Over 500 million people living in rural China could face a wave of Covid-19 infections in the coming days as millions of migrant labourers return to their villages for the Lunar New Year (LNY) holidays in January with the government rolling back travelling restrictions earlier this month.
A massive population spread over a large territory with limited per capita medical resources has made rural China the soft underbelly in the ongoing fast spreading Omicron-driven pandemic in the country.
Infections have already begun to spread in villages in China, according to social media reports with many village clinics already overwhelmed with patients suffering from fever and reporting to clinics with Covid symptoms.
Case surges (have) begun to sweep rural areas, where the medical system is relatively weaker, the state-run Global Times (GT) tabloid reported this week. Shortages of medicines and medical staff are the major problems they are facing, GT reported.
“On the one hand, county-level medical resources are already very limited, on the other hand, it is impossible to count on external support as before; so the rural medical system may face a ‘double blow’,” Lu Dewen, a professor at Wuhan University’s School of Sociology wrote earlier this week on China’s Twitter-like Weibo platform.
China’s rural areas have faced sporadic outbreaks before. What will be different this time?
According to Lu, in the past three years, pandemic control in rural areas has meant “external prevention”, meaning lockdowns, restricting people from outside coming in and movement restrictions.
“In the past, sporadic outbreaks, higher-level hospitals were able to send medical professionals to support…but in the next few months, especially during the Spring Festival (LNY), the epidemic may spread,” Lu wrote.
According to the 2021 population census, China has 509.8 million rural residents.
It’s this massive population which is at risk from Omicron waves in the weeks ahead.
What will add to the problem in tackling the outbreak is that in rural areas, the percentage of elderly population is larger than in urban areas. “In 2020, for instance, 23.81% of rural residents, or 120 million people, were 60 years old or older, 7.99% points higher than that in urban areas,” according to a report by state-run China Daily published in September.
“The vast majority of them (the elderly) suffer from some degree of underlying medical condition. Once a new crown infection occurs, it is very easy to cause the underlying disease to worsen,” an anonymous researcher wrote for the Kunlunce.cn academic website this week, complaining about the lack of medical infrastructure and preparedness to tackle the pandemic.
The unexpected rollback of Covid-10 control policies under the ‘zero-Covid’ policy took rural China by surprise but unlike in populous urban areas, which were better prepared to tackle a surge in infections, villages are not.
The problems of scarce medicine stocks and outpatient beds have been compounded by a lack of treatment guidance on how to face and survive a pandemic, wrote the Kunlunce researcher.
In 2021, China had 8.81 hospital beds for every 1,000 people in urban areas compared with 4.95 in rural areas, according to China’s health statistical yearbook, quoted by Bloomberg.
The lack of reliable data from the countryside will add to the confusion, given the government has stopped counting asymptomatic infections and narrowed the definition of death due to Covid.
“Due to the lack of medical resources and poor sanitation conditions in rural areas, the originally peaceful countryside has become a hotbed for the epidemic. The countryside is facing an unprecedented catastrophe,” the author wrote.
