Representational image. AFP
New Delhi: Zhu Wenbing is one of just over a million doctors across China’s vast countryside who have been bracing for the arrival of the pandemic, after three years of protection under the country’s zero-Covid policy.
However, the wave arrived in rural regions faster than anticipated, making it difficult for community hospitals and clinics to respond.
The largest yearly human movement takes place during the Lunar New Year’s official travel period, which this year runs from 7 January to 15 February. Once this period began, waves of infections were predicted.
Prior to the new year, when tens of millions of people typically travel throughout the country for family reunions and vacations, health authorities sent warnings to rural areas to prepare for Covid-19, setting up fever clinics and increasing manpower and medical supplies.
However, the early onset of the mass migration accelerated the spread of the virus and caught many community clinics off guard.
China has a three-tier rural healthcare network, with village clinics like Zhu’s at its base, followed by township health centres and the county hospitals.
Tucked into the rural pockets of Dezhou city, Zhu’s clinic – which has employed only two doctors since 1994 – is one of two serving a village of about 2,000 people with 20 per cent of them aged over 65.
“We mainly treat patients according to their symptoms with limited available drugs … and Chinese medicines,” South China Morning Post quoted Zhu as saying.
Severe cases are referred to higher-level hospitals.
In rural China, these are nowhere near the scale or facilities of the highest tier hospitals in the big cities. There are also only 1.48 practising doctors and 2.1 nurses for every 1,000 people in the countryside, compared with 3.96 doctors and 5.4 nurses per 1,000 in urban areas.
Zhu never saw his clinic under so much pressure, nor supplies of medicines run so low.
The worst moments were in late December, when the Omicron variant raged through his village in China’s eastern Shandong province. At its peak, Zhu was seeing more than 50 patients a day, and did not have enough medicines to treat them.
“All the Covid-related drugs were hard to get, and I kept phoning the [pharmaceutical company] salespeople and [township] clinics to make sure the patients could access the necessary medicines,” the report quoted Zhu as saying. “The price of medicines soared, [and that is] so unfair to the patients,” he added.
Rural hospitals and clinics were not permitted to accept patients with Covid-19-related symptoms prior to China abandoning its zero-Covid policy in December. This was done in an effort to stop the pandemic from spreading.
These facilities were also limited in the treatments they could prescribe – with antipyretics, cough medicine, antivirals and antibiotics not allowed – sending them scrambling to stock up on Covid-related medications when restrictions were lifted.
China’s underdeveloped healthcare system and uneven distribution of medical supplies were exposed last year when Shanghai – the country’s most developed city – struggled to cope with its Omicron outbreak.
In a number of large cities, restaurants, entertainment venues and businesses had been shut down since November because of zero-Covid lockdowns. When the policy was relaxed last month, mass infections among their employees kept them closed.
As a result, many migrant workers have returned to their hometowns several weeks earlier than expected. Students were also encouraged to go home before the semester ended, according to multiple sources.
Hongtang village, in central China’s Hunan province, recorded its first case on 9 December, when a homecoming migrant worker tested positive, according to an official in charge of the local pandemic response. Days later, students also started returning from various cities to the village.
In mid-December, local officials started stockpiling traditional Chinese medicines in preparation for a wave of infection, which struck the village – home to 530 people over 60 – within 10 days.
“In the second half of December, many people aged 80, 90 and above died. The deaths were quite concentrated,” the report quoted an official as saying.
While some medicines were available for sale online, supply was limited, so last week the village started appealing for help and donations via the internet, the official added.
After the early surge, many areas are now reporting a drop in Covid-19 infections, including the largely rural provinces of Henan in central China and Sichuan in the southwest. But public health experts warn that the challenge of more severe cases remains.
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