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Experts warn China's health care system could be overwhelmed by COVID cases

LEILA FADEL, HOST:

For nearly three years, China used extremely strict testing and lockdown policies to keep COVID out. Then it abruptly lifted nearly all those controls as a COVID surge spread across the country. Public health experts are warning the country's health care system could now be overwhelmed. NPR's Emily Feng joins us to talk about the outbreak. Good morning, Emily.

EMILY FENG, BYLINE: Good morning.

FADEL: So Emily, what are things like right now in China? Has the health care system been able to keep up with this surge?

FENG: So far, it appears yes, but barely. And that's because the surge in China is forecast to get way worse this month and into January. Anecdotally, everyone I know in Beijing has basically come down with COVID already in the last month. And it's spreading to other cities. A Shanghai hospital warned this week that half of the city's population - that's about 12.5 million people - could be infected by just the end of next week. There are long lines already outside of funeral homes and crematoria that we visited in Beijing.

Crematoria are telling us that their waiting list is now more than one week, which is unusual. Pharmacies in the countryside have been emptied of fever and pain medication. But the good news is that outside fever clinics and hospitals in Beijing that we visited this week is pretty busy, but it's actually pretty orderly. Unfortunately, we've seen in other pandemics that there's usually a lag of about a month after initial outbreak before we really start to see an increase in deaths and severe cases. And in China, that's supposed to happen in January.

FADEL: So what are public health experts saying about how bad it could get?

FENG: Their predictions vary widely, but they're all pretty devastating. There was one model last week from the University of Hong Kong that estimates up to nearly 1 million people will die if China doesn't mount a new vaccine booster campaign. And then this month, the U.S.'s Institute for Health Metrics and Evaluation predicts up to half a million deaths just by April if China doesn't have new travel and mask mandates. And the reason why they vary so widely is a model is only as good as the data that you put into it. And right now, there's no accurate data from China on infections. In fact, the WHO said this week that China has not released hospital data since early this month on who is coming in with COVID. For this, I talked to Ray Yip. He's an epidemiologist who founded the U.S. CDC office in China in 2003 and, more recently, the China Office for the Bill & Melinda Gates Foundation.

RAY YIP: They're going to do the same thing - what they did in Wuhan. Being, Wuhan - unless you have a confirmed PCR test, they're not going to call you a case of COVID in the beginning. So that's why the number of deaths in Wuhan was only 4,000. I'm sure it's at least four or five times that much. And what's happening in China right now, the death rate is probably, you know, in the thousands and every day. But they are only willing to report, you know, a small handful.

FENG: He's referring here to the extremely strict standards that China uses to determine who dies of COVID - so strict, in fact, that, officially, only two people have died in this latest surge, which just does not match up with what people are going through on the ground.

FADEL: So where does China go from here?

FENG: Well, it can only get worse because the real concern now...

FADEL: Yeah.

FENG: ...Is holiday travel. China has its Lunar New Year in late January. But people are already traveling home now for the holiday. And they're bringing the virus with them from cities to villages, where the health care system is even patchier. But in China, the trend is still towards rapid, full-scale opening up. In fact, some cities, like Chengdu, for example, are already reducing their quarantine requirements for inbound travelers coming from other countries. This was just simply unthinkable about a month ago when China was in the full throttle of zero COVID.

FADEL: That's NPR's Emily Feng. Thank you, Emily.

FENG: Thank you so much, Leila. Transcript provided by NPR, Copyright NPR.

Leila Fadel is a national correspondent for NPR based in Los Angeles, covering issues of culture, diversity, and race.
Emily Feng is NPR's Beijing correspondent.