At a hospital in the affluent Beijing district of Chaoyang, several dozen people lined up outdoors in near freezing weather on Friday at a clinic designated for fever patients. Some residents flocked to pharmacies, buying up stocks of at-home antigen Covid test kits. Many chose to stay home, leaving the capital’s usually busy streets quiet except for the puttering of motorbikes driven by food delivery workers.
Beijing is bracing for what could be a surge in Covid cases, as extensive controls that had kept the virus at bay for nearly three years have been abruptly abandoned following China’s reversal of its strict pandemic policy this week.
Across the country, officials have been scrambling to protect hospitals from being overwhelmed as more people become infected. At many of Beijing’s hospitals, health workers screen people who show up with fevers so as to identify those who are seriously ill and send home those with milder symptoms.
Part of the challenge for the ruling Communist Party is that less than 1 percent of the people in China has had Covid before. The general public has been told by state media for nearly three years that the virus leads to severe illness and death, a justification for the lockdowns and mass quarantines that set off widespread protests last month in a rare challenge to the government.
Health experts and Chinese officials are stepping up efforts to urge residents not to go to hospitals unless necessary. With the help of the government’s propaganda apparatus, they have been assuring residents that they have little to fear from the Omicron variants currently spreading around the country.
“The infections are not scary,” Zhong Nanshan, a respiratory scientist who is highly regarded in China, said at a conference on Friday that was covered by state media.
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“Ninety-nine percent of the people who get infected can fully recover within 7 to 10 days,” Dr. Zhong said. “As long as we get plenty of rest, isolate ourselves and stay at home, we can recover quickly.”
As the government has moved away from mass testing and contact tracing to focus on ramping up vaccinations and treating those who are severely ill, the scale of China’s outbreaks is increasingly unclear. Nationwide, the total number of cases has fallen, to just over 16,000 on Thursday, down from around 40,000 in early December — a decline so unlikely that even a prominent nationalist called the picture “distorted” and questioned the need for the government to continue releasing infection counts.
“This problem should be exposed, and the numbers should be returned to their true appearance, or they should not be reported at all,” said Hu Xijin, the former editor in chief of the Global Times, a Communist Party newspaper, on Weibo, a popular social media site. “This is not conducive to maintaining the seriousness of official information nor is it conducive to shaping everyone’s objective understanding of the spread of the epidemic.”
In Beijing, where P.C.R. testing booths have disappeared from many sidewalks,at least 2,600 cases were recorded on Thursday, according to the government, but that tally is widely seen as a significant undercount.
Some residents said that they already had the virus but were not seriously ill.
Hannah Yang, 38, a manager at a film distribution company in Beijing, said more than half of her colleagues had tested positive this week. “Most of the people feel there’s no need to see a doctor,” she said. “More people are stockpiling medicine.”
She said that she and her son, an elementary school student, also tested positive on Friday morning. “I feel nothing,” Ms. Yang said. “It seems that the virus is very gentle.” She said that her symptoms were a lot milder than the cold she had three months ago.
“I feel there must be many positive cases in Beijing,” she said. “No one is seriously fortifying against the virus anymore.”
Despite the government’s reassurances, the abrupt dismantling of three years of bureaucratic machinery to halt the spread of Covid has prompted concern from medical experts outside of mainland China. The experts had been calling instead for China to conduct a six-month vaccination campaign before opening up.
A year ago, China was vaccinating more than 20 million people a day. But that effort fizzled out last June, with vaccinations falling to a couple hundred thousand people a day. After pushing residents to have two shots and a booster last year, China has not yet moved on to administering fourth doses. So most of the population has had no recent protection.
China also has yet to approve mRNA vaccines. Its vaccines rely instead on an older technology that has been proven in other countries to be less effective than mRNA vaccines.
Jin Dongyan, a virologist at the University of Hong Kong, said that China needed to rapidly increase use of the Chinese vaccines that are available, while also importing mRNA vaccines for the inoculation campaign. And China should buy as much Paxlovid and other oral treatments for Covid infections as possible, Dr. Jin said.
But even these steps may now be insufficient. The current wave of cases is spreading so quickly, Mr. Jin said, that China should consider putting unvaccinated elderly, who are the most vulnerable, into recently built makeshift hospitals for their own protection. These makeshift hospitals were used until the last few days to isolate Covid patients and their close contacts.
Having large numbers of people in China catch Covid at the same time could help the country move past the pandemic swiftly by building up a natural immunity, but it risks causing many deaths, Mr. Jin said. Outside China’s major cities, the country’s health care system is chronically underfunded and short-staffed, and a wave of severely ill patients could quickly overwhelm hospitals in small towns that have few if any intensive-care beds.
Asked about the likelihood that 80 or 90 percent of China’s population might catch the virus, Mr. Jin said: “That’s very probable, and the question is within how long they get it — and what’s scary is, they don’t seem to have a road map.”
Amy Chang Chien and Joy Dong contributed reporting.