Yao’s elderly mother-in-law had fallen 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 cases of Covid-19, Yao was told. She was told that she was going to larger hospitals in adjacent counties.
As Yao and her husband drove from hospital to hospital, they found that all the wards were full. The Zhuozhou hospital, an hour’s drive from Yao’s hometown, was the latest disappointment.
Yao charged toward the check-in counter, passing wheelchairs frantically wheeling elderly patients. Once again, they told him that the hospital was full and he would have to wait.
“I’m furious,” Yao said, crying, as she grabbed lung scans from the local hospital. “I don’t have much hope. We’ve been gone a long time and I’m terrified because she’s having trouble breathing.”
Over two days, Associated Press journalists visited five hospitals and two crematoriums in towns and small 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 loosened Covid-19 controls in November and December. For weeks the region was silent as people fell ill and stayed home.
Many have already recovered. Today, markets are crowded, diners fill restaurants and cars honk in traffic, even as the virus is spreading in other parts of China. In recent days, state media headlines have said the area is “beginning to resume normal life.”
But life in the emergency rooms and crematoriums of central Hebei is anything but normal. Even as young people are back to work and lines at fever clinics are thinning, many of Hebei’s elderly are in critical condition. As intensive care units and funeral homes invade, it could be a harbinger of things to come for the rest of China.
The Chinese government has reported just seven deaths from Covid-19 since restrictions were dramatically relaxed on December 7, bringing the total death toll in the country to 5,241. On Tuesday, a Chinese health official said China only counts deaths from pneumonia or respiratory failure in its official number of deaths from covid-19, a narrow definition that excludes many deaths that would be attributed to covid-19 elsewhere.
Experts have forecast between 1 million and 2 million deaths in China through the end of next year, with a senior World Health Organization official warning that Beijing’s way of counting would “underestimate the true death toll.”
At Baoding No. 2 Hospital in Zhuozhou on Wednesday, patients thronged the corridor of the emergency room. The sick breathed with the help of respirators. A woman mourned after doctors told her a loved one had died.
The ER was so full that ambulances were turned away. A medical worker yelled at relatives bringing a patient from an arriving ambulance.
“There is no oxygen or electricity in this corridor!” exclaimed the worker. “If you can’t even give him oxygen, how can you save him?”
“If you don’t want any delay, turn around and get out quickly!” she said.
The relatives left and loaded the patient into the ambulance. He took off, lights flashing.
In two days of driving in the region, AP journalists passed close to thirty ambulances. On a road to Beijing, two ambulances followed one another with their lights on, while a third passed in the opposite direction. Dispatchers are overwhelmed, and Beijing city officials reported that emergency calls increased sixfold earlier this month.
Some ambulances go to funeral homes. At the Zhuozhou crematorium, furnaces are burning overtime as workers struggle to cope with a surge in deaths in the past week, according to an employee. One funeral home worker estimated that he is burning 20 to 30 bodies a day, up from three to four before Covid-19 measures were relaxed.
“A lot of people died,” said Zhao Yongsheng, a worker at a funeral goods shop 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, because funeral homes in the Chinese capital were full, according to the woman’s grandson, Liang.
“They said we would have to wait 10 days,” Liang said, giving only his last name due to the sensitivity of the situation.
Liang’s grandmother was not vaccinated, Liang added, when she contracted symptoms of the coronavirus and spent her last days on a ventilator in a Beijing ICU.
During two hours at the Gaobeidian crematorium on Thursday, AP journalists observed three ambulances and two vans unloading bodies. About a hundred people huddled together in groups, some in traditional white Chinese mourning attire. They burned funeral paper and set off fireworks.
“There’s been a lot!” a worker said when asked about the number of deaths from covid-19, before funeral director Ma Xiaowei intervened and led reporters to meet with a local government official.
As the official listened, Ma confirmed that there were more cremations, but said he did not know if Covid-19 was involved. She blamed the additional deaths on the onset of winter.
“Every year this season, there are more,” Ma said. “The pandemic hasn’t really shown up” in the death toll, he said, as the official listened and nodded.
Even as anecdotal evidence and modeling suggest large numbers of people become infected and die, some Hebei officials deny that the virus had much of an impact.
“There is no so-called explosion in cases, everything is under control,” said Wang Ping, administrative manager of Gaobeidian Hospital, speaking outside the hospital’s main gate. “There has been a slight decrease in patients.”
Wang said only a sixth of the hospital’s 600 beds were occupied, but he refused to allow AP journalists inside. Two ambulances arrived at the hospital during the half hour that AP journalists were present, and a relative of a patient told the AP that they could not get into the Gaobeidian emergency room because it was full.
Thirty kilometers (19 miles) to the south in the city of Baigou, emergency room doctor Sun Yana was candid, 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 become even busier or not. Our emergency department has always been busy.”
The Baigou New Area Aerospace Hospital was quiet and orderly, with empty beds and short lines as nurses sprayed disinfectant. Covid-19 patients are kept apart from others, staff said, to avoid cross-infection. But they added that serious cases are being directed to hospitals in larger cities, due to limited medical equipment.
The lack of ICU capacity in Baigou, which has about 60,000 inhabitants, reflects a national problem. Experts say medical resources in China’s villages and towns, home to some 500 million of China’s 1.4 billion people, lag far behind those of big cities like Beijing and Shanghai. Some counties lack a single ICU bed.
As a result, critically ill patients 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 into the emergency room of Langfang No. 4 People’s Hospital on Thursday night.
The guards worked to corral the crowd as people jostled for position. With no space in the ward, patients spilled out into the hallways and hallways. The sick lay on blankets on the floor as staff frantically pushed stretchers and ventilators. In one hallway, half a dozen patients huffed and puffed on metal benches as oxygen tanks pumped air into their nostrils.
Outside a CT scan room, a woman sat on a bench wheezing as snot trickled from her nostrils onto the crumpled tissues. A man lay on a gurney outside the emergency room as medical workers attached electrodes to his chest. Next to 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 covid,” asked a man at the counter, as four others called for attention behind him. “What medicine can we get?”
In a hallway, a man was pacing while yelling into his cell phone.
“The number of people has exploded!” he said. “There is no way you can get care here, there are too many people.”
It was not clear how many patients had covid-19. Some had only mild symptoms, illustrating another problem, experts say: People in China are more reliant on hospitals than in other countries, which means it’s easier to overwhelm emergency medical resources.
For two hours, AP journalists watched half a dozen or more ambulances arrive at the hospital’s emergency room and load critically ill patients to rush to other hospitals, even as cars arrived with dozens of new patients.
A beige van pulled up to the ER and frantically honked at a waiting ambulance. “Move!” the driver yelled.
“Go Go!” a terrified voice shouted. Five people pulled a man wrapped in blankets from the back of the van and took him to the hospital. Security guards shouted into the packed room: “Make way, make way!”
The guard asked a patient to move, but he backed off when a relative snarled at him. Instead, the cloaked man was lying on the ground, amidst medics running to and fro. “Grandfather!” a woman yelled, crouching over the patient.
Medical workers rushed over a ventilator. “Can you open his mouth?” someone yelled.
When white plastic tubes were placed in his face, the man began to breathe easier.
Others were not so lucky. Relatives surrounding another bed began to cry as an elderly woman’s vital signs stalled. A man pulled a cloth over the woman’s face and they fell silent before her body was carried away.
Within minutes, another patient had taken his place.