It’s been two weeks since China tore up its zero-Covid policy, and now its citizens are bracing for what’s likely to be the world’s largest coronavirus surge since the pandemic began.

The dramatic overhaul of restrictions means the virus is now running wild through a population of 1.4 billion, largely unchecked. Chinese authorities have ended mass lockdowns of entire cities, lifted restrictions on travel within and between regions and are allowing those infected with the virus to isolate at home instead of in centralised facilities. In several provinces including Zhejiang and Anhui, infected residents with mild or no symptoms can even go to work – a major U-turn given that, several months ago, citizens could be arrested for going to work while testing positive.

A lack of reliable government data (China reported no new Covid deaths for a second consecutive day on 21 December) makes it difficult to know the true extent to which infections and deaths are already surging. But a series of reports on the situation on the ground paint a bleak picture. 

While official figures record a relatively low numbers of Covid patients in intensive care, “anecdotally ICUs are filling up,” says Mike Ryan, the WHO emergencies director. Radio Free Asia has reported that funeral homes in and around Beijing are operating around the clock while long queues are forming outside crematoriums. And in one large factory in the Eastern province of Shandong, only 20 per cent of staff came to work last Friday; the rest were off sick with Covid. 

This is just the beginning. 

The Shanghai Deji Hospital has told its staff to prepare for a “tragic battle” with Covid-19, estimating that half of the city’s 25 million residents will have tested positive by the end of next week.

Alarming modelling predicts that over 800 million people in China – roughly 10 per cent of the planet’s population – will be infected over the next few months, resulting in up to one million Covid deaths. 

Scientists at the China National Health Commission estimate that the virus’s R number – a measure of transmissibility – is currently a whopping 16 in China. If they’re right, this means Covid is now spreading faster there than ever before anywhere in the world. 

In many respects, this is unsurprising. Not only does China have such a huge population but additionally, only a tiny percentage of it has any natural immunity to the virus. Former draconian restrictions mean that the vast majority have never been infected.

What’s more, vaccination rates are lagging, especially among the elderly. According to the WHO, there has been a surge in vaccination rates in China over the last weeks. But even so, just over 40 per cent of over-80s have received a booster shot, while millions remain unvaccinated. Beijing has also refused to import any international vaccines despite studies indicating that protection from its homegrown shots is largely undetectable after six months. 

This week, Berlin sent a batch of mRNA Covid vaccines to China to be administered to German nationals – the first foreign coronavirus vaccine to reach Chinese soil. Yet Xi Jinping is still refusing German President Frank-Walter Steinmeier’s offer of shots of Germany’s BioNTech vaccine for the wider Chinese population. 

It’s set to be a highly difficult winter for the population of China as it learns to live with the virus. And, while “zero-Covid” was neither a scientifically nor economically sustainable policy, the reports of growing numbers of sick staff emerging from the Shandong factory are a reminder that a huge virus surge will be bruising for the economy too.

The UK’s own battle with Covid may feel like a distant memory. But make no mistake, the struggles facing the world’s second largest economy will reverberate across the entire globe.

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