A senior doctor at one of Shanghai's top hospitals has said 70 percent of the megacity's population may have been infected with Covid-19 during China's huge surge in cases, state media reported Tuesday.

The steep rise in infections came after years of hardline restrictions were abruptly loosened last month with little warning or preparation, and quickly overwhelmed hospitals and crematoriums.

Chen Erzhen, vice president at Ruijin Hospital and a member of Shanghai's Covid expert advisory panel, estimated that the majority of the city's 25 million people may have been infected.

"Now the spread of the epidemic in Shanghai is very wide, and it may have reached 70 percent of the population, which is 20 to 30 times more than (in April and May)," he told Dajiangdong Studio, owned by the Communist Party mouthpiece People's Daily.

Shanghai suffered a gruelling two-month lockdown from April, during which over 600,000 residents were infected and many were hauled to mass quarantine centres.

But now the Omicron variant is spreading rampantly across the city.

In other major cities, including Beijing, Tianjin, Chongqing and Guangzhou, Chinese health officials have suggested that the wave has already peaked.

In neighbouring Zhejiang province, disease control authorities said Tuesday that there had been one million new infections in recent days and that the province was entering a peak plateau for Covid.

Chen added that his Shanghai hospital was seeing 1,600 emergency admissions daily — double the number prior to restrictions being lifted — with 80 percent of them Covid patients.

"More than 100 ambulances arrive at the hospital every day," he was quoted as saying, adding that around half of emergency admissions were vulnerable people aged over 65.

At Tongren Hospital in downtown Shanghai, AFP reporters saw patients receiving emergency medical attention outside the entrance of the overcrowded emergency ward on Tuesday.

The corridors overflowed with dozens of elderly patients lying on beds crammed together, hooked up to IV drips. Some patients wore oxygen masks attached to bedside canisters.

– 'Enormous challenge' –

Chinese officials are readying for a virus wave to hit China's underresourced rural interior, as millions of people prepare to travel back to their hometowns for the week-long Lunar New Year public holiday beginning January 21.

In an interview with state broadcaster CCTV on Monday, National Health Commission (NHC) official Jiao Yahui admitted that dealing with the expected peak in rural areas would be an "enormous challenge".

"What we are most worried about is in the past three years nobody has returned home for Lunar New Year but they finally can this year," said Jiao.

"As a result, there may be a retaliatory surge of urban residents into the countryside to visit their relatives, so we are even more worried about the rural epidemic."

She also acknowledged pressure on hospital emergency departments and promised that authorities would coordinate medical resources to ensure treatment of patients in underfunded areas.

Meanwhile, around a dozen countries have imposed Covid testing restrictions on passengers from China after Beijing announced its borders would reopen from January 8.

Countries including the United States have also cited Beijing's lack of transparency around infection data and the risk of new variants as a reason to restrict travellers.

China has only recorded 22 Covid deaths since December and has dramatically narrowed the criteria for classifying such deaths.

But Jiao told reporters on Thursday that China had always published data "on Covid-19 deaths and severe cases in the spirit of openness and transparency".

"China has always been committed to the scientific criteria for judging Covid-19 deaths, from beginning to end, which are in line with the international criteria," Jiao said.

Why China's Covid wave is stirring fear
Beijing (AFP) Jan 3, 2023 –

China is experiencing a huge Covid-19 surge after years of hardline containment restrictions were dismantled last month.

A growing number of countries are worried about a lack of data and transparency surrounding China's outbreak.

Here is why it is sparking concern:

– Unreliable data –

Beijing has admitted the scale of the outbreak has become "impossible" to track following the end of mandatory mass testing last month.

The National Health Commission has stopped publishing daily nationwide infection and death statistics.

That responsibility has been transferred to the Chinese Center for Disease Control and Prevention (CDC), which will only publish figures once a month after China downgrades its management protocols for the disease on January 8.

China has only reported 15 Covid deaths since it began unwinding restrictions on December 7, shortly after which it narrowed the criteria by which deaths from the coronavirus are recorded.

This has stoked concerns that the wave of infections is not being accurately reflected in official statistics.

Authorities admitted last week that the scale of data collected is "much smaller" than when mandatory mass PCR testing was in place.

CDC official Yin Wenwu said authorities are now compiling data from hospitals and local government surveys as well as emergency call volumes and fever medicine sales, which will "make up for deficiencies in our reporting".

Chinese hospitals and crematoriums are struggling with an influx of patients and bodies, with rural areas hit particularly hard.

Several countries including the United States, Australia and Canada last week said they were imposing testing restrictions on arrivals from China because of a lack of transparency on infection data.

– Piecemeal estimates –

Last month, a few local and regional authorities began sharing estimated daily infection totals as the scale of the outbreak remained unclear.

Disease control authorities in the wealthy coastal province of Zhejiang said Tuesday that the number of new cases jumped one million in the past few days, and "the epidemic is expected to enter a peak plateau in January".

The Zhejiang cities of Quzhou and Zhoushan said at least 30 percent of the population had contracted the virus.

The eastern coastal city of Qingdao also estimated around 500,000 new daily cases and the southern manufacturing centre of Dongguan forecast up to 300,000.

Officials in the island province of Hainan estimated Friday that the infection rate there had surpassed 50 percent.

But top health official Wu Zunyou said Thursday that the peak had passed in the cities of Beijing, Chengdu and Tianjin, with Guangzhou city officials saying the same on Sunday.

A senior doctor at a Shanghai hospital estimated Tuesday that up to 70 percent of the city's 25 million population may have been infected in the current wave.

Leaked notes from a meeting of health officials last month revealed they believed 250 million people had been infected across China in the first 20 days of December.

Independent infection models paint a grim picture. University of Hong Kong researchers have estimated nearly one million Chinese may die this winter as a result of opening up.

And health risk analysis firm Airfinity forecast 11,000 deaths and 1.8 million infections per day, with a total of 1.7 million fatalities by the end of April.

– New variants? –

Many countries have cited concerns over potential new variants as a reason to screen Chinese arrivals for Covid.

But there is as yet no evidence of new strains emerging from the current wave.

Top CDC official Xu Wenbo said last month that China was developing a national genetic database of Covid samples derived from hospital surveillance that would help track mutations.

Chinese health experts have said in recent days that the Omicron subvariants BA.5.2 and BF.7 are most prevalent in Beijing, in response to public fears that the Delta variant may still be circulating.

They said Omicron also remained the most dominant strain in Shanghai.

In many Western nations, these strains have been overtaken by the more transmissible subvariants XBB and BQ, which are not yet dominant in China.

Beijing has submitted 384 Omicron samples in the past month to the global online database GISAID, according to its website.

But the country's total number of submissions to the database, at 1,308, is dwarfed by those of other nations, including the United States, Britain, Cambodia and Senegal.

Recent samples from China "all closely resemble known globally circulating variants seen… between July and December", GISAID said Friday.

University of Hong Kong virologist Jin Dong-yan said on an independent podcast last month that people need not fear the risk of a deadlier new variant in China.

"Many places all over the world have experienced (large-scale infection) but a more deadly or pathogenic variant did not emerge afterwards," said Jin.

"I'm not saying that the emergence of a (more deadly) strain is completely impossible, but the possibility is very small."