A Shanghai hospital has told its staff to prepare for a "tragic battle" with COVID-19 as it expects half of the city's 25 million people to get infected by the end of the year while the virus sweeps through China largely unchecked.
After widespread protests and a relentless rise in cases, China this month took an abrupt shift in policies and began dismantling its "zero-COVID" regime, which has taken a great financial and psychological toll on its 1.4 billion people.
Still, China's official death count since the pandemic began in early 2020 stands at 5,241 - a fraction of what most other countries faced.
China reported no new COVID deaths for a second consecutive day for Dec. 21, even as funeral parlour workers say demand has jumped in the past week, pushing fees higher.
Authorities, who have narrowed the criteria for COVID deaths, confirmed 389,306 cases with symptoms.
Some experts say official figures have become an unreliable guide as less testing is being done across China following the easing of restrictions.
The Shanghai Deji Hospital, posting on its official WeChat account late on Wednesday, estimated there were about 5.43 million positives in the city and that 12.5 million in China's main commercial hub will get infected by the end of the year.
"This year's Christmas Eve, New Year's Day, and the Lunar New Year are destined to be unsafe," the hospital said.
"In this tragic battle, the entire Greater Shanghai will fall, and we will infect all the staff of the hospital! We will infect the whole family! Our patients will all be infected! We have no choice, and we cannot escape."
In an effort to prevent the virus from letting rip across China, Shanghai residents endured a two-month lockdown which ended on June 1, with many losing income and having poor access to basic necessities. Hundreds died and hundreds of thousands were infected during those two months.
Experts say China could face more than a million COVID deaths next year.
The head of the World Health Organization said it is concerned about the spike in infections and is supporting the government to focus on vaccinating those at the highest risk.
WHO Director-General Tedros Adhanom Ghebreyesus told reporters the agency needed more detailed information on disease severity, hospital admissions and requirements for intensive care units for a comprehensive assessment.
China's policy U-turn caught a fragile health system unprepared, with hospitals scrambling for beds and blood, pharmacies for drugs and authorities racing to build special clinics.
Smaller cities away from the affluent eastern and southern coast are particularly vulnerable. Tongchuan, a city of 700,000 in the northwestern Shaanxi province, called on Wednesday for all medical workers who retired in the past five years to join the battle against COVID.
"Medical institutions at all levels in the city are under great pressure," it said in a public notice.
State media said local governments were trying to tackle drug shortages, while pharmaceutical companies were working extra-time to boost supplies.
Dongguan, a sprawling city in southern China, said a total of 100,000 ibuprofen tablets had arrived in the city, and will be distributed to 41 state drug stores this week, before being made available for free, the Global Times reported.
In Wuhan, the central city where the virus was first discovered in late 2019, 3 million ibuprofen tablets have been supplied to medical institutions and retail pharmacies each day since Dec. 17, the report said.
Authorities in Sanya on the southern Hainan island have lined up 18 pharmacies to distribute free drugs, while pharmacies in Zhoukou are giving as many as 10 free tablets a day to residents who present an ID card.
mRNA VACCINES FOR GERMANS
Germany said it has sent its first batch of BioNTech COVID vaccines to China to be administered initially to German expatriates. Berlin is pushing for other foreign nationals to be allowed to take them.
These would be the first mRNA vaccines, seen as most efficient against the disease, available in China.
China has nine domestically-developed COVID vaccines approved for use.
Some Chinese experts predict the COVID wave to peak in late January, with life likely to return to normal by late February or early March. (Reporting by Bernard Orr and Martin Pollard in Beijing, Zoey Zhang and Casey Hall in Shanghai; Writing by Marius Zaharia; Editing by Lincoln Feast.)