Overcrowded ICUs, overcrowded crematoriums: Covid shakes Chinese cities

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Yao’s elderly mother-in-law fell ill a week ago with the coronavirus. They first went to a local hospital, where lung scans showed signs of pneumonia. But the hospital could not handle severe cases of Covid-19, Yao was told. She was instructed to go to larger hospitals in adjacent counties.

As Yao and her husband drove from hospital to hospital, they found that all the wards were full. Zhuozhou Hospital, an hour’s drive from Yao’s hometown, was the ultimate disappointment.

Yao ran towards the check-in counter, past wheelchairs frantically moving elderly patients. Once again, she was told that the hospital was full and that she would have to wait.

“I’m furious,” Yao said, crying, as she held up lung scans from the local hospital. “I don’t have much hope. We’ve been gone a long time and I’m terrified that she’s having trouble breathing.

Over two days, Associated Press journalists visited five hospitals and two crematoria in towns and small towns in Baoding and Langfang prefectures in central Hebei province. The area was the epicenter of one of China’s first outbreaks after the state loosened Covid-19 controls in November and December. For weeks, the region was quiet as people got sick and stayed indoors.

Many have already recovered. Today, markets are bustling, shoppers crowd restaurants and cars honk in heavy traffic, even as the virus spreads to other parts of China. In recent days, state media headlines have said that the area is “beginning to resume normal life”.

But life in the emergency wards and crematoriums of central Hebei is anything but normal. Even as young people return to work and queues at fever clinics thin, many of Hebei’s elderly are in critical condition. As they invade intensive care units and funeral homes, it could be a harbinger of things to come for the rest of China.

The Chinese government has recorded just seven deaths from Covid-19 since restrictions were drastically eased on Dec. 7, bringing the total death toll in the country to 5,241. On Tuesday, a Chinese health official said China counts only deaths from pneumonia or respiratory failure in its official death toll from Covid-19, a narrow definition that excludes many deaths that would be attributed to Covid-19 elsewhere. .

Experts have predicted between 1 million and 2 million deaths in China by the end of next year, and a senior World Health Organization official warned that Beijing’s way of counting “would underestimate the true death toll”.

At Baoding Hospital No. 2 in Zhuozhou on Wednesday, patients crowded the emergency ward corridor. The sick breathed with the help of respirators. A woman mourned after doctors told her a loved one had died.

The emergency room was so crowded that ambulances were turned away. A medical worker shouted at relatives who were bringing a patient from an arriving ambulance.

“There is no oxygen or electricity in this hallway!” the worker exclaimed. “If you can’t even give him oxygen, how can you save him?”

“If you don’t want delays, turn around and leave quickly!” she said.

The relatives left, hoisting the patient back into the ambulance. It took off, lights flashing.

In two days traveling through the region, AP journalists passed around thirty ambulances. On a highway towards Beijing, two ambulances followed each other, their lights flashing, while a third drove by in the opposite direction. Dispatchers are overwhelmed, with Beijing city officials reporting a six-fold increase in emergency calls earlier this month.

Some ambulances are heading to funeral homes. At the Zhuozhou crematorium, ovens are burning overtime as workers struggle to cope with a spike in deaths over the past week, according to an official. A funeral home worker estimated he is burning 20 to 30 bodies a day, down from three to four before Covid-19 measures were loosened.

“A lot of people are dying,” said Zhao Yongsheng, an employee at a funeral home shop near a local hospital. “They work day and night, but they cannot burn them all.”

At a crematorium in Gaobeidian, about 20 kilometers (12 miles) south of Zhuozhou, the body of an 82-year-old woman was brought from Beijing, a two-hour journey, because funeral homes in China’s capital were packed, according to the woman’s grandson, Liang.

“They said we would have to wait 10 days,” Liang said, giving only his last name because of the sensitivity of the situation.

Liang’s grandmother was not vaccinated, Liang added, when she developed symptoms of the coronavirus and spent her final days hooked up to a ventilator in a Beijing intensive care unit.

For two hours at the Gaobeidian crematorium on Thursday, AP journalists observed three ambulances and two vans unloading bodies. About a hundred people gathered in groups, some in traditional white Chinese mourning attire. They burned funeral paper and set off fireworks.

“There has been a lot!” said a worker when asked about the death toll from Covid-19, before undertaker Ma Xiaowei stepped in and brought the journalists in for a meeting with a local government official.

As the official listened, Ma confirmed there were more cremations but said he didn’t know if Covid-19 was involved. He blamed the extra deaths on the arrival of winter.

“Every year during this season, there are more,” said Ma. “The pandemic really didn’t show up” in the death toll, he said, as the official listened and nodded.

Even with anecdotal evidence and modeling suggesting large numbers of people are becoming infected and dying, some Hebei officials deny the virus has had much of an impact.

“There is no so-called explosion in cases, everything is under control,” said Wang Ping, administrative manager of Gaobeidian Hospital, speaking at the hospital’s main gate. “There was a slight decline in the number of patients.”

Wang said only one-sixth of the hospital’s 600 beds were occupied, but he refused to let AP journalists in. Two ambulances arrived at the hospital during the half hour that AP journalists were present, and a relative of a patient told the AP that they were turned away from the Gaobeidian emergency ward because it was overcrowded.

Thirty kilometers (19 miles) to the south, in the city of Baigou, emergency room doctor Sun Yana was sincere, even with local authorities listening.

“There are more people with a fever, the number of patients has really increased,” Sun said. She hesitated and added, “I can’t tell if I’m even busier or not. Our emergency department has always been busy.”

The Baigou New Area Aerospace Hospital was quiet and orderly, with empty beds and short queues as nurses sprayed disinfectant. Covid-19 patients are separated from others, according to the team, to avoid cross-infection. But they added that severe cases were being referred to hospitals in larger cities because of limited medical equipment.

The lack of ICU capacity in Baigou, which has about 60,000 residents, reflects a national problem. Experts say medical resources in China’s towns and cities, which are home to about 500 million of China’s 1.4 billion people, lag far behind those of big cities like Beijing and Shanghai. Some municipalities lack a single ICU bed.

As a result, critically ill patients are forced to go to larger cities for treatment. In Bazhou, a city 40 kilometers (25 miles) east of Baigou, 100 or more people crowded the emergency ward of No. 4 People’s Hospital Langfang on Thursday night.

Guards worked to corral the crowd as people jockeyed for position. With no room in the ward, patients were spilling out into hallways and corridors. Sick people sprawled on blankets on the floor as workers frantically rotated gurneys and ventilators. In one hallway, half a dozen patients panted on metal benches as oxygen tanks pumped air into their noses.

Outside a CT scan room, a woman sat on a bench, panting as snot oozed from her nostrils onto crumpled fabrics. A man sprawled on a gurney outside the emergency ward as doctors placed electrodes on his chest. At a check-in counter, a woman sitting on a stool gasped as a young man took her hand.

“Everyone in my family has Covid,” asked a man at the counter, as four others clamored for attention behind him. “What medicine can we get?”

In a hallway, a man walked while shouting into his cell phone.

“The number of people has exploded!” he said. “There is no way you can get care here, there are too many people.”

It was unclear how many patients had Covid-19. Some had only mild symptoms, illustrating another problem, experts say: People in China are more reliant on hospitals than in other countries, meaning it’s easier to overwhelm emergency medical resources.

Over the course of two hours, AP journalists witnessed half a dozen or more ambulances arriving at the hospital’s emergency room and carrying critical patients to rush to other hospitals, even as the cars stopped with dozens of new patients.

A beige van pulled into the emergency room and honked its horn frantically at a waiting ambulance. “To move!” the driver yelled.

“C’mon C’mon!” shouted a panicked voice. Five people removed a man wrapped in blankets from the back of the van and rushed him to the hospital. Security guards shouted across the crowded ward, “Make way, make way!”

The guard urged a patient to move, but backed away when a relative snarled at him. Instead, the wrapped man was placed on the floor, amid doctors rushing to and fro. “Grandfather!” a woman screamed, crouched over the patient.

Medical workers ran over a ventilator. “Can you open his mouth?” someone shouted.

As white plastic tubes were placed in his face, the man began to breathe more easily.

Others weren’t so lucky. Relatives around another bed burst into tears as an elderly woman’s vitals plateaued. A man pulled a cloth over the woman’s face, and they stood there in silence before her body was carried away.

Within minutes, another patient took his place.