SHANGHAI - A Shanghai hospital has told its staff to prepare for a “tragic battle” with Covid-19, as it expects half of the city’s 25 million people to get infected by the end of the year while the virus sweeps through China largely unchecked.

After widespread protests and a relentless rise in cases, China in December took an abrupt shift in policies and began dismantling its zero-Covid regime, which has taken a great financial and psychological toll on its 1.4 billion people.

Still, its official death count since the pandemic began in early 2020 stands at 5,241 – a fraction of what most other countries have faced.

China reported no new Covid-19 deaths for a second consecutive day for Wednesday, even as funeral parlour workers say demand has jumped in the past week, pushing fees higher.

The authorities, who have narrowed the criteria for Covid-19 deaths, confirmed 389,306 cases with symptoms.

Some experts said official figures have become an unreliable guide, as less testing is being done across China following the easing of restrictions.

The Shanghai Deji Hospital, posting on its official WeChat account late on Wednesday, estimated that there were about 5.43 million positive cases in the city and that 12.5 million people in China’s main commercial hub will get infected by the end of the year.

“This year’s Christmas Eve, New Year’s Day and the Chinese New Year are destined to be unsafe,” said the hospital.

“In this tragic battle, the entire Greater Shanghai will fall, and we will infect all the staff of the hospital! We will infect the whole family! Our patients will all be infected! We have no choice, and we cannot escape.”

At Tongren Hospital, one of Shanghai’s biggest public hospitals, doctors in the intensive care unit were using hallways to handle the overflow of seriously ill patients on Wednesday. Outside a fever clinic, several dozen visibly sick people were being made to wait in the cold. Several pharmacies near the hospital were no longer allowing people to enter, saying they had run out of cold and fever medicine.

Healthcare workers described an increasingly dire situation of too many patients and staff falling sick. Cases have also increased after the city stopped requiring people to show negative polymerase chain reaction test results before entering a hospital.

A cancer specialist at one public hospital in Shanghai said she was told that all doctors would need to work in the emergency room because it was overrun by patients with fever and many colleagues were out sick.

The hospital threatened to punish doctors by taking away their bonuses if they did not agree, she said, adding that she is avoiding eating, drinking and going to the bathroom at work to limit her chance of catching Covid-19.

In an effort to prevent the virus from letting rip across China, Shanghai residents endured a two-month lockdown that ended on June 1, with many losing income and having poor access to basic necessities. Hundreds died and hundreds of thousands were infected in those two months.

Shanghai’s economy shrank almost 14 per cent in the second quarter as the lockdown in the financial and trading hub shuttered factories, curbed consumer spending and disrupted operations at the world’s largest port.  

“We are now repeating what we got through during the city lockdown: lack of delivery capacity, no drugs, super busy hospitals, kids being sent home,” said Mr Peter Hu, a car company engineer and father of a two-year-old boy.

“Thinking about all this, I’m so mad that our time during the lockdown has been totally wasted,” he added.

This time round, many residents are choosing to stay at home – either because they are infected with Covid-19 or they are trying to avoid it. The subway operator cut services because of a drop in passenger numbers and staff getting sick.

In the latest week, Shanghai subway usage was down 51 per cent compared with the same period in 2019, according to Bloomberg analysis of the transit data. That compares with a month ago, when metro ridership was 18 per cent below the same period three years earlier.

Businesses are closing. At Art Park mall, not far from Tongren Hospital, popular bistro Baker and Spice told customers that it was no longer serving food because the cooks all had Covid-19.

Mr Hu has been living in a hotel near his office for a week to avoid potentially infecting his family. So far, he has tested negative, but he is losing patience.

“Lately, I keep asking friends who get infected if their symptoms are mild,” Mr Hu said. “I’m thinking to actively get infected by a mild-symptom friend and this terrible life can be over.”

Experts said China could face more than a million Covid-19 deaths in 2023.

The head of the World Health Organisation (WHO) said it is concerned about the spike in infections and is supporting the government to focus on vaccinating those at highest risk.

WHO director-general Tedros Adhanom Ghebreyesus told reporters that the agency needed more detailed information on disease severity, hospital admissions and requirements for intensive care units for a comprehensive assessment.

Free medicine

China’s policy U-turn caught a fragile health system unprepared, with hospitals scrambling for beds and blood, pharmacies for drugs, and the authorities racing to build special clinics.

Smaller cities away from the affluent eastern and southern coast are particularly vulnerable. Tongchuan, a city of 700,000 in the north-western Shaanxi province, called on Wednesday for all medical workers who retired in the past five years to join the battle against Covid-19.

“Medical institutions at all levels in the city are under great pressure,” it said in a public notice.

The state media said local governments were trying to tackle drug shortages, while pharmaceutical companies were working extra time to boost supplies.

Dongguan, a sprawling city in southern China, said a total of 100,000 ibuprofen tablets for fever had arrived in the city, and will be distributed to 41 state drug stores this week, before being made available for free, the Global Times reported.

In Wuhan, the central city where the virus was first discovered in late 2019, three million ibuprofen tablets have been supplied to medical institutions and retail pharmacies each day since Dec 17, the report said.

The authorities in Sanya on the southern Hainan island have lined up 18 pharmacies to distribute free drugs, while pharmacies in Zhoukou are giving as many as 10 free tablets a day to residents who present an identification card. REUTERS, BLOOMBERG