A hospital in Shanghai has told its staff to prepare for a “tragic battle” against COVID-19 as it expects half of the city’s 25 million people to be infected by the end of the year as the virus crosses China largely unchecked.

After widespread protests and a relentless rise in cases, China this month made a sharp shift in policy and began to dismantle its “zero-COVID” regime, which has taken a heavy economic and psychological toll on its 1 .4 billion people.

Yet China’s official death toll since the pandemic began three years ago stands at 5,241 – a fraction of what most other countries have faced.

China reported no new covid-related deaths for a second straight day on Dec. 21, even as funeral workers say demand increased last week, driving up costs.

Authorities – who have relaxed the criteria for COVID deaths, drawing criticism from many disease experts – have confirmed 389,306 cases with symptoms.

Some experts say official figures have become an unreliable guide as fewer tests are being carried out across China after restrictions are eased.

Posting to its official WeChat account on Wednesday evening, Shanghai’s Deji Hospital estimated that there were around 5.43 million positives in the city and 12.5 million in China’s main trading hub will be infected by the end of the year.

“Christmas Eve, New Year’s Day and Lunar New Year this year are supposed to be uncertain,” the hospital said.

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

People in Shanghai endured a two-month lockdown that ended on June 1, with many lost incomes and limited access to basic necessities. Hundreds of people died and hundreds of thousands were infected during those two months.

Experts say China could face more than a million COVID deaths next year, given relatively low vaccination rates among its vulnerable elderly population.

China’s vaccination rate is over 90%, but the rate for adults who received boosters drops to 57.9% and 42.3% for those over 80, according to government data.

At a hospital in Beijing, footage from state broadcaster CCTV showed rows of elderly patients in the intensive care unit breathing through oxygen masks. We didn’t know how many had covid.

The deputy director of the hospital’s emergency department, Han Xue, told CCTV they were seeing 400 patients a day, four times more than usual.

“These patients are all elderly people who have underlying illnesses, fever and respiratory infections, and they are in very serious condition,” Han said.

The head of the World Health Organization has expressed concern about rising infections and backs the government to focus on vaccinating those most at risk.

WHO Director-General Tedros Adhanom Ghebreyesus told reporters the agency needed more detailed information on disease severity, hospitalizations and intensive care unit needs for a full assessment.


China’s policy reversal has caught a fragile health system off guard, with hospitals scrambling for beds and blood, pharmacies for medicine and governments rushing to build special clinics.

Small towns far from the wealthy east and south coasts are particularly vulnerable. Tongchuan, a city of 700,000 in northwestern Shaanxi province, on Wednesday called on all medical workers who retired in the past five years to join the fight against covid.

“Medical institutions at all levels in the city are under severe pressure,” a public notice read.

State media said local authorities were trying to cope with drug shortages, while drug companies worked overtime to boost supplies.

Cities across the country have distributed millions of ibuprofen tablets to medical facilities and pharmacies, according to a report by the state Global Times.

Germany said it had sent its first batch of BioNTech (22UAy.DE) COVID vaccines to China for initial administration to German foreigners. Berlin is pushing for other foreign nationals to take them.

These would be the first mRNA vaccines, considered the most effective against the disease, available in China.

China has nine domestically developed covid vaccines approved for use.

Some Chinese experts predict that the covid wave will peak in late January and life will likely return to normal in late February or early March.

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