As Lunar New Year nears, China's rural residents fear relatives will bring COVID home

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As millions of Chinese head home for the Lunar New Year celebrations on Jan. 22 and hospitals struggle amid a nationwide wave of COVID-19 cases, concerns are growing for the country"s rural healthcare systems, which have far fewer resources than the big city hospitals to treat the elderly and vulnerable.

Officials have warned of a fresh surge in coronavirus cases brought to rural areas by city residents traveling back home to welcome in the Year of the Rabbit, state broadcaster CGTN reported.

"We are extremely worried about the potential COVID-19 surge in rural areas as people are visiting homes after three years of strict measures that prevented people from going home," Jiao Yahui, head of the Bureau of Medical Administration under the National Health Commission, told journalists on Jan. 3.

Villages in general lack adequate medical care or preventive measures, with many rural counties only served by a single hospital, two at the most, news site Guancha.cn quoted Wuhan University sociologist Lv Dewen as saying.

But some rural doctors told Radio Free Asia that the rural COVID-19 wave, which started last month in big cities like Beijing and Shanghai, is already well under way.

Already stretched

A doctor working at the Gaoping township clinic in the central province of Hunan, serving a local population of some 40,000, said the clinic is already stretched with an influx of coronavirus cases.

"I haven"t had a day off in two weeks," said the doctor, who declined to be named for fear of reprisals. "If we get sick with a fever, we carry on working if we"re not too bad."

She said the clinic was in the process of hiring two more doctors, but that the process was being drawn out further by the requirement that they undergo political vetting before starting work.

Tang Shunping, 80, receives IV drip treatment at a clinic in a village of Lezhi county in Ziyang, Sichuan province, China, Dec. 29, 2022. Credit: Reuters

She added that the majority of the clinic"s current COVID patients are elderly people with underlying conditions.

"We have reached our limit, and if there is a new wave coming, all we can do is to rely on the support of those higher up, and [refer patients] to a higher-level hospital," the doctor said.

A doctor working at a clinic in nearby Zhenzi township said they are already at full capacity.

"We have more than 30 medical staff here, and they are already operating at full capacity, or beyond it," said the doctor, who asked to remain anonymous for fear of reprisals. "This started as soon as the zero-COVID restrictions were lifted."

Antivirals shortage

Meanwhile, a doctor at the Tonggu township clinic on the outskirts of Chongqing, which serves a local population of around 17,000 people, said there is currently an acute shortage of antivirals in their district.

"COVID-19 is a viral disease, so we need antivirals, but all we can do at our hospital here is to offer infusions of ribavirin," he said. "No other antivirals [are available] apart from a few orally administered antiviral solutions."

A September 2020 report in the International Journal of Antimicrobial Agents found that ribavirin did little to help COVID patients clear the virus, nor was it linked to improved mortality rates.

The Tonggu clinic currently employs just two doctors and two nurses, and they are struggling to give adequate care to critically ill patients.

"If they need emergency care, all we can do is call 120 [the emergency number] to get help from nearby towns like Wujia or Renyi," the doctor said. "They have slightly better staff levels and equipment, and we would transfer those patients there, or to a district-level [government-run] People"s Hospital."

She said local pharmacies currently have little or no supplies of montmorillonite powder, believed to be helpful in treating the diarrhea experienced by patients infected with the XBB Omicron subvariant.

According to a Jan. 2 report in the China Securities Journal, many rural doctors have scant experience of treating the coronavirus, as they have been entirely occupied delivering mass testing and quarantine requirements under the zero-COVID policy for the past three years.

Clearly unprepared

A doctor working in the southern city of Guangzhou said hospitals and clinics at township level are clearly unprepared for the COVID-19 wave.

"I have two relatives who came to the city to seek treatment, because there was no way to treat their symptoms, such as fever, and [local clinics] didn"t even have intravenous antipyretics," the doctor, who asked to remain anonymous, told Radio Free Asia.

He said there is a lack of data on infections in rural areas, but he would guess that more than half the population of rural Guangdong, of which Guangzhou is the provincial capital, has already been infected with COVID-19.

Tang Lilong, a farmer from Pingshun county in the northern province of Shanxi, was reluctant to discuss the pandemic when contacted by Radio Free Asia on Wednesday, saying only "it doesn"t matter." Asked if the government had taken any measures to mitigate transmission in the community, he said "no."

Elderly people pick up medicine at a pharmacy near a hospital in Yongquan town of Jianyang, Sichuan province, China, Dec. 29, 2022. Credit: Reuters

Wang Zhaoqing, a farmer from Laixi in the eastern province of Shandong said many of his family have already gotten COVID-19, but hadn"t taken medicine for it. He also said there were no disease prevention measures in place.

A veteran healthcare worker who gave the pseudonym Lu Qing said he is very concerned about the rural wave, because local governments and healthcare providers have run out of cash.

"Governments at all levels, local and central, have run out of money," Lu said. "They actually don"t have the resources to care [for people] or manage [the current wave]," he said.

He said the fact that rural residents brushed off questions about the pandemic didn"t mean they weren"t suffering.

"Actually, people living in rural parts of China are actually in a more desperate situation [than city-dwellers]," Lu said. "They are more bearish generally about life and death, and figure that they"ll die when they die. They don"t typically make a fuss."

Translated by Luisetta Mudie. Edited by Malcolm Foster.

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