A week into easing, uncertainty over China virus direction

A worker in protective gear prepares to administer a COVID-19 test inside a hospital compound in Beijing, Dec. 15. China said Wednesday that it would stop reporting asymptomatic COVID-19 cases, another step in the country's departure from some of the world's strictest COVID-19 policies. AP-Yonhap

A week after China eased some of the world's strictest COVID-19 containment measures, uncertainty remains over the direction of the pandemic in the world's most populous nation.

While there are no official indications yet of the massive surge of critically ill patients some had feared, informal surveys and social media posts suggest huge numbers of people are being infected. The government says it is now essentially impossible to get an accurate picture of the actual numbers nationwide.

In Beijing and elsewhere, pharmacies are running out of medications and testing kits. Some hospital staff are staying home, while others are back to work after being infected.

Downtown Beijing was largely empty Thursday and those businesses and restaurants that remained open or had not cut back radically on operating hours saw few customers. Many of those sick stayed at home, while others avoided venturing out to avoid getting infected.

Some lines formed outside pharmacies and fever clinics ― the number of which has more than tripled in Beijing to over 300. The government is appealing to those with mild symptoms to recuperate at home to avoid straining health resources.

Fever clinics visited by AP journalists were generally calm and orderly, with few indications of overcrowding. A children's hospital had 50 or 60 people waiting in line Wednesday afternoon, but three others had shorter queues. At one clinic in southern Beijing, a few elderly patients were put on IV drips, and one was inhaling pressurized oxygen.

China's ''zero-COVID'' policy of lockdowns, quarantines and mandatory testing was blamed for hindering the economy and creating massive societal stress, and though the Dec. 7 relaxation of measures has allowed more avenues for the coronavirus' spread across the country, the full effects have yet to come into focus.

Elsewhere in the economy, the news has been mixed. The National Bureau of Statistics on Thursday said China's value-added industrial output rose a modest 2.2 percent year-on-year.

''The industrial output remained stable in November despite the short-term impact of the pandemic,'' bureau official Tang Weiwei was quoted as saying by the official Xinhua News Agency.

China's urban unemployment rate rose slightly to 5.7 percent in November, from 5.5 percent the month before, the NBS said. China does not survey unemployment outside of major cities.

While cities such as Beijing, Shanghai and Shenzhen have invested heavily in health care, second- and third-tier cities and communities in the vast rural hinterland have far fewer resources to deal with a major outbreak.

In an interview with The Associated Press, Yale professor of public health Xi Chen said that strains rose partly from the lack of a family doctor system, making people reliant on hospitals even for illnesses that are not severe.

''If people do not have such culture to stay at home, to keep those resources for sicker people, then that could easily crash the system,'' Chen said.

Other bottlenecks include boosting China's elderly vaccination rate and bolstering the country's intensive care capacity. Though most of China's population is vaccinated, millions of older adults haven't had a booster shot of the country's domestically made vaccines. Studies show Chinese vaccines are effective in preventing hospitalization and death, but require at least three doses in order to be fully effective.

According to authorities, 86.6 percent of people aged 60 or over have received at least two shots. On Wednesday, the government said it would offer a second booster shot to those in vulnerable groups who had received their first booster more than six months ago. Inhalable COVID-19 vaccines that do not require a syringe to be administered are also being offered in major cities such as Beijing and Shanghai.

Though the health care system in big cities appears to be holding up so far, Chen cautions that it's too soon to tell when cases will peak. The January Lunar New Year travel rush is expected to present another challenge, Chen said.

''I'm concerned it could be a super-spreader event,'' he said.

Masked residents wait in line for their COVID-19 throat swab test inside a hospital compound in Beijing, Dec. 15. AP-Yonhap

Now is also not an ideal time for China to be loosening restrictions, Chen said, as the virus circulates more easily during the cold and flu season in winter.

The task of gauging China's preparedness is made all the harder by the lack of reliable statistics and projections.

The only numbers the National Health Commission is currently reporting are confirmed cases detected in public testing facilities where symptoms are displayed. Many people also test at home, and any positive results there would also not be captured.

The government stopped announcing asymptomatic case totals earlier this week, saying an accurate count was impossible.

China's official death toll remains low, with just 5,235 deaths ― compared with 1.1 million in the United States. However, public health experts caution that such statistics can't be directly compared.

Chinese health authorities count only those who died directly from COVID-19, excluding those whose underlying conditions were worsened by the virus. In many other countries, guidelines stipulate that any death where COVID-19 is a factor or contributor is counted as a COVID-related death.

Experts say this has been the longstanding practice in China, but questions have been raised at times about whether officials have sought to minimize the figures.

President Xi Jinping's government is still officially committed to stopping virus transmission. But the latest moves suggest the party will tolerate more cases without quarantines or shutting down travel or businesses.

Starting Tuesday, China also stopped tracking some travel, though China's international borders remain largely shut.

The easing of measures came after Beijing and several other cities saw protests over the measures that grew into calls for Xi and the Communist Party to step down ― a level of public dissent not seen in decades.

Though China's ''zero-COVID'' policy has for years successfully kept cases and deaths low, the more infectious omicron variant made containing the virus far more difficult, leading to increasingly harsh restrictions. (AP)