Full intensive care units, overcrowded crematoria: COVID is shaking Chinese cities

BAZHOU, China (AP) — Yao Ruyan frantically paced outside the fever clinic of a district hospital in China’s industrial province of Hebei, 70 kilometers (43 miles) southwest of Beijing. Her mother-in-law had COVID-19 and needed urgent medical care, but all the nearby hospitals were full.

“They say there are no beds here,” she barked into her cell phone.

As China grapples with its first-ever national wave of COVID-19, Emergency rooms in small towns and small towns southwest of Beijing are overwhelmed. Intensive care units turn away ambulances, relatives of sick people search for free beds, and patients are slumped on benches in hospital corridors and lie on the floor for lack of beds.

Yao’s elderly mother-in-law contracted the coronavirus a week ago. They first went to a local hospital, where lung scans showed signs of pneumonia. But the hospital cannot treat COVID-19 cases, Yao was told. She was told to go to larger hospitals in adjacent counties.

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

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

“I’m angry,” Yao said, bursting into tears as she clutched the lung scans from the local hospital. “I don’t have much hope. We’ve been out late and I’m very scared because she’s having trouble breathing.”

Over two days, AP journalists visited five hospitals and two crematoria in towns and cities in Baoding and Langfang prefectures in central Hebei province. The area was the epicenter of one of China’s first outbreaks after the state eased COVID-19 controls in November and December. For weeks it was quiet in the region, people got sick and stayed at home.

Many have since recovered. Today markets are bustling, restaurants crowding restaurants and cars honking in angry traffic as the virus spreads to other parts of China. In recent days, state media headlines have said that the area is “starting to resume normal life.”

But life in the emergency rooms and crematoria in central Hebei is anything but normal. Even as the young go back to work and lines at fever clinics shrink, many of Hebei’s elderly are in critical condition. As they overrun ICUs and funeral homes, it could be a harbinger of what’s to come for the rest of China.

The Chinese government has reported just seven COVID-19 deaths since restrictions were dramatically eased on December 7, bringing the country’s total death toll to 5,241. On Tuesday, a Chinese health official said China was only counting deaths of pneumonia or respiratory failure in its official COVID-19 fatality rate, a narrow definition that excludes many deaths that would be attributed to COVID-19 elsewhere.

Experts have forecast between one and two million deaths in China next year, and the World Health Organization has warned that Beijing’s counting “underestimated the true death toll.”

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

The intensive care unit was so overcrowded that ambulances were turned away. A medical worker yelled at relatives who were wheeling in a patient from an oncoming ambulance.

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

“If you don’t want any delays, turn around and hop off quickly!” She said.

The relatives went and lifted the patient back into the ambulance. It started, the lights flashed.

During the two-day drive through the region, AP reporters passed about thirty ambulances. On a highway bound for Beijing, two ambulances followed each other with blue lights flashing while a third passed in the opposite direction. Dispatchers are overwhelmed, and Beijing city officials reported a six-fold increase in emergency calls earlier this month.

Some ambulances go 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 employee. A funeral home worker estimated 20 to 30 bodies are being cremated a day, down from three to four before COVID-19 lockdowns were eased.

“So many people have died,” said Zhao Yongsheng, a worker at a funeral supplies store near a local hospital. “They work day and night, but they can’t burn them all.”

The body of an 82-year-old woman was taken to a crematorium in Gaobeidian, about 20 kilometers south of Zhuozhou, from Beijing, a two-hour drive away, because funeral homes in China’s capital were overcrowded, according to a woman’s grandson, Liang.

“They said we had to wait ten days,” Liang said, using only his last name because of the sensitivity of the situation.

Liang’s grandmother was not vaccinated when she contracted coronavirus symptoms, Liang added, and spent her final days on a ventilator in an intensive care unit in Beijing.

For more than two hours Thursday at the Gaobeidian crematorium, AP journalists watched as three ambulances and two vans unload bodies. About a hundred people huddled in groups, some in traditional white Chinese mourning clothes. They burned mourning papers and set off fireworks.

“A lot has happened!” said one worker when asked about the number of COVID-19 deaths, before undertaker Ma Xiaowei stepped in and brought the journalists to a meeting with a local government official.

As the officer listened, Ma confirmed there were other cremations but said he didn’t know if COVID-19 was involved. He blamed the additional deaths on the arrival of winter.

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

Even though anecdotal evidence and models suggest large numbers of people are becoming infected and dying, some Hebei officials dispute that the virus has had a major impact.

“In some cases, there is no so-called explosion, everything is under control,” Wang Ping, administrative head of Gaobeidian Hospital, said at the hospital’s main gate. “There was a slight decrease in patients.”

Wang said only a sixth of the hospital’s 600 beds were occupied, but refused to allow AP journalists inside. During the half-hour that AP journalists were present, two ambulances arrived at the hospital, and a patient’s relative told the AP they were turned away from Gaobeidian’s emergency room because it was full.

Thirty kilometers south in the town of Baigou, emergency room doctor Sun Yana was open even as local officials listened.

“There are more people with fever, the number of patients has actually increased,” Sun said. She hesitated, then added, “I can’t tell if I’ve gotten any busier or not. Our emergency room was always busy.”

Baigou New Area Aerospace Hospital was quiet and orderly, with empty beds and short lines as nurses sprayed disinfectant. COVID-19 patients are being separated from others, staff said, to prevent cross-infection. But they added that severe cases would be referred to hospitals in larger cities because of limited medical equipment.

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

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

Guards worked to contain the crowd as people jostled for positions. Since there was no more space on the ward, patients poured into the corridors and hallways. Sick people lay on blankets on the floor while staff frantically wheeled around stretchers and ventilators. In a hallway, half a dozen patients panted on metal benches while oxygen tanks pumped air into their noses.

Outside a CT scan room, a woman seated on a bench gasped as snot dripped from her nostrils into crumpled tissue. A man lay on a gurney outside the emergency room while medical staff placed electrodes on his chest. At a check-in desk, a woman seated on a stool gasped as a young man held her hand.

“Everyone in my family has COVID,” a man asked at the counter, while four others behind him requested attention. “What medicine can we get?”

A man was pacing up and down a corridor while calling on his cell phone.

“The number of people has exploded!” he said. “You can’t get treatment here, there are far too many people.”

It was not clear how many patients had COVID-19. Some had only mild symptoms, highlighting another problem, experts say: people in China are more reliant on hospitals than other countries, meaning emergency medical resources can be more easily overstretched.

Within two hours, AP journalists saw half a dozen or more ambulances pull up to the hospital’s intensive care unit, inviting critical patients to sprint to other hospitals even as cars pulled up with dozens of new patients.

A beige van pulled up in front of the ICU and frantically honked at a waiting ambulance. “Move!” shouted the driver.

“Here we go!” shouted a panicked voice. Five people pulled a man wrapped in blankets from the back of the van and took him to the hospital. Security guards yelled, “Make way, make way!” in the crowded station.

The guard asked a patient to move but backed away when a relative growled at him. The wrapped man was instead placed on the ground amid doctors pacing back and forth. “Grandpa!” shouted a woman bending over the patient.

Medical personnel rushed on a ventilator. “Can you open his mouth?” someone called.

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

Others weren’t so lucky. Relatives surrounding another bed began to cry as an elderly woman’s vitals fell flat. A man pulled a cloth over the woman’s face and they stood in silence before her body was rolled away. Within minutes another patient had taken her place.

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