Administrators at Xiangfu Nursing Home, a state-of-the-art facility for the elderly in Shanghai’s Changning district, are struggling to keep up with the sudden end of China’s Covid Zero policy. Their so far simple solution: close the door. To buy time while the virus spreads rapidly across the country, Xiangfu barred entry to relatives and other visitors in late November. Employees who have completed their shifts cannot leave and must instead sleep on site.
The same squatting is happening across China as its under-vaccinated seniors suddenly find themselves surrounded by infection after three years of little threat. In cities including Beijing, Shanghai and Nanjing, local governments are enforcing the same lockdown in nursing homes that factories adopted during earlier outbreaks. No one comes and no one goes. Time is running out. Evidence from around the world shows that care facilities often see the biggest waves of deaths, which is why countries prioritized vaccination homes first.
This is not the case in China, where 38,000 homes provide beds for 8.2 million seniors as of 2020. Only 42% of people over 80 have had a booster shot. That’s well below levels in other countries that have reopened after abandoning strict approaches to the virus. “This is just the beginning of a really difficult period,” said a statement from Pudong Shinan Nursing Home in Shanghai, which explained its new rules this week. “When experts say that 80-90% of the population will eventually become infected, we are afraid!”
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Officials from the National Health Commission last week provided basic advice to care homes facing a potential Covid outbreak. Minimize the risk of infection by improving ventilation, hand hygiene, wearing masks and avoiding gatherings. They also encouraged older people to get vaccinated, without mandatory vaccination. Convincing the seniors turned out to be a difficult task. Many older Chinese are reluctant to get vaccinated, said Feng Wang, a sociology professor at the University of California, Irvine. Forcing them to get vaccinated risks creating a backlash in a society that has traditionally emphasized respect for the elderly, he said.
The price of such hesitation can be high. According to Bloomberg Intelligence chief pharmaceutical analyst Sam Fazeli, China could see about 5 million people hospitalized and up to 700,000 deaths after leaving Covid Zero. When omicron swept Hong Kong earlier this year, undervaccinated residents in care facilities accounted for many of the thousands of deaths that followed.
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In Xiangfu, Shanghai, employees are settling in for the long haul. “In the face of threatening epidemics, we must remain vigilant and respond to what the government demands at any time to ensure the control of Covid and the safety of the elderly,” Xiangfu said in a statement.
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