China’s nursing homes are fighting an uphill battle to keep their elderly residents safe as a wave of Covid-19 infections sweeps the country following a relaxation of the government’s zero-tolerance virus policy.

Facilities are locking themselves off from the outside world with staff sleeping on-site, while struggling to get their hands on drugs.

Authorities have warned of rapidly growing caseloads, and industry ministry official Zhou Jian said on Wednesday that the country was “making all-out efforts to ramp up the production of key medicines”.

Experts fear the country is ill-equipped to manage the “exit wave” of infections as it presses ahead with the reopening, with millions of vulnerable elderly people still not fully vaccinated.

And eldercare facilities have now been left to fend for themselves as society reopens, the manager of one privately run Beijing home said.

“We are fully sealed off,” the manager, who asked to remain anonymous, told AFP. Only food and supplies are allowed in — no one is allowed to enter or leave.

He said the home had ordered medical supplies “at a high price”, but they had not arrived yet after a week, with the city’s logistics network battered by infections among delivery workers.

He warned it would be impossible to keep the virus out forever.

“Couriers and delivery personnel are almost all Covid positive,” he said. “Even if you disinfect or throw away all the outer packaging, plus the plastic packaging, you can’t spray disinfectant on all the food that comes in.”

Many Chinese eldercare facilities have already been locked down for weeks following local government directives, with Yuecheng Senior Home in Beijing saying last week it had already been sealed off for nearly 60 days.

In Shanghai, the Xiangfu Nursing Home said this week it would continue “closed management”, forcing all employees to sleep on site and giving staff nucleic acid tests every day.

“As society optimises prevention and control policies, our home should in particular maintain high vigilance,” the home said in its statement.

Hospitals under pressure

Visits to hospital fever clinics surged in the days following China’s lifting of restrictions last week, though the World Health Organisation (WHO) said the virus was already spreading widely in the country as “the control measures in themselves were not stopping the disease”.

The toll of the abrupt shift away from zero-Covid is still unfolding, with multiple funeral homes in the capital telling AFP they experienced a recent surge in demand.

Health authorities have reported no deaths from Covid-19 in the past week, but have admitted that official figures no longer capture the full picture of domestic infections now that mass testing requirements have been dropped.

“We’ve had hundreds of patients, with a number of patients coming from nursing homes and in their 90s,” though there appeared to be few severe cases, one nurse at a Beijing hospital, who asked to remain anonymous, told AFP.

The nurse, who had recently caught Covid himself and returned to work after just three days, said more than half of his colleagues had been infected over the past few days.

“We can only force ourselves to work to keep the hospital running,” he said. “Those who have no fever and only mild symptoms are returning to work.”

Deserted streets

Streets in major Chinese cities were eerily quiet on Sunday as people stayed home to protect themselves from a surge in Covid-19 cases.

China is in the first of an expected three waves of Covid cases this winter, according to the country’s chief epidemiologist, Wu Zunyou. Further waves will come as people follow the tradition of returning en masse to their home areas for the Lunar New Year holiday next month, he said.

In Beijing, the spread of the highly transmissible Omicron variant has already hit services from catering to parcel deliveries. Funeral homes and crematoriums across the city of 22 million are also struggling to keep up with demand amid staff shortages as workers and drivers call in sick.

At Beijing’s largest funeral parlour in Babaoshan, also known for handling the bodies of top Chinese officials and leaders, several hearses a minute could be seen entering on Sunday, while the parking area for private cars was also full.

“Right now it is difficult to book a hearse so many relatives transport the body with their own vehicles,” said an employee on condition of anonymity.

Smoke billowed out of crematoriums, where groups of people were gathered to collect the ashes of the deceased. It was not immediately clear to what extent a rise in Covid-related deaths was responsible.

Social media posts also showed empty subways in the city of Xian in China’s northwest, while in Shanghai, the country’s commercial hub, there was none of the usual bustle in the run-up to the New Year.

“Festive vibes are missing,” said a resident who gave her name as Alice.

In Chengdu, streets were deserted but food delivery times were improving, said a resident surnamed Zhang, after services began to adapt to the recent surge in cases.

Getting hold of antigen test kits was still difficult, however, she said, explaining that she had been told the kits she ordered recently had been diverted to hospitals.

In Shanghai, authorities said schools should move most classes online from Monday, and in nearby Hangzhou, most school grades were encouraged to finish the winter semester early.

In Guangzhou, those already doing online classes as well as pre-schoolers should not prepare for a return to school, said the education bureau.