BEIJING – China’s sprawling and thinly resourced countryside is racing to beef up medical facilities before hundreds of millions of factory workers return to their families for the Chinese New Year holiday next month from cities where Covid-19 is surging.

Having imposed the world’s strictest Covid-19 regime of lockdowns and relentless testing for three years, China abruptly reversed course earlier in December towards living with the virus, leaving its fragile health system overwhelmed.

The lifting of restrictions, following widespread protests against them, means Covid-19 is spreading largely unchecked and likely infecting millions of people a day.

The lifting of restrictions, following widespread protests against them, means Covid-19 is spreading largely unchecked and likely infecting millions of people a day, according to some international health experts.

China officially reported one new Covid-19 death for Wednesday, down from three on Tuesday, but foreign governments and many epidemiologists believe the numbers are much higher, and that more than 1 million people may die next year.

China has said it only counts deaths of Covid-19 patients caused by pneumonia and respiratory failure as Covid-related.

In the south-western city of Chengdu, funeral parlours were busy after dark on Wednesday, with a steady stream of cars entering one, which was heavily guarded by security personnel.

One van driver working for the parlour said the past few weeks have been particularly busy and that “huge numbers of people” were inside.

Hospitals and funeral homes in major Chinese cities have been under intense pressure, but the main concern over the health system’s ability to cope with surging infections is focused on the less affluent and poorly equipped countryside.

At a Shanghai pharmacy, Wang Kaiyun, 53, a cleaner in the city who comes from the neighbouring Anhui province, said she was buying medicines for her family back home.

“My husband, my son, my grandson, my mother, they are all infected,” she said. “They can’t get any medicine, nothing for fever or cough.”

Each year, hundreds of millions of people, mostly working in factories near the southern and eastern coasts, return to the countryside for Chinese New Year festivities, due to start on Jan 22.

The travel rush is expected to last 40 days, from Jan 7 to Feb 15, the Ministry of Transport said this week.

The state-run China Daily reported on Thursday that rural regions across China are beefing up their medical treatment capacities and ensuring availability of life-support equipment and critical-care beds.

It said a hospital in a part of Inner Mongolia where more than 100,000 people live in the countryside was seeking bidders for a 1.9 million yuan (S$367,000) contract to upgrade its wards into intensive care units.

Liancheng County Central Hospital, in the eastern Fujian province, was seeking tenders for ambulances and medical devices, ranging from breathing machines to electrocardiogram monitors.

A hospital in Huailai county, in Hebei province, also said it needed equipment for its emergency wards.

Testing requirements

The world’s second-largest economy is expected to suffer a slowdown in factory output and domestic consumption in the near term as workers and shoppers fall ill. But it is also predicted to bounce back later in 2023 once the Covid-19 wave eases.

The re-opening also raises the prospects of Chinese tourists returning to shopping streets around the world, although some countries are taken aback by the scale of the outbreak and are sceptical of Beijing’s Covid-19 statistics.

China’s official death toll of 5,246 since the pandemic began compares with more than 1 million deaths in the United States.

The Chinese-ruled global financial hub of Hong Kong, a city of 7.4 million people which lost control over Covid-19 earlier in 2022, reported more than 11,000 deaths.

The US, India, Italy, Japan and Taiwan said they would require Covid-19 tests for travellers from China. Britain is considering a similar move, the Telegraph reported.

The US issued a travel alert on Wednesday advising Americans to “reconsider travel to China, Hong Kong, and Macau” and citing “reports that the healthcare system is overwhelmed” along with the risk of new variants.

The main airport in the Italian city of Milan started testing passengers arriving from Beijing and Shanghai on Dec. 26 and found that almost half of them were infected.

China has rejected criticism of its statistics as groundless and politically-motivated attempts to smear its policies. It also played down the risk of new variants, saying it expects future mutations to be potentially more virulent but less severe.

Omicron was still the dominant strain in China, Chinese health officials said this week.

Australia, Germany, Thailand and others said they would not impose additional travel restrictions for now.

For its part, China, whose borders have been all but shut to foreigners since early 2020, will stop requiring inbound travellers to go into quarantine from Jan 8. REUTERS