more people than the one racing through cities now.
The toll may be worsened by the government’s abrupt shift in propaganda messaging about Covid. The virus had been presented as a menace to be avoided at almost any cost, but now Chinese citizens are told it is little worse than a cold.
“My home town has quietly changed the way they talk about getting sick,” said the person posting on WeChat from Henan. “‘Every family has caught the cold’, so there is nothing to be afraid of.”
That position means there is little official promotion of basic measures such as social distancing that could slow the spread of the disease and possibly buy time for overwhelmed hospitals.
Jeremy Wallace, a professor of government at Cornell University, said: “I’m very surprised that the messaging seems to be denial of the depth of suffering from this wave and, as far as I’ve seen, no communication about flattening the curve to reduce pressure on its overburdened health systems. As such, I would expect staggering death totals, as predicted by models looking at the experience of Taiwan, South Korea and Hong Kong, on the order of 1 million.”
In some urban areas, Covid has spread so fast that infections may soon reach a peak, analysts believe, although the course of the disease is difficult to trace because when China cut back on disease controls, it also cut back on publishing Covid statistics.
China was once proud of its Covid statistics. Then, as deaths and infections mounted, the National Health Commission (NHC) said it would no longer publish a daily death toll.
On Friday, despite widely circulating images and stories of hospitals unable to cope with the influx of patients, the NHC said there had been one Covid death and 5,500 new cases in the last 24 hours, AFP reported.
By contrast, Airfinity estimates that about 9,000 people a day are dying from Covid in China. Next month that could rise to as many as 25,000 a day, and the company forecasts a death toll by April of up to 1.7 million people.
An NHC spokesperson, Jiao Yahui, admitted this week that China was excluding from tolls many deaths that would be counted in other countries as Covid fatalities, AFP reported.
Elsewhere in the world, any death within 28 days of a positive nucleic acid test is counted. Beijing has decided to count only those who die of respiratory failure caused by the virus.
“China has always been committed to the scientific criteria for judging Covid-19 deaths, from beginning to end, which are in line with the international criteria,” Jiao said.
While China’s propaganda systems are claiming the government’s sudden pivot on the pandemic – from harsh controls to letting the disease rip – has been managed perfectly, social media is filled with the grim realities of life mid-pandemic.
Chinese authorities are normally quick to stifle online dissent and criticism, but a surprising number of posts discussing the reality of Covid in China today are making it online and staying up for some time, said Charlie Smith, a co-founder of Greatfire.org, a censorship monitoring site.
“Most of these posts are surviving because the censorship boundaries are changing so quickly and the censors cannot keep up. But it also makes sense that the real humans who are behind censorship can see for themselves that current Covid management is all over the place,” he said. “They must be asking themselves how they could possibly censor Covid-related posts when everyone has Covid.”