Rural China especially vulnerable to "dark COVID winter"

Emily Feng reports for NPR this afternoon.  Here are some excerpts that illustrate the problem: 

As COVID-19 spreads largely unchecked from Beijing to Shanghai, China is bracing for a second surge, jumpstarted by millions of people who are planning holiday travel from cities back to their rural villages, where the health care system is far patchier.

"I really don't think the village doctors, or even the township or county hospital, can handle the increased number of severe cases," says Huan Wang, a researcher at the Stanford Center on China's Economy and Institutions. "I think the rural villagers are just left on their own in a dark COVID winter."

As the Lunar New Year approaches, health officials are concerned the celebrations could turn into superspreader events, catching rural systems off guard and driving up infections in a country where natural immunity is nearly non-existent and vaccine hesitancy has remained stubbornly high among the older population.

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However, the strain China's on countryside is already evident as medicine shortages hit rural pharmacies. On Chinese social media, rural residents have been asking for donations, posting pictures of ransacked pharmacy shelves devoid of fever and pain medication. Some of the medication has been diverted to cities, which were initially hardest-hit by the surge and where supplies first ran out.

"People from the cities have been coming over and buying all of our medicines, or they'll order online and have our pharmacies mail it over to them," says Li Qian, a recent college graduate, who lives in a village in China's southern Jiangsu province. She worries most about her asthmatic grandparents; the nearest hospital, she says, is two hours away.

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Last Thursday, China's national health commission said it was accelerating the expansion of fever treatment clinics – where patients can get quick medical consultations and supplies from a pharmacy — to cover 90% of rural areas to prepare them for the anticipated increase.

The audio has some information not in the transcript, so it's worth a listen.  

Postscript:  Here's a mid-January 2023 story from the Washington Post speculating about the impact Lunar New Year travel will have on the pandemic in China, again because many will travel from urban to rural areas to mark the holiday.