Chinese authorities have warned of successive waves of Covid infections over the coming months, as cases continue to surge after the lifting of restrictions earlier this month.
Across major cities people appear to be staying inside, either with the virus or in fear of contracting it, but authorities have pushed on with the reopening.
There are also mounting questions over the full impact of the current outbreak, with just three officially recorded Covid-19 deaths despite widespread reports of fatalities and busy funeral homes.
Speaking at a conference in Beijing on Saturday, Wu Zunyou, the chief epidemiologist at the Chinese Centre for Disease Control and Prevention, said the current outbreak would peak this winter and run in three waves for about three months, according to a state media report of his speech.
Wu said the first wave would run from now until mid-January. A second wave would likely follow soon after, triggered by the mass travel of hundreds of millions of people across the country for the Lunar New Year starting on 21 January.
He predicted a third wave from late February to mid-March after people returned to work from the holidays.
Residents in China are reporting countless cases of Covid around them, despite the official count being around jut 2,000 a day. Last week the national health commission conceded it was “impossible” to keep track of asymptomatic infections, and it would no longer be counting them. The removal of mass testing and reduction in mandatory tests mean few people are getting tested.
City streets appeared quiet over the weekend in Beijing and Shanghai, despite further liberalisation of restrictions, including the cancellation of 126 travel and testing measures on key industries, according to state media.
Concerns about government data have also extended to the way deaths are recorded. On Sunday, authorities reported three people had died, the first Covid deaths since 7 December.
China has narrow parameters for attributing a death to Covid, as opposed to any underlying condition the Covid patient was also suffering. It also does not release data on excess deaths, which has assisted with measuring Covid deaths in other jurisdictions with similar narrow parameters or poor record keeping.
Sunday’s report of fatalities in the single digits has jarred with some people’s experience on the ground. “If it weren’t for the fact that at noon yesterday, a family member of a friend had passed away due to infection with the coronavirus (non-elderly children), I would have believed it,” said one Sichuan resident on Weibo.
“Is the data accurate? Last week, two people next to me died suddenly because of the coronavirus fever ... I couldn’t get through to [emergency lines] 110 and 120 for half an hour, and I watched the people around me died,” said another in Beijing.
Funeral homes and crematoriums across the capital city of 22 million are also struggling to keep up with demand amid staff shortages as workers and drivers call in sick, Reuters reported.
At Beijing’s largest funeral parlour in Babaoshan, also known for handling the bodies of top Chinese officials and leaders, several hearses a minute could be seen entering on Sunday, while the parking area for private cars was also full.
“Right now it is difficult to book a hearse so many relatives transport the body with their own vehicles,” an employee told Reuters on condition of anonymity.
It was not immediately clear to what extent a rise in Covid-related deaths was responsible. Calls by the Guardian to various funeral homes were unanswered, or the employees declined to speak.
A US-based research institute said this week that the country could see an explosion of cases and over a million people in China could die of Covid in 2023.
There also continues to be concerns over the availability of medicine, with some calls for the government to set purchase limits, and the still low rates of vaccinations among the elderly.
In his Sunday address, Wu said severe cases had declined compared with past years and vaccination had offered a certain degree of protection. The vulnerable should be protected, he said, while recommending booster vaccines for the general public.
While China rolled out its first Covid vaccines in 2021, vaccination rates among people aged 60 and above have remained little changed since the summer, according to official figures. Only 66.4% of people over the age of 80 have completed a full course of vaccination, official news agency Xinhua reported.
Authorities have not made vaccination mandatory in the wake of previous public backlashes. Last week China said it would start to offer a second booster – or fourth shot – for high-risk groups and people over 60.
Overseas-developed vaccines are unavailable in mainland China, which has relied on inactivated shots by Sinopharm, Sinovac’s Coronavac and other domestically developed options. It has yet to introduce its own version of an mRNA vaccine, and questions remain over their efficacy compared with foreign-made mRNA counterparts, said Kelly Lei, a doctor in the southern Chinese city of Shenzhen.
“At least a half of doctors and educated people wanted to get the mRNA ones and refused to get the Chinese ones,” Lei said.
“After a while, people see no hope and also they are kind of forced to get the Chinese ones, so they had to accept it. Some doctors talked to me, and said it’s useless anyway, why waste the money.”
Lei said many of her friends are looking to visit the neighbouring Chinese territory of Macau, where mainlanders can receive mRNA vaccines.
Demand has surged in recent weeks, visitors to Macau say, with the online booking platform for vaccination showing no bookings available until 21 January.
On Monday Macau’s government said that it would cancel its regulations on risk zones in mainland China starting from Tuesday. It also eased test requirements on all arrivals from the mainland, asking for a negative result from within the last 72 hours, rather than 48.
Macau, which has been essentially closed off throughout the pandemic, is heavily reliant on Chinese visitors. Tourists from mainland China, Hong Kong and Taiwan, account for more than 90% of total visitation.
Reuters contributed to this report