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Crowded intensive care units, crowded crematoriums: Covid is ravaging 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 Covid-19 cases, Yao was told. He was told to go to larger hospitals in adjacent counties.

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

Yao walked towards the check-in counter, passing wheelchairs frantically moving elderly patients. Again, she was told the hospital was full and she should wait.

“I’m furious,” Yao said with tears in her eyes as she held up the local hospital’s lung scans. “I don’t have much hope. We’ve been dating for a long time and I’m terrified because she’s having trouble breathing.

Over two days, Associated Press reporters visited five hospitals and two crematoriums in cities and towns in Baoding and Langfang prefectures in central Hebei province. The region was the epicenter of one of China’s earliest outbreaks after the state eased Covid-19 controls in November and December. For weeks the area remained calm as people fell ill and stayed home.

Many have now recovered. Today, markets are bustling, diners pack restaurants and cars honk in rumbling traffic, even as the virus spreads to other parts of China. In recent days, state media headlines have said the region is “beginning to return to normal life.”

But life in the emergency departments and crematoria in central Hebei is anything but normal. Even as the young man returns to work and queues at fever clinics dwindle, many elderly people in Hebei are falling into critical condition. As they invade intensive care units and funeral homes, this could be a harbinger of what is to come for the rest of China.

The Chinese government has reported just seven Covid-19 deaths since restrictions were eased significantly on December 1. 7, bringing the country’s total toll to 5,241. On Tuesday, a Chinese health official said China only counts deaths from pneumonia or respiratory failure in its official Covid-19 death toll , a narrow definition that excludes many deaths that would be attributed to Covid-19 in other places.

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

At Baoding No. 2 Hospital in Zhuozhou on Wednesday, patients crowded the corridor of the emergency department. The patients breathed using respirators. A woman waited after doctors told her a loved one had died.

The ERs were so crowded that the ambulances turned away. A medical worker yelled at relatives who were bringing in a patient from an oncoming ambulance.

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

“If you don’t want to be late, turn around and get out quickly!” she said.

Relatives left, hoisting the patient into the ambulance. It took off, lights flashing.

In two days of road in the region, the journalists of the AP passed in front of about thirty ambulances. On a highway towards Beijing, two ambulances followed one another, flashing lights, while a third passed 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, the ovens burn over time as workers struggle to cope with a spike in deaths over the past week, according to an employee. A funeral home worker estimated he was burning 20 to 30 bodies a day, up from three to four before Covid-19 measures were eased.

“There were so many deaths,” said Zhao Yongsheng, a worker at a funeral goods store near a local hospital. “They work day and night, but they can’t 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 drive away, as funeral homes in the Chinese capital were packed , according to the woman’s grandson, Liang.

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

Liang’s grandmother had not been vaccinated, Liang added, when she showed symptoms of coronavirus and spent her final days hanging on a ventilator in a Beijing intensive care unit.

For more than two hours at the Gaobeidian crematorium on Thursday, AP reporters observed three ambulances and two vans unloading bodies. About 100 people crowded into groups, some in traditional Chinese white mourning attire. They burned funeral paper and set off fireworks.

“There were a lot of them!” A worker said when asked about the death toll from Covid-19, before funeral director Ma Xiaowei stepped in and brought reporters to meet a local government official.

As the official listened, Ma confirmed there were more cremations, but said he was unsure whether Covid-19 was involved. He blamed the additional deaths on the onset of winter.

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

Even though anecdotal evidence and models suggest large numbers of people are infected and dying, some Hebei officials deny the virus has had much impact.

“There is no so-called explosion of cases, everything is under control,” said Wang Ping, administrative director of Gaobeidian Hospital, speaking from the hospital’s main gate. “There has been a slight drop in the number of patients.”

Wang said only a sixth of the hospital’s 600 beds were occupied but refused to allow AP reporters to enter. Two ambulances arrived at the hospital during the half hour, AP reporters were present and a relative of a patient told the AP they were turned away from the Gaobeidian emergency department because it was full.

Thirty kilometers (19 miles) south of the town of Baigou, emergency department doctor Sun Yana was candid, even when local authorities listened.

“There are more people with fever, the number of patients has indeed increased,” Sun said. She hesitated, then added, “I can’t say whether I’ve become even busier or not.” Our emergency department has always been busy.

Baigou New Area Aerospace Hospital was quiet and orderly, with empty beds and short lines as nurses sprayed disinfectant. Covid-19 patients are kept separate from others, staff said, to avoid cross infection. But they added that serious cases are referred to hospitals in major cities, due to limited medical equipment.

The lack of intensive care capacity in Baigou, which has a population of around 60,000, reflects a national problem. Experts say medical resources in China’s villages and towns, home to around 500 million of China’s 1.4 billion people, lag far behind those in major cities like Beijing and Shanghai. Some counties lack a single intensive care bed.

As a result, patients in critical condition are forced to travel to major cities for treatment. In Bazhou, a city 40 kilometers (25 miles) east of Baigou, a hundred or more people filled the emergency department of Langfang No. 4 People’s Hospital on Thursday evening.

Guards worked to herd the crowd as people jostled for positions. With no space in the way, patients spilled out into hallways and corridors. Sick people sprawled on blankets on the floor as staff frantically rolled around stretchers and ventilators. In a hallway, half a dozen patients huffed on metal benches as oxygen tanks pumped air into their noses.

Outside a CT scan room, a woman sitting on a bench wheezed as snot dripped from her nostrils into crumpled tissue. A man lay on a stretcher outside the emergency department as medical workers taped electrodes to his chest. Near a check-in counter, a woman sat on a stool gasping for air as a young man held her hand.

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

In a hallway, a man was pacing, shouting into his cell phone.

“The number of people has exploded! he said. “There’s no way to get treatment here, it’s way too crowded.”

It was not known how many patients had Covid-19. Some had only mild symptoms, illustrating another problem, experts said: People in China rely on hospitals more than in other countries, which means it’s easier for emergency medical resources to d be overloaded.

For more than two hours, AP reporters watched half a dozen or more ambulances stop at the hospital emergency room and load critical patients to sprint to other hospitals, even as cars were stopping with dozens of new patients.

A beige van pulled up to the emergency room and honked frantically at a waiting ambulance. “Move!” shouted the driver.

“Let’s go let’s go!” shouted a panicked voice. Five people hoisted a man bundled in blankets into the back of the van and rushed him to hospital. Security guards shouted into the crowded room, “Make way, make way!

The guard asked a patient to move, but backed down when a relative harassed him. The bundled up man was laid on the ground instead, amid doctors running back and forth. ” Grandfather ! cried a woman, squatting over the patient.

Medical workers rushed to a ventilator. “Can you open his mouth?” someone shouted.

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

Others weren’t so lucky. Relatives surrounding another bed began to tear as an elderly woman’s vital signs flattened out. A man pulled a rag over the woman’s face, and they stood, silent, before her body was taken away.

Within minutes, another patient had taken her place.

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