COVID-19 in China | Health system challenges

(Beijing) China is facing its worst outbreak of the entire pandemic: millions of people are confined, thousands of beds hastily set up and the medical system is under pressure – especially in Shanghai.

Posted yesterday at 9:58

Hélène ROXBURGH
France Media Agency

The country applies the zero COVID-19 strategy, which consists of doing everything to avoid the appearance of cases. As a result, thousands of people declared positive are isolated in dedicated centers or hospitals.

Result: the Shanghai health system, the epicenter of the current epidemic outbreak due to the Omicron variant, sticks out its tongue in order to simultaneously ensure screening operations, the isolation of infected people and non-COVID-19 care.

Here are the main challenges for China.

Vaccination rate

By mid-March, more than 1.2 billion people had received at least two doses of vaccines — about 90% of the population.

But only half of Chinese people have taken a booster dose so far.

Another difficulty is the protection of the elderly.

Because among those over 80, only half received two doses. Among those aged 60 and over, just over 50% received a booster dose.

A worrying situation, because in Hong Kong, a semi-autonomous territory in southern China, a recent epidemic outbreak has taken away many unvaccinated elderly patients.

In mainland China, Chinese vaccines are currently the only ones authorized. However, the authorities have given a green light “under conditions” to Paxlovid, the anti-COVID-19 pill from the American group Pfizer.

According to several studies, Chinese vaccines are deemed to be less effective than many foreign vaccines, even if they offer protection deemed reliable against severe forms of COVID-19.

Hospitals under pressure

The Chinese health system, much better than a few decades ago, however, has insufficient staff, especially in the face of an aging population.

According to the Ministry of Health, China has only 2.9 general practitioners per 10,000 people. By way of comparison, the United Kingdom has the same number of doctors, but per 1000 people.

And some regions of the country are less blessed than others.

Jilin province (northeast), with a population of 24 million and the seat of a recent outbreak of infection, has only 22,880 hospital beds, according to local authorities.

Researchers at the prestigious Peking University have warned: China could suffer a “huge outbreak” that would quickly overwhelm the healthcare system if it eases restrictions like in Europe or the United States.

The urban-rural divide

While poverty has fallen dramatically in recent decades, there are still very marked differences between cities and the countryside in terms of health.

State-of-the-art equipment, the most experienced doctors and the best establishments are in the big cities, where the inhabitants have a large choice between public hospitals and private clinics.

China has only 1.6 medical professionals and 1.5 hospital beds per 1,000 people in rural areas, according to the Ministry of Health.

Health below “zero COVID-19”

Shanghai is the most developed city in the country. The surprise is all the greater to see her shaken by the health crisis, now struggling to find new beds in order to isolate infected people.

According to the authorities, 130,000 beds are available or will be in the coming days.

About 40,000 of them are installed in the Shanghai National Exhibition and Convention Center.

Most are occupied by asymptomatic people.

For their part, confined Shanghainese complain of a lack of access to fresh produce, medicines and hospitals for emergencies.

According to the Chinese press, at least two people with asthma have died after not being able to access hospitals for lack of a negative COVID-19 test.

Some 38,000 health professionals and 2,000 soldiers, from all over the country, have been sent to Shanghai to help in particular to provide care and deliver food.

City health department director Wu Jinglei conceded that even though the city had 50 percent more ambulances than before COVID-19, it was struggling to handle all the calls for medical help.

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