Shanghai hospital is paying the price for China’s COVID response
BEIJING (AP) — A string of deaths at a hospital for elderly patients in Shanghai underscores the dangerous consequences of China’s dogged pursuit of a zero-COVID approach amid an escalating outbreak in the city of 26 million.
Several patients have died at Shanghai Donghai Elderly Care Hospital, relatives of patients told The Associated Press. They say their loved ones have not been properly cared for after caretakers who had been in contact with the virus were quarantined in compliance with strict pandemic regulations, exhausting staff at the hospital.
Family members have taken to social media to seek help and answers, demanding to see surveillance video from inside the facility after receiving little or no information from the hospital.
The hospital conditions and deaths are a sharp rebuke to China’s strategy of sticking to a zero-COVID policy given the outbreak in Shanghai, where most of those infected have no symptoms. With the focus on forcing positive cases and close contacts into designated collective quarantine facilities, the cost of zero-COVID may outweigh the risk of getting sick.
On Saturday, Shanghai Vice Mayor Zong Ming said lockdowns in communities not reporting positive cases within 14 days could soon be lifted or eased following another round of citywide COVID-19 testing.
Shen Peiming, 71, was one such victim of harsh measures. She died in hospital on Sunday morning without loved ones by her side. A family member said they kept calling the hospital to find out the circumstances of Shen’s death, but received no clear answer. “How many times have there been lockdowns since 2020? You still have no experience with it?” said the family member.
All they know is that their doctor and nurses weren’t there to take care of Shen, who was partially paralyzed after suffering a stroke. Her last nursing assistant was quarantined because she was a close contact of a positive case, the relative said, speaking on condition of anonymity for fear of retribution. An unidentified worker called to inform her of her death. The hospital later said it was due to a chest infection.
The hospital had had a COVID-19 outbreak, the family heard from carers, but Shen had tested negative last week.
Shanghai authorities have not reported any deaths from this outbreak, but questions have been raised about the reliability of the data. A city health official, speaking on condition of anonymity due to the sensitivity of the issue, said the criteria for confirming cases and deaths are very strict and prone to political interference.
It’s unclear how many patients died in the hospital and if any died from COVID-19. Families say they are speaking to other families whose loved ones have also died. An article by Chinese news agency Caixin detailing the deaths and infections was removed shortly after it was published and was apparently targeted by censors. Calls to Donghai Elderly Care’s main office went unanswered. The Shanghai government did not respond to a faxed request for comment.
Most experts agree that China’s zero-COVID approach was very successful in keeping deaths to a minimum when medicines or vaccines were limited. But now that syringes are widely available in China, and with the advent of the Omicron variant, many say the government should ditch politics and instead focus medical resources on the elderly and vulnerable.
Instead, Shanghai has locked down its 26 million people and repeatedly conducted mass testing to combat an outbreak caused by the highly contagious Omicron BA.2 variant. As of Saturday, the city reported more than 23,000 new local cases, with just 1,015 showing symptoms.
“If you are asymptomatic, what will hurt you?” said Ray Yip, the founding director of the US Centers for Disease Control Office in China, which has close ties with Chinese health officials. “The only people who get sick are people with diabetes, obesity, chronic diseases, old people. Protect these people. You can protect her.”
However, low vaccination coverage among older people remains a concern. According to the latest available data, only 62% of Shanghai residents over 60 have been vaccinated. Some experts support the strict approach, saying China needs to increase that rate before it can safely live with the virus.
Like the UK, US guidelines for asymptomatic cases are for people to isolate at home for five days. In Shanghai, workers are rushing to set up huge temporary facilities in exhibition halls and elsewhere to try to house everyone who has tested positive.
The citywide lockdown has disrupted daily life and the economy. Many residents trapped in their apartment buildings are scrambling to buy groceries through apps and placing bulk orders with neighbors. Some in quarantine have posted videos showing chaotic scenes of people rushing to get food and a lack of clean toilets. Others have published pleas for loved ones who are in urgent need of medication.
The US said Friday it is allowing the voluntary departure of non-essential staff and family members from its consulate in Shanghai due to the situation.
The government has trumpeted its success in containing COVID-19, touting it as proof of the superiority of China’s system of government — especially when compared to Western democracies, where the death toll has far exceeded China’s. According to experts, this narrative makes it difficult for Beijing to change tactics.
“They bragged too much to their own people about how wonderful they are, and now they’ve cornered themselves,” Yip said. “The only way to control Shanghai now is to repeat what they did in Wuhan.”
Wuhan’s 11 million residents were in lockdown for more than two months when the pandemic began in 2020.
Shanghai’s lockdown is an abrupt reversal from just a month ago, when some Chinese health experts publicly suggested relaxing measures to combat the pandemic.
Because of the city’s economic importance and advanced healthcare system, officials have been reluctant to take strict action and are confident in fighting outbreaks. Additionally, in mid-March, Chinese leader Xi Jinping ordered ongoing outbreaks in China to be controlled at “minimum cost,” stressing Beijing’s desire to protect the economy while containing the virus.
Shanghai took targeted steps, closed individual office buildings, shopping centers and districts for 48 hours, but otherwise let life go on as usual.
With the gentle measures, the number of cases in the city increased. According to a statement from southern China’s Guangxi province, the outbreak has spread to at least 71 other cities, and pressure for tougher measures is mounting.
On March 28, the city began a two-phase eight-day lockdown that has since evolved into a city-wide lockdown with no end in sight.
“We must not waste any time,” said Chinese Vice Premier Sun Chunlan during a visit to the city last weekend, according to a government statement. “We must move faster and harder to give strong support to eliminating cases in society.”
The measures quarantined nurses and doctors, causing conditions at Donghai Elderly Care to deteriorate.
Chen Jielei said the hospital outbreak infected her unvaccinated, partially paralyzed 81-year-old mother. Because employees also fell ill, her mother didn’t get her food on time and her sheets were unaltered for days. After a few days, a backup worker began to take care of her.
A college professor, who spoke on condition of anonymity for fear of retribution, said his family was not notified for more than a day after his 82-year-old father’s death on March 31. His last contact was on March 28 with a care assistant, who called to warn that there were positive cases and they could no longer care for his father.
“What happened to my father in those three days? What abuses has he suffered?” he asked. His father’s condition was stable on March 28 when he spoke to the nursing assistant.
Shen had lived in the hospital intermittently for three years after her stroke. Family members came every week. But visits were banned in early March as the COVID-19 outbreak spread in Shanghai, the relative said.
At first they were not worried because the hospital was always very accommodating and they were in touch with the nursing assistants who were taking care of Shen. But an orderly warned on March 26 that there were positive cases and many of Donghai’s staff were being quarantined.
The hospital hired temporary nursing assistants, but many had no healthcare experience, one nursing assistant said.
The woman, who gave only her last name, Zhang, said an employment agency told her it was a cleaning job.
“They said your work is just too clean, you don’t even have to wear a hazmat suit. But what they said was completely different than what I had to do,” she said.
Shen had to be tube-assisted to eat by having her food mixed into a liquid. She also had a tube down her throat that needed to be disinfected every day.
“In the past they always called me when there was a problem. This time there wasn’t even a voice message and she died so suddenly,” the relative said. Now the hospital is asking the families to sign a cremation form for the deceased. Shen’s relative said the family will refuse until they get a clear answer.
The hospital sent an apology letter to some of the families on Wednesday. The AP viewed a copy.
“Due to the emergency nature of the outbreak and the fact that many of the seniors had not been vaccinated, people with severe underlying illness and poor health died,” it said.
While Chinese government researchers have begun looking for ways to end zero-COVID, the government continues to punish officials with large outbreaks on their lawns.
“The space for discussion is now eliminated,” said Yanzhong Huang, public health expert at the US Council for Foreign Relations. “The message is loud and clear: zero COVID, no exceptions.”